Reports of data released by Healthwatch England reveal that one in five of the people surveyed admitted they had been to an A&E department when they did not need emergency care. Most of these were people seeking non-emergency healthcare when their GP surgeries were closed.
The root cause of much of this abuse of A&E departments appears to be a general and widespread lack of awareness of the alternatives available to people out of hours, including when to seek advice and treatment from minor injuries units, walk-in centres and calling 111, the NHS non-emergency helpline number. Walk-in centres and minor injuries units are both intended to treat non-serious injuries and can refer patients directly to hospital where necessary. They often have much shorter waiting times than A&E departments. The NHS 111 helpline has faced criticism in the past for staff inexperience and a formulaic approach to enquiries but is intended to provide advice on the most appropriate course of action for anyone uncertain where to go for treatment or who needs reassurance for non-life threatening injuries. Today's data come amid continuing pressure on A&E departments. Despite on-going campaigns to encourage patients not to attend A&E with minor injuries, the message does not appear to be getting through.
In response to the survey, the chair of Healthwatch England, Anna Bradley, suggested that A&E is being used as "NHS Express" but that blaming people for going to the wrong place for care and support will not solve the problem. Instead, she is of the view that things are only likely to improve if the NHS provides "a more consumer-friendly experience”.
Andrew Clayton, associate in Penningtons Manches' clinical negligence team, commented on the survey's findings: "There is clearly a need to improve out of hours services so that patients who do not need emergency care can still access advice and treatment when their GP's surgery is closed.
"These data, however, suggest that even patients who recognise that A&E is not the appropriate place for them to be treated either do not know about the alternatives or choose not to use them. We need the alternatives to A&E to be strengthened and widely promoted to improve both public confidence and public awareness.
“Fortunately, the widely predicted A&E winter crisis has not yet materialised, probably because of the ongoing mild weather. While attention may, therefore, have been diverted, the fundamental pressures and concerns in the system remain and still need to be addressed to avoid A&E departments failing under the burden of inappropriate use."