In this CLEAR Week session, leaders of a dedicated high intensity user service in East Warrington talked about the impact it has made since it started and aspirations to expand the service.

East Warrington has historically had a higher than average percentage of high intensity users (HIUs) – patients who had attended the emergency department (ED) five or more times in 12 months. An effective multidisciplinary HIU service exists in secondary care, which provides holistic and coordinated care to these patients to help manage their conditions.  The CLEAR national faculty analysed PCN data and found that 144 HIUs accounted for 14% of ED attendances and 20% of unplanned hospital admissions. It was recognised that there needed to be closer working between the secondary care HIU service and primary care to increase the support for these patients. The service is now expanding with a central hub with referrals from both the PCN and the acute trust. There are aspirations to roll it out across Cheshire and Merseyside providing more access to appropriate community-based support.

The session explored the value of a dedicated HIU service, how the CLEAR High Intensity User Project supported the expansion of the service, and the projected impact this will have on patient care and reduce unnecessary demand on primary and secondary care services.


Rob Dandy, High Intensity User Lead, Warrington Borough Council in partnership with the NHS

Jackie McClaughlin, High Intensity User Lead, Warrington Borough Council in partnership with the NHS

Claire Brewster, CLEAR Anticipatory Care Clinical Lead, former CLEAR Associate and frailty specialty nurse