PATIENTS who repeatedly use A&E are coming under the spotlight as part of an initiative to understand why they attend so frequently.

High-intensity users who attend A&E at least six times in as many months  include those with mental health problems, alcohol and substance abuse, long-term medical conditions, dementia and frailty, and medically unexplained symptoms.

It is part of a year-long pilot across eight London boroughs and seven emergency departments, including at Ealing and Northwick Park.

Harshal Goswani, who is Ealing’s case worker, said: “We have one individual who has come in more than 50 times but, when under observation, shows no signs of distress or ill health.

“We look into a patient’s medical history and socio-economic situation to see if there are any underlying patterns to their behaviour and what we can do to help.

“It involves some detective work, and I liaise with everyone from housing and social services to community and voluntary groups if we spot a trigger which may be causing frequent attendances.

“It can be something as simple as loneliness or poor living accommodation, and we work with agencies to address that.

“Sometimes, people aren’t confident enough to self-manage an existing condition. The team look at up to 25 cases a month.

Harshal added: “GPs face the same challenges but have a far more comprehensive picture of a patient’s history, in the shape of a Universal Care Plan, which we try and get hold of.

“It’s all about cause and effect. If we take a step back and find out why something is happening, we can hopefully change the outcome.”