Using Accident & Emergency (A&E) departments appropriately

It is often difficult to know the best place to go when faced with different medical problems. When you or someone in your family is unwell quite understandably you want help as soon as possible. Sometimes it is easy to think that going to the local Accident & Emergency department is the quickest way to obtain medical assistance.

However this is often not the case. A&E departments most definitely have their place for serious medical problems but often there are other options which are more appropriate to give you the care you need.

What are A&E departments?

The answer is in the question – ACCIDENT and EMERGENCY departments! They are hospital departments specializing in this area of medicine. They are sometimes called Casualty or Emergency Departments. People are able to attend 24 hours a day without appointment for a number of accidents and emergencies to be seen by a variety of trained staff. On arrival in the department patients are triaged or ‘prioritised’ depending on the urgency of their condition.

Examples of when it is appropriate to attend A&E

It is categorically appropriate to attend A&E with any of the following conditions;

  • Major injuries such as from road traffic accidents
  • Falls from a considerable height
  • Collapse
  • Severe breathing difficulty
  • Severe chest pain
  • Suspected stroke
  • Extensive burns
  • Severe bleeding that will not stop
  • Poisoning
  • Fits that will not stop

Please note that this list is not exhaustive and in some emergencies it may be appropriate to dial 999 for an ambulance.

What sort of conditions is it inappropriate to attend A&E for?

People who attend A&E with non-serious conditions risk overloading the services that are primarily intended for delivering emergency care for people who are critically ill. We should all remember that “one day it could be us” who need that life-saving care. Some doctors believe that people who attend hospital A&E departments are likely to be seen by junior staff, are more likely to undergo non-essential tests and are more likely to end up being admitted to hospital than if they are seen by experienced doctors such as GPs. The following conditions generally do not need attendance at A&E departments although again this list is not exhaustive);

  • Flu-like illnesses, coughs, earache
  • Sore throats
  • Minor breathlessness or wheezing
  • Tummy pain (unless extreme or associated with collapse)
  • Urinary difficulties (unless completely unable to pass water)
  • Vaginal bleeding (unless very heavy and associated with faintness)
  • Rashes (unless it appears like spontaneous bleeding under the skin or the person is very unwell)
  • Backache
  • Diarrhoea and vomiting
  • Simple bites and stings
  • Social problems
  • Emergency contraception
  • Dental problems (except major trauma)

It is also much more expensive to attend A&E than some of the alternatives listed below. It costs the NHS between £60-120 to attend A&E compared with around £25 to see a GP. So attending A&E with a sore throat could cost the NHS nearly £100 more than seeing a GP. Some people will say “I pay my taxes and it was urgent to me”, but we all have a responsibility to make best use of limited resources. Money spent on non-essential A&E attendance means less money to spend on other services or developing new ones which are crucial in these times of change for the health service.

What are the alternatives to A&E?

Herefordshire has Minor Injuries Units (MIUs) at community hospitals in Ledbury, Leominster, Kington and Ross-on-Wye. They are able to deal with cuts, grazes, wounds, sprains, strains, minor burns and broken bones. Their waiting times are generally much shorter than at Hereford or Worcester Accident & Emergency departments.

Ledbury MIU – Community Health and Care Centre. 01531632488. Open 24 hrs a day except public/bank holidays.

Leominster MIU – CommunityHospital. 01568614211. Open Mon-Fri 8.30am-5.30pm except public/bank holidays.

Kington MIU – Kington Court & Social Care Centre. 01544232333. Open daily 8am-8pm except public/bank holidays.

Ross-on-Wye MIU – CommunityHospital. 01989562100. Open Mon-Fri 8.30am-5.30pm except public/bank holidays.

Tenbury A&E – Worcester RoadTenbury. 01584810643. Open 8am-8pm.

Nunwell Surgery – we are open from 8am to 6pm and can provide treatment for most conditions including some minor injuries. Everyday at the surgery we have appointments for urgent cases. Outside of these hours Primecare (same number as surgery 01885483412) can provide the same service.

Walk in centres – Hereford (ASDA 8am-8pm) and Worcester (Farrier Street 8am-8pm) have walk in centres.

Pharmacies – most pharmacies can offer advice on simple conditions.

NHS direct – can be useful for advice on simple conditions and information such as emergency dentist details. 08454647.