Pathways to Emergency Department and Urgent Treatment Centres

Healthwatch East Sussex worked with the East Sussex Healthcare NHS Trust to understand why there had been an increase in the number of people attending A&E.  They visited both acute hospitals operated by the Trust in July/August and October/November 2024.  They spoke to 358 people in total.

Most people engaged with had used or sought to use another health service about their condition before attending the emergency department or urgent care service.  This suggests that many take reasonable steps to avoid using urgent and emergency services unnecessarily.

Whilst nearly three quarters of attendees felt they were in the right place for their medical needs, one in five felt they could have been treated elsewhere.  They had come because alternative services were closed, other services sent them there or they experienced challenges getting appointments at other services in a timely way.

People told of repeated barriers getting a GP appointment or poor experiences of NHS 111 may make people more likely to attend A&E or urgent care directly as they knew they'd be seen.

Whilst there was no evidence that services were disproportionately referring people to A&E or urgent care, the numbers attending after contact with NHS 111 and GPs is high.  Nearly one in ten had contacted GPs but not engaged with a clinician before attending A&E or urgent care.

People who choose to come to A&E or urgent care in the face of barriers to using alternatives or inappropriate referrals from other services may add to the pressures on A&E and urgent care.

Many people are unclear about the differences between A&E and urgent care.  Working to clarify the differences may further support patient understanding and help them navigate services more efficiently.  Similarly raising awareness of alternatives amongst all patients and common referrers may help reduce A&E and urgent care attendance.