Enter and view: St Thomas Hospital A&E

Healthwatch Southwark undertook an Enter and View visit to St Thomas’ Hospital A&E Department between 2 February and 4 March 2016. They spoke to 40 patients and 12 members of staff across four visits. Overall, patients were positive about staff, describing them as friendly, helpful and professional, and many recognised the pressures staff were working under. Staff also spoke positively about teamwork, support from colleagues and the way the department operated despite ongoing refurbishment work. 

The visit found that many patients attended A&E because they could not get a GP appointment, were unsure which other service to use, or believed they would receive faster or better care in hospital. Awareness of services such as NHS 111, out-of-hours GPs and other urgent care options was limited, and staff felt patients often lacked confidence in using alternatives to A&E. Patients generally felt the department was functioning well despite building works, although some reported a lack of information about waiting times and limited access to refreshments while waiting.

Staff identified increasing numbers of attendances, pressures relating to mental health presentations and concerns that some patients were being directed to A&E by other services when primary care may have been more appropriate. They also highlighted the impact of the four-hour target, workforce pressures and the challenges created by the temporary layout during refurbishment. Healthwatch observed a generally clean, calm and well-organised environment but noted issues relating to signage, seating, visibility of water facilities and the availability of patient information.

Healthwatch Southwark recommended improving signage, seating, patient information and communication about waiting times, ensuring better access to food and refreshments, promoting alternatives to A&E more effectively, supporting people to register with GPs, improving understanding of urgent care pathways and undertaking further research into why people choose A&E over community services. The report concluded that the department was providing a good service under challenging circumstances but that improving awareness and use of alternative services would be essential to reducing pressure on A&E.