Thousands of patients are being excluded from official health statistics because they are not being seen by hospitals or GPs, according to an intensive study of ambulance data in England.
More than a third of people who called Yorkshire Ambulance Service (YAS) last year – 288,000 out of almost 800,000 – did not go to hospital. Many of these patients had mental health problems.
Some people were treated by ambulance crews at the scene, or later saw a doctor or went to A&E. But conditions that are not often treated in hospital, such as mental health problems, substance abuse or self-harm, may be significantly under-diagnosed, according to a review by YAS and the Association of Ambulance Chiefs (AACE).
Take mental health problems for under-18s in Yorkshire and the Humber in 2022-23. NHS figures show there were 870 hospital admissions but YAS received around 3,300 calls.
Verity Bellamy, senior public health analyst at YAS, said: “This suggests we are missing almost a quarter of those young people using hospital data.”
The highest number of mental health calls came from girls and young women aged between 15 and 24 – about 13% of the 50,000 calls.
Bellamy said it might be the right thing for those young people not to be admitted to the hospital. But if we want to measure the prevalence of mental health needs in young people, we should consider using ambulance data. [as well as] hospital details.”
She led the study, which was presented at NHS ConfedExpo in June, with YAS colleague Ruth Crabtree, who is also AACE’s national lead for public health, and they plan to carry out a wider review. of England’s ambulance data.
Crabtree said it was the first time an ambulance service had analyzed its data in this way. “As a sector, we tend to measure performance and demand, as opposed to this way of looking at things,” he said.
“So it’s very interesting that Verity came in and saw something that surprised her and was very different from what we’ve seen before.”
Dr Steven Dykes, deputy medical director of YAS, said ambulances were still providing care in the area to people who did not want to go to hospital, such as the homeless, refugees and the elderly. , very few.
“One of the key things for us was that the ambulance rate for those in the poorest areas is twice that of the least privileged,” he said. There is more money than that [ambulance crews] they are really in control at home and when you see that in the data, it is very scary”.
The analysis showed that 55% of all mental health calls were from people under the age of 40, with almost a quarter for those under the age of 25. People the poorest fifth of people in society were five times more likely to call an ambulance for mental health problems.
after the news release
People in the most deprived areas also made 40% of the 72,000 calls for respiratory problems. “We understand why that might be. We have very high rates of smoking in very poor groups. We have people with a lot of industrial jobs and low-quality housing. But “We saw the same trend in young people, which we were very surprised by. That doesn’t involve smoking and it doesn’t involve long-term mortality,” said Bellamy.
Studies also reveal the impact of dental problems. YAS received more than 5,000 calls for toothaches under the age of 10, of which 64% were from the most disadvantaged group, compared to 4% from those in need.
Some of this information is found elsewhere in other news, such as a report by the Health Foundation earlier this year that showed that one in three people aged 18-24 reported common mental health problems such as anxiety or depression, rising to 41% for young women.
But Bellamy said the ambulance service could act as an “early warning system” for other parts of the health service. “We’ll probably see this before, maybe, the commissioners of mental health services,” he said. “So we’re trying to share this data with the right parts of the system, so they can design better.”
Dykes says YAS works with mental health trusts and charities to help patients access those services effectively.
“There is a big problem in moving from children’s services to adults, which is the group of patients we see here. Is it that the services are not there for them and they fall between the gaps of this age group? That is why it is important that we convert this data and return it to the system. ”
Bellamy said: “We think a lot about how we get ambulances to people quickly but really, if we start thinking from the top down, we can go into prevention. And it’s a better thing to people and to people.”
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