Can a targeted letter and leaflet sent to households living in areas with high rates of non-urgent A&E attendance reduce A&E attendance rates in these areas?
| ISRCTN | ISRCTN84242914 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN84242914 |
| Secondary identifying numbers | N/A |
- Submission date
- 18/03/2015
- Registration date
- 21/05/2015
- Last edited
- 01/06/2018
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
Emergency (A&E) Departments have been under particular pressure this winter. We know that there are many factors causing A&E pressure. One reason is the demand on A&E from patients with minor ailments that could have been treated elsewhere. An audit by the National Audit Office reports that one in five A&E attendances could have been treated by GPs or by other professionals outside of hospitals. This study aims to test whether a letter intervention can reduce demand on A&E by patients coming with minor problems that could be treated elsewhere. We are sending a letter and leaflet to households in Medway in areas where people use A&E much more than average. These areas tend to be closer to the hospital. We will look at whether the areas that are sent the letter have lower use of A&E for minor reasons, compared to similar areas that did not get sent the letters. We will look at the effect of the letters 1, 3 and 6 months after the letters are sent.
Who can participate?
50,000 households with the highest use of A&E in Medway. These households are located in 73 target areas close to the hospital.
What does the study involve?
The target areas will be divided into two groups: the intervention group (who are sent the letter) and the control group (who are not sent the letter). We will study the effect of the intervention by comparing the intervention and control areas. People living in the target areas will not know that they are joining the study. Letters will be sent on or around 4 April. The letter includes a leaflet and map giving information on all the local health services that can help with urgent medical problems.
What are the possible benefits and risks of participating?
The benefits of participating in this study include the fact that patients who receive the intervention letter and leaflet will be better informed about the many local healthcare options available when they next have an urgent health problem. The results of the study will help improve the information and communication for patients about NHS services. We anticipate no risks to the people included in the study, either those receiving the letter (intervention group) or those who do not (control group). In the past, a range of letters that have intermittently been sent to local residents and no adverse events have resulted previously. The letter is a small part of a larger communications campaign run by the local NHS trying to reduce pressure on Medway Hospital’s A&E. An ethics panel has looked at the study design and agreed that it is not necessary for patients to give consent to this study because of this.
Where is the study run from?
Medway Foundation Trust (UK).
When is the study starting and how long is it expected to run for?
From April 2015 to April 2016.
Who is funding the study?
Department of Health (UK).
Who is the main contact?
Ms Laura Freeman
Contact information
Public
Department of Health
Richmond House
79 Whitehall
London
SW1A 2NS
United Kingdom
 ORCID ID |
0000-0001-6212-7961 |
|---|
Study information
| Study design | Single-centre interventional cluster randomised controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | Other |
| Study type | Other |
| Scientific title | Can a letter and leaflet sent to households in Medway neighbourhoods identified as having high A&E use for minor ailments reduce Category D (i.e. minor) A&E attendance rates in those areas? |
| Study acronym | Medway A&E - CCG letter |
| Study hypothesis | A letter based on behavioural insights sent to areas with high baseline A&E attendance for non-urgent reasons can reduce attendance rates for non-urgent reasons in these areas. |
| Ethics approval(s) | IRAS project ID 174817, REC number 15/WM/0119 |
| Condition | Non-urgent attendance at A&E |
| Intervention | The treatment arm will receive a targeted letter and leaflet highlighting local alternatives to A&E which can be used in non-urgent situations. The control group will receive no letter or leaflet. |
| Intervention type | Other |
| Primary outcome measure | Attendance rates at Medway Maritime Hospital from the intervention neighbourhoods compared to the control neighbourhoods. Attendance rates for minor ailments (Category D as defined in our protocol) per capita at baseline, 1, 3 and 6 months after the letter is sent. Attendance rates are routinely available from the Hospital Episode Statistics data available to DH via HSCIC. |
| Secondary outcome measures | Overall A&E attendance rates per capita at baseline, 1, 3 and 6 months after the letter is sent. This data is also available via HSCIC. Both primary and secondary outcomes will be analysed for any interaction with deprivation using postcodes as proxy. |
| Overall study start date | 04/04/2015 |
| Overall study end date | 04/04/2016 |
Eligibility
| Participant type(s) | All |
|---|---|
| Age group | All |
| Sex | Both |
| Target number of participants | 73 clusters (neighbourhoods). Total number of households will be around 52,000 |
| Participant inclusion criteria | Live in a neighbourhood with high levels of non-urgent attendance at Medway Hospital A&E based on HES statistics |
| Participant exclusion criteria | Those not living in target neighbourhoods |
| Recruitment start date | 02/03/2015 |
| Recruitment end date | 06/04/2015 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
ME7 5NY
United Kingdom
Sponsor information
Government
Richmond House
79 Whitehall
London
SW1A 2NS
United Kingdom
| Website | https://www.gov.uk/government/organisations/department-of-health |
|---|---|
"ROR" |
https://ror.org/03sbpja79 |
Funders
Funder type
Government
No information available
No information available
Results and Publications
| Intention to publish date | |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | To be confirmed at a later date |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| HRA research summary | 28/06/2023 | No | No |
Editorial Notes
01/06/2018: No publications found, verifying study status with principal investigator.
