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August 29, 2017

1. Patients who attend the Emergency Department frequently should be treated with the same care and respect as other patients.


2. Emergency Departments should have a method of identifying ‘Frequent Attenders’ to their department. This may consist of a data trawl or staff identifying patients who they think need input in the form of a care plan, liaison with specialties or case management.


3. Patients may benefit from a bespoke ED care plan. A plan may be used to give consistent care, improve analgesia, manage risk, or reduce unnecessary investigations.

4. Patients should be given the opportunity to be involved in the production of their care plans and be given a copy of the plan wherever possible.


5. Case management for Frequent Attenders may be helpful to identify unmet needs for patients and get other services involved in a patient’s ongoing care.


6. Multidisciplinary case conferences are recommended to improve engagement with community services for some patients. They are also helpful to manage risk for certain patients with risky behaviour.

August 06, 2017

The following National CQUIN has been introduced for England:


For 2017/18: 1. Reduce by 20% the number of attendances to A&E for those within a selected cohort of frequent attenders who would benefit from mental health and psychosocial interventions, and establish improved services to ensure this reduction is sustainable.


For 2018/19: 1. Sustain the reduction in year 1 of attendances to A&E for those within the selected cohort of frequent attenders who would benefit from mental health and psychosocial interventions. 2. Reduce total number of attendances to A&E by 10% for all people with primary mental health needs.

July 02, 2017

1. Emergency Departments should strive to consistently provide all 50 care standards listed.


2. These standards should be regularly audited

Section 46 relates to Care for Frequent Attenders being a FUNDAMENTAL standard

January 01, 2016

This document sets out the policy and the procedure for the identification, referral and management of frequent calling patient groups and a model to be used by CSO/Locality Management Teams.


It also includes identification criteria for vexatious callers and the mechanisms to address these. Callers identified by NHSDW or patients accessing via 0845 46 47 will be highlighted to the relevant CSO/Locality Manager

July 31, 2014

1.Emergency Department staff should have procedures for identifying patients who feign illness or injury.

2. Emergency Department staff should consider producing clear individualised management plans for those patients who feign illness / injury and who are frequent attenders.

3. The patient’s General Practitioner and liaison Psychiatry should be involved at an early stage.

4. Management plans for frequent attenders at multiple Emergency Departments should seek to limit any potential harm to patients or staff involved in their care.

5. Emergency Departments should cooperate with each other in the identification and support of frequent attenders at multiple Emergency Departments. This includes sharing relevant information, sometimes without the consent of the patient, where it is thought to be in the best interests of the patient

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