24 Hour Survey in A&E

Healthwatch Northamptonshire undertook research on patient experiences of Accident and Emergency services at Northampton General Hospital. They spoke to 144 patients over a 24-hour period in March 2016 to understand why people attended A&E, whether they had contacted other healthcare services first and whether their attendance was clinically appropriate.

The survey found that 65% of patients had contacted a healthcare professional before attending A&E, most commonly a GP or NHS 111. Eighty per cent of those who sought advice were told to attend A&E and 89% of patients believed they were in the right place. However, clinical review of the cases found that only 52% of attendees required emergency department treatment, while 37% could have been treated within primary care. Many patients said they attended because they were unable to get a GP appointment or had been directed to A&E by healthcare professionals.

The report identified particular concerns about advice given by telephone. Patients who had spoken to a GP by phone, NHS 111 or a GP receptionist were often advised to attend A&E despite their condition potentially being suitable for treatment in primary care. The survey highlighted the significant influence healthcare professionals have on patients' decisions, with most people trusting and following the advice they received without questioning whether another service might be more appropriate.

Healthwatch Northamptonshire concluded that reducing inappropriate A&E attendances would require improvements outside the hospital setting. Recommendations included improving access to GP appointments, increasing face-to-face consultations, promoting greater use of community pharmacies, preventing GP receptionists from directing patients to A&E because of a lack of appointments, improving the accuracy of NHS 111 advice and helping the public better understand when emergency services should be used.