Our findings of the patient experience of accessing the Emergency Department at QA Hospital, Portsmouth Hospital University Trust (PHUT)

Healthwatch Portsmouth undertook a survey between July 2021 and September 2021, examining patients’ experiences of accessing the Emergency Department (ED) at Queen Alexandra (QA) Hospital following the introduction of the NHS 111 First system. 

The NHS 111 First initiative, introduced in December 2020, aims to ensure that patients with urgent but non-life-threatening conditions are assessed remotely and directed to the most appropriate service, with NHS 111 acting as the primary route to urgent care. 

The findings show mixed awareness of the new system. While 60% of respondents knew that access arrangements had changed, 35% were unaware that they should contact NHS 111 before attending the ED. Additionally, 39% said they would have used NHS 111 First if they had known about it. 

In terms of behaviour prior to attending ED, 55% of respondents contacted NHS 111 First, 37% contacted their GP, and 17% did not contact any service before attending hospital. 

Patient experience at the ED highlighted several inefficiencies. Over one-third of respondents (37%) were not directed to contact NHS 111 upon arrival, while 31% were. A significant majority (71%) reported having to repeat their medical issue to staff despite already going through NHS 111 triage. 

Patient satisfaction with remote assessment was limited, with 35% stating they were “not at all happy” being assessed by phone or tablet. Some patients reported delays, technical issues, and concerns about the appropriateness of remote assessment for certain conditions. 

The system did redirect some patients away from ED, with 28% referred to an Urgent Treatment Centre and 10% to their GP following NHS 111 assessment. 

Views on appointment time slots for attending ED were mixed. Around one-third (32%) felt neutral, 42% expressed positive views (happy or very happy), and 28% reported being very unhappy with the system. 

Based on these findings, Healthwatch Portsmouth made several recommendations. These include improving public awareness of NHS 111 First, increasing promotion to reduce unnecessary ED visits, ensuring better sharing of triage information between NHS 111 and hospital staff, and making the service more user-friendly. The report also suggests promoting the convenience of appointment-based attendance, as some patients were receptive to this approach.