Emergency Care: patient insights and experience summary document

Healthwatch Blackpool, Healthwatch Blackburn with Darwen, Healthwatch Cumbria and Healthwatch Lancashire spoke to 565 people about access to urgent and emergency care to support the Lancashire and South Cumbria Health and Care Partnership with winter planning, messaging and communication.

They found that people didn’t know what help NHS 111 could provide, particularly online. Multiple participants reported that a clinician did not follow up with a call within an appropriate timescale, leading to frustration and/or choosing to attend another service. 

Patients wait long times to speak to an NHS 111 telephone call handler, often then being referred onto someone else. A large number of patients shared that due to long waiting times on the phone, they gave up and went straight to an Emergency Department. The NHS 111 online service requires users to answer a long list of questions which is time consuming and frustrating.

Parents shared that they cannot use NHS 111 online for their children aged under 5, however, parents were not aware that they could use the NHS 111 telephone service.

For those whose first language is not English, the NHS 111 service was difficult to use. The NHS 111 telephone service can be difficult to understand when a translator is not available and the 111 online service does not appear to have an option to translate into other languages.

Some patients shared their experience of being told to attend at a specific time by 111 and thinking this was an appointment time, rather than a guidance time and still having to wait many hours to be seen. More clarity on this will help manage expectations.

Many patients shared that they attended an Emergency Department/Urgent Treatment Centre/ Walk-in-Centre as they could not get a GP appointment and wanted to be seen quickly. Allowing 111 to book priority GP appointments could reassure patients that they will be seen in good time and stop them from attending Emergency Departments when not necessary.

Patients frequently mentioned the difficulty of getting a GP appointment and long waiting lists and so go to an Emergency Department to be seen quicker. For those who worked fulltime, were self-employed or cared for young children, attending an Emergency Department at the weekend was the best option as they could not get a GP appointment in the week and GP’s were closed at the weekend.

Multiple patients expressed their preference towards face-to-face appointments over virtual appointments. Clarifying a person’s right to request a face-to-face appointment should also be considered.

Patients shared their frustration of long waiting times on hold to their GP to make an appointment. Alternative ways to book an appointment, such as online, could be better advertised. Alternatives to a GP appointment, for example, pharmacy advice could also be advertised wider.

A large number of patients shared that they had attended an Emergency Department/ Urgent Treatment Centre/Walk-In-Centre as they could not get a GP appointment.

The NHS website was the most preferred method of communication for all age groups, with the exception of those 65 and over who preferred TV adverts. Leaflets in health centres was a preferred method for under 18’s and 45+.

Multiple patients mentioned having to wait much longer than they were told which caused frustration. Being transparent on waiting times will help manage expectations. Numerous participants shared their experience of attending an Emergency Department and being unprepared for long waits. For example, not having money for refreshments, things to keep them occupied.

People didn’t know they could go to their pharmacy for advice. It was highlighted that multiple participants shared that they went to an Emergency Department because they knew they would need an x-ray. Further, several patients were referred to Urgent Treatment Centres/Walk-in-Centres for blood tests.

For those who chose to attend an Emergency Department due to geographical convenience, if Walk-in-Centres or Urgent Treatment Centres were closer this may help relieve pressures at Emergency Departments.

Lack of understanding and awareness of minor injuries units leads to patients going straight to Emergency Departments.