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Trial will see inappropriate A&E attenders redirected to other services

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A hospital in Greater London is to trial a new system where patients attending accident and emergency “who do not need to be there” will be given advice on more appropriate services.

Redbridge Clinical Commissioning Group said it was “trying something new” as a potential way of “keeping A&E for genuine emergencies”.

“Our doctors and nurses are finding it harder to cope”

Redbridge CCG

If the trial proves successful it would potentially help hospitals across the country find a solution to the seemingly intractable problem of reducing unnecessary attendance at emergency departments.

Other trusts have attempted to reduce pressure on A&E by co-locating primary care and urgent care clinics with or nearby hospital services, but with limited success.

The CCG noted that its own research suggested one in three people attending A&E at its local hospitals “simply do not need to be there”, because they “do not have a life-threatening condition and they are not an emergency”.

The two-week trial of a “new way to focus A&E on emergencies only” will operate at Queen’s Hospital in Romford, which is part of Barking, Havering and Redbridge University Hospitals NHS Trust. It will run from Monday 11 July to Friday 22 July, between 8am and 8pm.

Explaining the need for the trial to the public, the CCG said: “Many people are no longer put off by long waits in A&E and our doctors and nurses are finding it harder to cope.”

“We need new ways of assessing and helping you to get the right care in the right place – and reduce the pressure on our busy A&Es,” stated the commissioning body.

It cautioned patients attending A&E during the trial period who it was decided “could be seen and treated elsewhere” would be given advice on where to go for help, such as primary care.

“There’s no need for anyone to worry: no-one will be ‘turned away’ until they’ve been checked over by a senior doctor and given advice on what they need to do,” said the CCG.

“Extra appointments will be available in our GP hubs during the trial to support patients redirected from Queen’s who need to see a GP urgently,” it added.

The CCG said the trial would help reveal what patients did when unable to “simply walk in to A&E and wait to be seen”.

“It will allow us to see what this means for our GPs and other health and care services. We can then make a decision about what is best for patients and what it means for health services across Barking and Dagenham, Havering and Redbridge,” it said.

The CCG highlighted that it had also carried out a major piece of market research – co-designed by our three local Healthwatch organisations – in March on the use of urgent and emergency care services.

Key findings from the study of 4,000 people found locals in Barking and Dagenham, Havering were “very aware of alternative services, but default to A&E due to confusion about choices”.

A&E was seen as a “reliable, same-day service for urgent care needs” and long waits were “not a deterrent”, the study found. However, it suggested those who given professional healthcare advice on alternative service options “will tend to follow it”.

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  • http://www.bmj.com/content/351/bmj.h6119/rr-3

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