A&E feeling strain as patients misuse emergency service

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FOUR out of 10 patients are flouting advice and still turning up to A&E with problems that can be seen elsewhere, The News can reveal.

(Video shows health reporter Priya Mistry explaining the A&E situation)

Ambulances outside Queen Alexandra Hospital. ''Picture: Sarah Standing (142613-7044)

Ambulances outside Queen Alexandra Hospital. ''Picture: Sarah Standing (142613-7044)

In a week when Queen Alexandra Hospital’s A&E department saw unprecedented demand and was forced to divert patients to another hospital, figures show 41 per cent did not need to be there.

Between September 5 and September 11 2,125 people turned up at A&E – an average 303 a day.

But 880 people went with problems that could have been dealt with by GPs, walk-in centres, minor injuries units or pharmacists.

Minor ailments seen included sprain or ligament injuries, bruises, bites, stomach aches and muscle injuries.

QUEEN ALEXANDRA HOSPITAL // FILER//  (PM) MRW  22/5/2013''The Queen Alexandra Hospital - ''Picture: Malcolm Wells (131379-5322) PPP-140725-132208001

QUEEN ALEXANDRA HOSPITAL // FILER// (PM) MRW 22/5/2013''The Queen Alexandra Hospital - ''Picture: Malcolm Wells (131379-5322) PPP-140725-132208001

And 44 people who went to the A&E turned out to have ‘no abnormality detected’.

As reported, a woman was left waiting for an ambulance after being knocked over by a bike on Friday due to the service facing high demands.

Health officials say they have spent money providing information on other options for people who do not need urgent care, but these are being ignored.

Portsmouth Clinical Commissioning Group (CCG) is responsible for signposting people to the right place.

Innes Richens, chief operating officer, said: ‘We appreciate it can be confusing for people to understand which service might be best suited – and that is an area we are looking at.

‘It’s also disappointing a high number of people continue to pitch up at the emergency department when they could be helped more appropriately and faster if they pursued one of these other options.

‘What we know from engagement work, is people do understand there are other options out there – and generally they know what these are – but many still take a decision not to use them.’

As reported in The News, patients had to be diverted from QA’s emergency department on September 8 because of high demand. Up to 17 ambulances were seen queued up to get into the hospital.

This year the CCG has spent about £70,000 on marketing urgent care messages, including £30,000 for an advertising campaign across Portsmouth, Fareham and Gosport, £11,000 for bus advertising and £9,000 on an urgent care guide.

Mr Richens added: ‘We have invested a lot of public money into various ways of alleviating the pressures on A&E.

‘This includes a fair amount of marketing and publicity of other services available.

‘We have commissioned GPs to triage patients in ED (Emergency Department).

‘This helps signpost other services, advises people where they could go instead and ensure the ED is what it says on the tin – for genuine medical emergencies, and not hangovers, bad colds or wanting a second opinion.’

These thoughts are echoed by Portsmouth Hospitals NHS Trust (PHT) which runs QA.

Simon Hunter, chief of service for QA’s A&E, said: ‘The simplest thing is to self-care. You can see people came in with minor head injuries, but that can be people who got up too quickly and banged their head on a cupboard.

‘Some people would take a paracetamol if they got a headache, but others decide to come to A&E with a head injury.

‘Sometimes people want to have an X-ray, but what they may not realise is those services can be offered in Gosport War Memorial’s minor injuries unit, or St Mary’s Treatment Centre, in Portsmouth.

‘If you did need A&E treatment, then these places can fast-track you over to us.

‘I’ve known people come to us because they don’t want to wait for their doctor’s appointment, which might be later that same day.’

As reported, MPs have met with PHT, Solent NHS Trust, Southern Health NHS Trust, South Central Ambulance Service, Portsmouth City Council and Hampshire County Council, to look at improving patient flow in and out of QA.

For the past 18 months, PHT has failed to consistently meet the national benchmark of seeing, treating or discharging 95 per cent of patients within four hours.

Mr Hunter added: ‘Going to walk-in centres means they still need to see patients in the four-hour time frame QA is measured on, people need to be using the right system.

‘Otherwise we will always be at the bottom of performance tables. Of course we prioritise patients and make sure the most urgent are seen first, but many others could be getting treated more quickly by choosing the right place.’

St Mary’s Treatment Centre, in Milton Road, Milton, is run by private firm Care UK. However it still needs to meet government benchmarks and said it can take on a lot of patients that are going to QA.

Penny Daniels, hospital director at St Mary’s, said: ‘Like A&E, no appointment is necessary and our team can provide care for suspected fractures, sprains and strains, minor burns and wounds, animal and insect bites, and minor back, chest, eye, head and shoulder 

‘All patients are assessed upon arrival and anyone with a more serious condition is quickly referred to A&E.

‘Looking at the most common conditions that patients presented with at QA, many of them could have been treated at the minor injuries unit.’

Calls for patients to choose their NHS treatment well

OTHER options are available for people who need medical attention.

Portsmouth Hospitals NHS Trust, which runs Queen Alexandra Hospital, is reminding people of the alternatives to A&E.

If your injury is not serious you can get help from a Minor Injuries Unit (MIU), so staff in the emergency department can concentrate on people with serious, life-threatening conditions.

The three MIUs locally are:

- Gosport War Memorial Hospital, open every day from 8am to 9pm. Call (023) 9279 4753.

- St Mary’s Treatment Centre, Portsmouth, open Monday to Friday from 7.30am to 10pm, weekends and bank holidays 8am to 10pm. Call 0333 200 1822.

- Petersfield Community Hospital, open daily from 8am to 6pm. Call 01730 263221.

MIUs can treat injuries and illnesses such as cuts and grazes, sprains and strains, broken bones and fractures, bites and stings, infected wounds, minor head injuries and minor eye problems.

X-rays are also available.

You can also visit your local pharmacy.

Work to ease pressure on overstretched NHS

WORK needs to be done to find out why people might be ignoring other health choices, an MP has said.

Fareham MP Mark Hoban, is heading a group of MPs trying to alleviate pressure on Queen Alexandra Hospital.

Mr Hoban said he was shocked by the number of people going to A&E, instead of using other options.

He said: ‘These figures are quite shocking, and we need to find out why people are turning up at A&E, and not using other resources available.

‘Is it because they have left a problem so late that the only option is the hospital, is it because they can’t see their doctor, or is it because they do not trust other places?

‘Of course more can always be done to ensure the options available are advertised, particularly as there are so many.’

The group of MPs is made up of Penny Mordaunt, for Portsmouth North, Gosport’s Caroline Dinenage, George Hollingbery from the Meon Valley and East Hampshire’s Damian Hinds.

Ms Mordaunt said: ‘There’s still a job to be done to educate people where to go.

‘But we need to ask why people are choosing A&E, it’s not a fun place to be, so what’s causing them to go there.

‘Are patients fully aware of all the health options available to them?’

To read The News’ view on this click here.