Greenwich health officials are examining why young children are attending emergency departments at high rates, with a particular focus on those under the age of one. The Greenwich Council Health and Wellbeing Board discussed the issue at its meeting on Tuesday, noting that a significant portion of these attendances are for non-urgent conditions such as fever, vomiting, and breathing difficulties.
According to a report presented at the meeting, emergency department (ED) attendances for Greenwich residents at Queen Elizabeth Hospital have remained relatively stable. However, the data reveals that the rate of ED visits is highest among the youngest and oldest age groups.
 attendance by age group, showing percentage and rates per 1,000 population from 2018/19 to 2024/25.
The report also highlighted health inequalities, with higher attendance rates observed among specific ethnic groups and in areas with higher levels of deprivation. The board is particularly interested in understanding potential cultural or language barriers that may influence health-seeking behaviours among Asian and other ethnic groups when it comes to emergency care for infants. Kate Anderson, Chief of Staff at Lewisham and Greenwich NHS Trust, noted that the highest rates of attendances are in the older population, and that increases from 65-74 up to 85 pluses. She also noted that the 0 to 17 rate is also high compared to the working age population. Half of those attendances are in the under 1 population.
Specifically, the Public reports pack stated:
The rate of standard/non urgent attendance by the younger age groups, particular 0-1 should be further explored to assess whether the needs of this group could be met elsewhere, particularly where vomiting or fever are being experienced. There could be a more detailed exploration of the health seeking behaviours of people from asian and other ethnic groups in the youngest age groups.
To address these issues, Jessica Arnold, Director of Primary Care and Neighbourhoods within Greenwich ICB, outlined several initiatives aimed at providing care in the community and reducing the demand on emergency services. These include:
- Improving access to general practice appointments.
- Expanding the role of pharmacies in delivering health services.
- Enhancing community response teams and virtual wards.
- Developing proactive care pathways for patients with complex long-term conditions.
Ms. Arnold also mentioned a local child health pilot in the west of the borough that has shown promising results in delivering community-based care for children, with aspirations to replicate this model in other areas through the neighbourhood health service.
The board discussed the challenges of capacity at Queen Elizabeth Hospital, with the ED regularly seeing well over 400 patients a day, despite being built for a capacity of 200. Gabi Darby, from the South East London Integrated Care Board, stated that plans are in place to increase the physical capacity of the hospital's emergency department with the construction of an additional ward. The board agreed that further analysis is needed to understand the reasons behind the high ED attendance rates among young children and to develop targeted interventions to address the issue.
The Health and Wellbeing Board plans to revisit the issue at a future meeting to review progress on referral tracking and implementation of agreed actions. The Public reports pack contains more information.
