The North Cumbria Accident and Emergency Delivery Board commissioned Healthwatch Cumbria (HWC) to design and deliver a project exploring why people were accessing the Accident & Emergency (A&E) Departments at the West Cumberland Hospital (WCH) in Whitehaven and the Cumberland Infirmary (CIC) in Carlisle. They wanted to better understand the reasons people give for ‘self-presenting’ at A&E, particularly in the evening.
A topic of much attention and interest for the public and NHS trusts, the report produced recommendations that have been fully accepted by the Accident and Emergency Delivery Board and which have started to inform change to enhance the A&E service for patients.
The research took place from 2 – 15th September 2019, covering attendance from 9am-9pm across seven days. There were 243 respondents in total, with a fairly even split of females and males. Almost everyone present in the A&E waiting rooms was interviewed, with exceptions for ambulance arrivals and those who were visibly distressed or vomiting (these numbered less than 15).
The most represented age group was 21-29 years, followed by 60-69. During the evening peak (4-8pm), this was identified as young males and older females.
- The vast majority of people at A&E were attending because of either an accident or illness, or had previously been to the hospital and were returning for further help or treatment.
- 60% of them had not attempted to see their GP first as they felt A&E was the most appropriate service for them, at that time.
- Although comments were made to the effect that they would have gone to their GP if it was more convenient to get an appointment.
- 67% of people were advised to attend A&E. Half of this group were advised to attend by medical professionals, a quarter were advised by friends, family or work colleagues.
- 75% of people did not seek help anywhere else (excluding their GP).
Based on this information, HWC made eight recommendations which include:
- Ensuring the public are aware of GP appointment availability and opening hours.
- Providing information on the availability and opening hours of alternative urgent treatment and open access centres.
- Communicating what services are available, where they
About the report and its recommendations: Anna Stabler, Director of Nursing and Quality for NHS North Cumbria Clinical Commissioning Group and Interim Chief Nurse for North Cumbria Integrated Care NHS Foundation Trust said: “We are grateful to Healthwatch for this very helpful piece of work looking at some of the peaks of attendances we were seeing in our A&E departments in Whitehaven and Carlisle. Talking to people using our services can only help us to improve how we respond to the needs of our community and support staff.
“We know our services have been very busy over the last few weeks and would urge people to choose wisely the services they need and remember NHS111 is available 24 hours to help you seek help from the most appropriate health professionals. A&E is really only for very serious emergencies.
“We are looking at the feedback from this study and are already responding to some of the suggestions including making more information available for people in A&E including the process when they are waiting.”
David Blacklock, CEO, of HWC said: “Healthwatch Cumbria was delighted to be asked to carry out this piece of work. People often talk to us about their experiences of A&E departments, both the successes and their frustrations. We hope our findings can help to shape a more effective and efficient service in the future.”
