{"id":"https://openalex.org/W7220845848","doi":"https://doi.org/10.1016/j.fhj.2026.100572","title":"How many patients attending London Emergency Departments could be managed elsewhere? A whole-system review of missed opportunities for care in more appropriate settings","display_name":"How many patients attending London Emergency Departments could be managed elsewhere? A whole-system review of missed opportunities for care in more appropriate settings","publication_year":2026,"publication_date":"2026-10-07","ids":{"openalex":"https://openalex.org/W7220845848","doi":"https://doi.org/10.1016/j.fhj.2026.100572","pmid":"https://pubmed.ncbi.nlm.nih.gov/42964637","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13720474"},"language":"en","primary_location":{"id":"doi:10.1016/j.fhj.2026.100572","doi":"https://doi.org/10.1016/j.fhj.2026.100572","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.fhj.2026.100572","pdf_url":"https://www.sciencedirect.com/science/article/pii/S2514664526000743/pdf","source":{"id":"https://openalex.org/S4210167701","display_name":"Future Healthcare Journal","issn_l":"2514-6645","issn":["2514-6645","2514-6653"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1"],"host_organization":"https://openalex.org/P4310311682","host_organization_name":"Royal College of Physicians","host_organization_lineage":["https://openalex.org/P4310311682"],"host_organization_lineage_names":["Royal College of Physicians"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Future Healthcare Journal","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.sciencedirect.com/science/article/pii/S2514664526000743/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5157836498","display_name":"Catherine Wilson","orcid":"https://orcid.org/0009-0008-3001-1022","observed_orcids":["https://orcid.org/0009-0008-3001-1022"]},"institutions":[{"id":"https://openalex.org/I125671874","display_name":"National Health Service","ror":"https://ror.org/02wnqcb97","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I125671874","https://openalex.org/I1311074006"]},{"id":"https://openalex.org/I4400009038","display_name":"NHS England","ror":"https://ror.org/00xm3h672","country_code":"GB","type":"funder","lineage":["https://openalex.org/I4400009038"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Catherine Wilson","raw_affiliation_strings":["NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom"],"raw_orcid":"https://orcid.org/0009-0008-3001-1022","affiliations":[{"raw_affiliation_string":"NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom","institution_ids":["https://openalex.org/I125671874","https://openalex.org/I4400009038"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5024138126","display_name":"Sanjeet Johal","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I125671874","display_name":"National Health Service","ror":"https://ror.org/02wnqcb97","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I125671874","https://openalex.org/I1311074006"]},{"id":"https://openalex.org/I4400009038","display_name":"NHS England","ror":"https://ror.org/00xm3h672","country_code":"GB","type":"funder","lineage":["https://openalex.org/I4400009038"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Sanjeet Johal","raw_affiliation_strings":["NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom","institution_ids":["https://openalex.org/I125671874","https://openalex.org/I4400009038"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5065784852","display_name":"Gary Davies","orcid":"https://orcid.org/0000-0001-9945-4616","observed_orcids":["https://orcid.org/0000-0001-9945-4616"]},"institutions":[{"id":"https://openalex.org/I125671874","display_name":"National Health Service","ror":"https://ror.org/02wnqcb97","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I125671874","https://openalex.org/I1311074006"]},{"id":"https://openalex.org/I4400009038","display_name":"NHS England","ror":"https://ror.org/00xm3h672","country_code":"GB","type":"funder","lineage":["https://openalex.org/I4400009038"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Gary Davies","raw_affiliation_strings":["NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom"],"raw_orcid":"https://orcid.org/0000-0001-9945-4616","affiliations":[{"raw_affiliation_string":"NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom","institution_ids":["https://openalex.org/I125671874","https://openalex.org/I4400009038"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5080914775","display_name":"Susan M. Robinson","orcid":"https://orcid.org/0000-0002-1796-6739","observed_orcids":["https://orcid.org/0000-0002-1796-6739"]},"institutions":[{"id":"https://openalex.org/I125671874","display_name":"National Health Service","ror":"https://ror.org/02wnqcb97","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I125671874","https://openalex.org/I1311074006"]},{"id":"https://openalex.org/I4400009038","display_name":"NHS England","ror":"https://ror.org/00xm3h672","country_code":"GB","type":"funder","lineage":["https://openalex.org/I4400009038"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Susan M. Robinson","raw_affiliation_strings":["NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom","institution_ids":["https://openalex.org/I125671874","https://openalex.org/I4400009038"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5157836498"],"corresponding_institution_ids":["https://openalex.org/I125671874","https://openalex.org/I4400009038"],"apc_list":{"value":2000,"currency":"USD","value_usd":2000},"apc_paid":{"value":2000,"currency":"USD","value_usd":2000},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.78262893,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"13","issue":"4","first_page":"100572","last_page":"100572"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11467","display_name":"Trauma and Emergency Care Studies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11773","display_name":"Healthcare Operations and Scheduling Optimization","score":0.0,"subfield":{"id":"https://openalex.org/subfields/1803","display_name":"Management Science and Operations Research"},"field":{"id":"https://openalex.org/fields/18","display_name":"Decision Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/emergency-department-crowding","display_name":"emergency department overcrowding","score":0.9210000038146973},{"id":"https://openalex.org/keywords/missed-opportunities-for-care","display_name":"missed opportunities for care","score":0.902999997138977},{"id":"https://openalex.org/keywords/alternative-care-settings","display_name":"alternative care settings","score":0.6290000081062317},{"id":"https://openalex.org/keywords/system-design","display_name":"system design","score":0.5400000214576721},{"id":"https://openalex.org/keywords/health-care-access","display_name":"health care access","score":0.7519999742507935}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7213000059127808},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.6776999831199646},{"id":"https://openalex.org/C3020052602","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Accident and emergency","level":2,"score":0.5565000176429749},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.5404999852180481},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.5178999900817871},{"id":"https://openalex.org/C18762648","wikidata":"https://www.wikidata.org/wiki/Q42213","display_name":"Work (physics)","level":2,"score":0.40880000591278076},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.36629998683929443},{"id":"https://openalex.org/C545288138","wikidata":"https://www.wikidata.org/wiki/Q860447","display_name":"Emergency medical services","level":2,"score":0.3522999882698059},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.33889999985694885},{"id":"https://openalex.org/C2994511739","wikidata":"https://www.wikidata.org/wiki/Q336641","display_name":"Emergency physician","level":3,"score":0.3244999945163727},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.31520000100135803},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.2766999900341034},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2741999924182892},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.26899999380111694},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.2669999897480011},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.2653999924659729},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.26159998774528503},{"id":"https://openalex.org/C157660682","wikidata":"https://www.wikidata.org/wiki/Q419793","display_name":"Accommodation","level":2,"score":0.250900000333786}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1016/j.fhj.2026.100572","doi":"https://doi.org/10.1016/j.fhj.2026.100572","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.fhj.2026.100572","pdf_url":"https://www.sciencedirect.com/science/article/pii/S2514664526000743/pdf","source":{"id":"https://openalex.org/S4210167701","display_name":"Future Healthcare Journal","issn_l":"2514-6645","issn":["2514-6645","2514-6653"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1"],"host_organization":"https://openalex.org/P4310311682","host_organization_name":"Royal College of Physicians","host_organization_lineage":["https://openalex.org/P4310311682"],"host_organization_lineage_names":["Royal College of Physicians"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Future Healthcare Journal","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13720474","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13720474/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13720474/pdf/main.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Future Healthc J","raw_type":"Text"},{"id":"pmid:42964637","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42964637","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Future healthcare journal","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:c7ab5e999ac84380a48e92dd548a007b","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/c7ab5e999ac84380a48e92dd548a007b","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Future Healthcare Journal, Vol 13, Iss 4, Pp 100572- (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1016/j.fhj.2026.100572","doi":"https://doi.org/10.1016/j.fhj.2026.100572","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.fhj.2026.100572","pdf_url":"https://www.sciencedirect.com/science/article/pii/S2514664526000743/pdf","source":{"id":"https://openalex.org/S4210167701","display_name":"Future Healthcare Journal","issn_l":"2514-6645","issn":["2514-6645","2514-6653"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1"],"host_organization":"https://openalex.org/P4310311682","host_organization_name":"Royal College of Physicians","host_organization_lineage":["https://openalex.org/P4310311682"],"host_organization_lineage_names":["Royal College of Physicians"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Future Healthcare Journal","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9537000060081482,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220845848.pdf","grobid_xml":"https://content.openalex.org/works/W7220845848.grobid-xml"},"referenced_works_count":3,"referenced_works":["https://openalex.org/W2042549448","https://openalex.org/W2110342300","https://openalex.org/W4205611220"],"related_works":["https://openalex.org/W4411011234","https://openalex.org/W1990174394","https://openalex.org/W4234719738","https://openalex.org/W2922212955","https://openalex.org/W2047501060","https://openalex.org/W1825707112","https://openalex.org/W2765375953","https://openalex.org/W7163922065","https://openalex.org/W2006622260","https://openalex.org/W4410036318"],"abstract_inverted_index":{"ABSTRACT":[0],"Emergency":[1,56],"Departments":[2],"(EDs)":[3],"in":[4,36],"England":[5],"experience":[6],"sustained":[7],"crowding,":[8],"affecting":[9],"patient":[10,68],"and":[11,15,39,49,55,79,98,106,115,121],"staff":[12],"experience,":[13],"safety":[14],"system":[16,46],"flow.":[17],"This":[18],"programme":[19],"of":[20,104,123,149],"work":[21],"aimed":[22],"to":[23,40],"identify":[24],"opportunities":[25],"where":[26],"patients":[27,108,124],"attending":[28],"London":[29,53,72],"EDs":[30,75],"could":[31],"have":[32],"been":[33],"managed":[34],"safely":[35],"alternative":[37,117],"settings,":[38],"explore":[41],"what":[42],"this":[43],"reveals":[44],"about":[45],"design,":[47],"access":[48],"behaviour":[50],"within":[51],"the":[52,102,147],"Urgent":[54],"Care":[57],"(UEC)":[58],"system.":[59],"A":[60,82],"cross-sectional":[61],"retrospective":[62],"observational":[63],"study":[64],"reviewed":[65],"over":[66],"2,000":[67],"attendances":[69],"across":[70],"27":[71],"Type":[73],"1":[74,84,109],"between":[76],"October":[77,80],"2021":[78],"2023.":[81],"type":[83],"ED":[85],"is":[86],"defined":[87],"as":[88],"a":[89],"consultant":[90],"led":[91],"24-hour":[92],"service":[93],"with":[94],"full":[95],"resuscitation":[96],"facilities":[97],"designated":[99],"accommodation":[100],"for":[101,128],"reception":[103],"accident":[105],"emergency":[107],".":[110],"Multidisciplinary":[111],"panels":[112],"assessed":[113],"appropriateness":[114],"potential":[116],"pathways.":[118],"Between":[119],"66%":[120],"81%":[122],"were":[125,134],"judged":[126],"suitable":[127],"non-ED":[129],"care,":[130],"yet":[131],"only":[132],"29%":[133],"redirected":[135],"or":[136],"streamed":[137],"away.":[138],"These":[139],"findings":[140],"largely":[141],"reflected":[142],"whole-system":[143],"factors":[144],"rather":[145],"than":[146],"performance":[148],"individual":[150],"organisations.":[151]},"counts_by_year":[],"updated_date":"2026-11-03T10:50:19.383937","created_date":"2026-10-08T00:00:00"}