Derby Hospitals Foundation Trust will seek to cut its number of emergency admissions to help it save £24.6m

The trust has seen demand for emergency services increase by an average of five more patients for every day of the year, and has reported record A&E attendances in March.

More than 400 people attended the hospital’s A&E. This corresponded with the trust failing to meet the four-hour A&E waiting time target.

This has now sparked talks with FT regulator Monitor and work on a recovery plan for the department.

To alleviate pressure on services and to help it save money Derby has embarked on an ambitious plan to cut emergency admissions, particularly among frail older people.

The trust is working with local GPs and nurses in the community to find new ways of caring for patients to prevent admissions to hospital.

It has now started a rapid access process to its clinical decisions unit and improved the way GPs and A&E doctors work together.

In its surgical assessment unit a pilot project saw consultants on call to take telephone queries from GPs about patients to discuss the way forward and where appropriate prevent admission.

The hospital, which saved £12.2m last year, is also looking to cut the number of unnecessary follow-up appointments and increase the amount of day surgery to cut inpatient numbers.

Chief executive Sue James said: “Although, of course, many emergency admissions are unforeseeable, and unavoidable, there are a significant number, particularly for frail older people where we feel that careful management and support of the patient in their home could prevent the need to bring them into hospital as an emergency admission. This would be much better for patients, and save the NHS money - a good result all round.”

She added: “We know the aging population, and increasing numbers of patients with long-term conditions, mean the challenge of reducing emergency activity is growing bigger each year. This will be the main focus of our work over the coming 12 months.”