The National Audit Office published a report on 31 October, on managing the demand for emergency admissions to hospital. It scarcely needs saying that this is a hot topic and likely to be the product of numerous headlines this winter. The report usefully pulls together the main themes on this issue - the various causes of the surge in emergency admissions - and discussed ways in which demand can be managed (which I suppose is a pleasant euphemism for reduced or at least relocated). It fairly concedes that: there is limited evidence on what works in reducing avoidable emergency admissions but sets out a number of recommendations for seeking to achieve this. Perhaps surprisingly only one of the recommendations is aimed at CCGs: the focus appears to be on the DH Monitor and NHS England. The one recommendation that applies to CCGs is this: Many local initiatives are underway that aim to reduce admissions and improve the discharge process including through better integration and joint working. CCGs need to assess which of these initiatives are working and NHS England needs to ensure that successful initiatives are promoted more widely. CCG representatives on Urgent Care Boards should ensure that they are familiar with this report and that local commissioners continue to play a lead role in addressing this issue with their local providers. The link to the NAO report is here.