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Should I Go to A&E?

Over the last few years there has been a dramatic increase in people visiting Accident & Emergency Departments (A&E), with over 21 million attendances every year. Concerns have been raised that some people attend with injuries or illnesses which are not urgent instead of going to see their GP.

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Health secretary Jeremy Hunt recently admitted that he has taken his children to A&E at the weekend because he didn’t want to wait to see a GP. He claimed ‘people do not know whether the care they need is urgent or whether it is an emergency’. It has been consequently suggested that if people had less difficulty seeing their GP this would ease the pressure on A&E departments.

Difficulties in Seeing GPs

At the moment, many people have difficulty arranging appointments to see their GP. The Care Quality Commission, after inspecting over 350 surgeries between April and September 2014, recently reported that one in six surgeries have problems booking appointments.

Recent research has also supported the idea that the inaccessibility of GP surgeries leads to higher A&E attendances. This research was funded by the National Institute for Health Research and estimated that for the financial year 2012-2013, 5.77 million A&E attendances occurred after patients were unable to get a timely GP appointment. This amounts to 26.5% of unplanned A&E attendances during this time. However, it should be noted that some or all of these patients may have been admitted to A&E, even if they had seen their GP, due to their ailment or injuries.

Dr Maureen Baker, chairwoman of the Royal College of General Practitioners has commented that the vast majority of practices are doing an excellent job, but points to the increasing pressure on GPs. It is estimated the annual number of GP consultations have increased by 40 million over the past five years. There is also a shortage of GPs in many parts of the country.

In addition, the British Medical Association has warned that patients are often waiting one to two weeks for an appointment. It is somewhat understandable then that faced with waiting for that length of time, some patients would prefer to go to A&E. However, many practices are able to facilitate urgent appointments and there are alternative out-of-hours services such as walk-in-centres.

Changes are being proposed to help ensure GPs run a more flexible service. More than one in eight practices in England have signed up to an initiative to extend opening hours and to incorporate technologies such as Skype and e-mail. Such improvements may well reduce pressure on A&E departments and help patients to efficiently access health services during the weekends and out-of-hours.

What Should I do if I am Sick?

If the situation is not an immediate emergency, the NHS advises you to call NHS 111 or to attend a minor injuries unit or walk-in-centre. There are walk-in-centres at Leominster Community Hospital, Ross on Wye Community Hospital, the Shropshire Walk in Health Centre in Shrewsbury and at Malling Health Wrekin. At a walk-in-centre you can see an experienced nurse or doctor (although not all centres have a doctor), without an appointment who can offer advice and treatment for minor illnesses and injuries.

If the illness is not life-threatening, you should contact your GP. An out-of-hours service should be available from 6:30pm to 8am weekdays and all day on weekends and Bank holidays.

If you are suffering from a loss of consciousness, an acute confused state; persistent fits, persistent severe chest pain, breathing difficulties or severe bleeding that cannot be stopped, then the NHS recommend you call 999 or attend your local A&E department. There are A&E departments at the Princess Royal Hospital in Telford, The Royal Shrewsbury Hospital and the County Hospital in Hereford.