How Can Community Teams Reduce Hospital Admissions?

Unplanned hospital admissions are costly and infrastructure-intensive. They require extra time from already stretched teams and funding from an already tight NHS budget, as well as resulting in long patient waits in ambulances and in corridors.

Despite the fact that there are now 24% more hospital doctors compared to five years ago and 22% more nurses, hospitals are still feeling the pinch from increased demand and emergency hospital admissions.

According to NHS England, there were 27.4 million emergency admissions in 2024-25, which was a 4% increase on the previous year and a 27.4% increase on 2011-12. According to the NHS’ aggregated Monthly Situational Reports into A&E in England in 2024-25, major A&E unit admissions increased 1.74% compared to 2023-24 and minor injuries and walk-in admissions increased by 8.09% compared to the previous year.

Between February 2026 and April 2026 alone, 76,400 people visited either a major or minor A&E unit every single day. On top of that, ‘trolley waits’ - where patients experience long delays for emergency hospital admissions - have dramatically increased in the past 10 years. According to a report published by the House of Commons Library:

“In April 2026, around 170,400 patients waited for longer than 4 hours for admission, compared with around 38,800 in April 2016 (an increase of 339%). This is measured from the time that a decision to admit is made, which is not necessarily when a patient arrived at A&E or hospital. This means that, for many patients, this measure is an underestimate of their total wait in hospital before admission.”

It’s clear that there’s more demand on the NHS than ever before. That’s due to people living longer and with more complex needs which suggests that unless the NHS is able to reform the way that care is delivered, these issues will only continue.

Avoidable hospital admissions are those where Accident & Emergency is not the best place for patients to be treated. It could be that someone would receive more appropriate care in an alternative, non-emergency setting. It could also be that these admissions could have been prevented as a result of care being administered earlier on.

It’s thought that up to 15% of emergency admissions within some NHS trusts are avoidable. This means that doctors and nurses are spending time on cases that could be treated elsewhere and potentially creating a higher risk for people suffering with more serious conditions.

This is where community teams can help. They offer rapid medical support which can often be specialised and treat people within the comfort of their own homes. Not only is this better for care teams in hospitals but it’s also better for the patient. Community teams provide more personalised and convenient care.

A pioneering nurse-led model of care trialled in the Netherlands is already proving to have a positive effect.

Buurtzorg, which has now been rolled out across 24 countries, has been able to increase patient satisfaction in the communities it operates in, as well as reducing healthcare costs by 40%. It empowers nurses to deliver care, contributing to a 50% reduction in hours of care given. Despite that, patients feel happier with their treatment and organisations are finding it a cost-effective solution with a positive knock-on effect for the wider healthcare system.

It provides integrated home care which is reducing unplanned hospital admissions by:

• Speeding up medical intervention thanks to smaller teams who develop strong relationships with their community
• Better continuity of care
• Experienced staff who are in favour of at-home care
• Making hospital admission less necessary in the first place

Learning from Buurtzorg’s model, the effect of multidisciplinary community teams on the NHS could allow early warning signs to be picked up before they turn into something more serious, as well as providing rapid response when they do. It would help to provide coordinated care across teams, meaning that long-term health conditions can be better managed and monitored, plus prevent people from returning to hospital after their initial treatment.

In 2024, the NHS revealed that it planned to rely more heavily on the presence of virtual wards to reduce avoidable hospital admissions. It means that patients referred to virtual wards would receive care from their homes and allow hospital beds to remain free for the sickest of patients.

This will, in part, support the NHS’ ambitions to reduce unplanned emergency A&E admissions. However, ensuring admissions reduce further requires additional digital infrastructure that works for multidisciplinary teams (MDTs). MDTs are important enablers of holistic healthcare in that they combine experts from a broad range of specialisms. Their strength is in their breadth but also in their depth of knowledge, being able to treat a range of symptoms and conditions without the need to visit a hospital.

For MDTs to work their best, they need the right tools to support their care. Since they’re rarely in the same place at the same time, technology can enable them in their jobs. Multidisciplinary teams need to speak to each other when out in the community, so they need systems to manage and coordinate care plans across multiple organisations, plus keep track of patient records, in real time. This ensures that teams are aligned and can deliver efficient care at home.

Social prescribing tools, like Access Elemental, give patients the ability to use services that improve their health and wellbeing within their community. Where care is non-urgent or can be supported by a different organisation, Elemental acts as a platform to surface available services, such as community groups and advice hubs.

Data is served in real-time delivering interconnected care and preventing record duplication. It can also save up to 2 hours per day on core admin tasks, giving time back to teams to do what they do best.

A more preventative approach to care in the NHS is the way forward to solve for reduced hospital admissions and to deliver more personalised care across the country. Digital infrastructure means that when MDTs are deployed into the community, their work is more efficient because they are able to communicate across teams, update records, share results and develop an individualised pathway for patient care.