The Patient Experience Library: Patient experience in urgent and emergency care (August 2022)

Summary

This report by The Patient Experience Library looks at patient experience in urgent and emergency care (UEC), reviewing four years' worth of studies from sources including government bodies, policy think tanks, academic institutions and the local Healthwatch network.

Content

Key findings

• Awareness of the range of UEC options is generally good but patients and the public are sometimes confused about the difference between A&E and walk-in centres, minor injuries units and urgent treatment centres. Confusion is compounded by the patchy availability of some of these, in terms of both locations and opening times.
• A key driver of attendance at A&E is the difficulty of getting appointments or advice from GPs and NHS 111. Another is that people are not getting the support they need in the community - for example to manage long term conditions. Some of those going to A&E are clear that they would have preferred a GP appointment.
• Some evidence suggests that referrals to UEC might not always be appropriate. Between 2019 and 2021, GP referrals in general increased significantly (179%), but avoidable attendances from GP referrals more than doubled (255%). Care homes might be taking an overly cautious approach - 41% of care home referrals may be avoidable. NHS 111 might also be over-cautious.
• Patients enduring long waits in A&E seem less concerned about adherence to the four hour target (if they are even aware of it) than about unpleasant experiences in waiting areas - some with possible clinical or patient safety risks. Some discomfort could be mitigated by better communication - for example regular updates on anticipated waiting times.