Health ‘Don’t visit A&E if you’re not at risk of dying’
ALOCAL NHS campaign to stop people going to A&E unless they are at risk of dying could dramatically cut waiting times, ambulance queues and violence against staff, say health chiefs.
The pioneering initiative, launched in Bristol, North Somerset and South Gloucestershire (BNSSG) last September encouraging patients with urgent but not life-threatening conditions to instead ring 111 to speak to a new team of medics, is being ramped up, councillors heard.
Programme director Jenny Theed told Bristol City Council’s health scrutiny committee that reducing unnecessary visits to the BRI, Southmead and Weston General Hospital emergency departments (EDs) would free up staff to save lives.
She said: “We are hoping there will be less pressure in ED waiting rooms.
“If you go to ED and it’s not lifethreatening, you can be waiting many hours to be seen.
“We are encouraging people that if you ring 111, there may be a slight delay in speaking to someone but it will be a lot quicker than going to an ED.
“Very sadly we had a really big increase in violence and aggression in EDs and urgent care services and we are hoping if people realise they won’t be subjected to very long waits by working with us and going on this new approach, that might reduce frustrations and lead to a more speedy response to ambulances that turn up at ED.”
Ms Theed said a survey last summer ahead of the trial found 43 per cent of patients at an ED, minor injury unit or urgent care centre in the area had tried but failed to get treatment elsewhere, but 38 per cent had arrived there as their “default position” without seeking alternatives.
Once the new system was under way, less than 15 per cent of 111 callers needed to go to ED and more than 80 per cent were directed to another service.
People calling the number are put through to a new clinical assessment service with a wide range of doctors, nurses, mental health practitioners and emergency consultants working together in Bristol, who then direct them to the right service.
Ms Theed said: “If it is obvious that they need to go to ED then they are advised to go straight away.
“GPs keep open same-day slots for referrals from this service.”
“For the person, the response is urgent and needs to be the same day, so you can see why people are using ED inappropriately.”
She said patients could also be referred for a consultation with a community pharmacist, who was authorised to write and issue prescriptions.
Southmead ward Labour Cllr Brenda Massey told the meeting on Monday: “I like the idea of the community pharmacists. In South Bristol that has been working very well.
“It doesn’t seem to be quite the same in north Bristol where some of our pharmacists are overwhelmed.
“I had to make three visits and wait two weeks for an absolutely standard repeat prescription. I don’t know why there is a divide across the city.” Ms Theed said the programme was still building and the aim was to double the existing 2,000 monthly pharmacist appointments in BNSSG over the next six to eight weeks by expanding the scheme.
She said: “Between October and December, students accounted for 20 per cent of the people who walked into an ED.”
Ms Theed said universities surprisingly relied on freshers’ week to ask students to register with a doctor’s surgery, by which point they were already here, but that they had now agreed to send out information packs including the request before they arrived in Bristol.
She said a lot of others attending EDs were parents with children and that Bristol Children’s Hospital was running a pilot where youngsters were treated but then a health visitor would explain more appropriate services if the condition was classed as minor.
Committee chairman Stockwood ward Conservative Cllr Graham Morris said: “It’s about changing mindsets and behaviours. That’s not going to be an easy job.”
He said it was really important not just to ask for change but to explain why it was needed – to reduce waiting times, ambulance queues and aggression against staff.
❝ We are hoping if people realise they won’t be subjected to very long waits... that might reduce frustrations Jenny Theed