PLUS: How much it costs the NHS in Wales for you to use it
WHEN we call an ambulance, walk into A&E or see our GP, we don’t have to worry about the costs involved thanks to the wonderful NHS, free at the point of use.
But, as a consequence, these services can often get taken for granted, resulting in people dialling 999 or turning up at emergency departments when it is simply not necessary.
So, in the depths of the busy winter period, the Welsh Government has revealed how much certain NHS services cost on average to serve as a timely reminder to people not to abuse them.
Calling 999 and getting an ambulance to the scene.
■ Cost per call and attendance in 2018-19: £267.
In November 2019, ambulance crews went to the scene of 2,892 immediately life-threatening “red” calls and 20,643 serious “amber” calls.
Therefore, if each callout costs £267, the Welsh Ambulance Service spent a colossal £6,283,845 during that month alone.
But, while these calls merited an emergency response, there were also many more calls which didn’t.
In 2018-19, the number of 999 calls classified as “green” – considered neither serious nor life-threatening – was 114,230.
Without processes in place to screen these calls and divert them to more appropriate NHS services, the Welsh Ambulance Service would have spent in excess of £30m on these patients.
The trust has recently made a fresh plea to the public to only use its services when absolutely necessary after it failed to reach its response times target for the first time in four years.
Crew members are tasked with reaching 65% of “red” calls within eight minutes.
However, just 61.4% were reached within the target time in November.
Stepping into an A&E department.
■ Cost per attendance in 2018-19: £200.
Emergency departments are notoriously busy places, particularly during the winter period when the cold weather tends to exacerbate chronic health problems.
In November 2019 there were 85,910 attendances to all Welsh A&Es – one of the highest amounts of the year. By our calculations, that would have cost the Welsh NHS an eye-watering £17,182,000.
And that’s not including any treatment the patient received after leaving the unit.
In November 74.4% of patients spent four hours or less in an emergency department before being admitted, transferred or discharged.
That is a drop on the 75.3% in October and 75.3% in September and is the worst performance since the figures were first recorded in 2009.
Health boards claim these A&E waiting-times would drastically improve if some people used more suitable services to meet their needs.
Getting an appointment with a GP.
■ Cost per attendance in 2018-19: £27.
Despite the Welsh Government admitting that this is an estimated figure – based on dividing the total cost of the General Medical Services (GMS) contract by the number of consultations – a 10-minute appointment with a GP is thought to cost just 10% of a typical A&E attendance.
However, the likes of the Royal College of General Practitioners (RCGP) claim far more investment and resources need to be ploughed into these primary care services to meet an unrelenting demand and stop people using A&E as an alternative.
Calling NHS Direct Wales.
■ Cost per call: £27
NHS Direct Wales is a health advice and information service available 24 hours a day, every day.
It can come in handy if someone is feeling unwell and isn’t sure which treatments or NHS services would be best to use.
The phone number is 0845 46 47, but if you live in Swansea, Neath Port Talbot or Bridgend, the Hywel Dda University Health Board area (Carmarthenshire only) or Ystradgynlais,
in Powys, you can access NHS Direct Wales via 111.
It’s certainly a cheaper option for the NHS than simply trying your luck in A&E.
A broken bone.
■ Cost to fix it without surgery: £272.
While we obviously can’t help sustaining a broken bone, we can help where we go to get it fixed quickly and effectively.
Simple breaks can be seen at minor injuries units across the country, avoiding the trip to A&E, which would cost an additional £200 on top of the £272 to get the leg or arm treated and in plaster.
What do the experts think about these costs?
David Bailey, chairman of the BMA’s Welsh Council, said: “These figures highlight the need to choose well this winter, and indeed, all year round.
“Patients should be mindful of these figures before they decide to head to the emergency room with minor ailments that could be dealt with elsewhere.
“Frontline staff are working harder than ever but the system is struggling to cope with the number of patients coming through the hospital door, and the entire system often becomes congested.
“Before walking into A&E this winter, ask yourself if you really need to be there. Consulting your pharmacist, making an appointment with your GP or calling NHS Direct instead could provide much-needed relief on parts of the service which are struggling.”
Director of the Welsh NHS Confederation Darren Hughes said: “The publication of these costs is a timely reminder of the vital services the NHS provides people in Wales, no matter what their circumstance.
“Now we’re in winter, it is more important than ever that everyone is aware of the range of NHS services available to them in their communities.
“There will always be people who need emergency care, but we can all do the simple things. Make sure you get your repeat prescriptions before you run out, visit your local pharmacy first for help with coughs and colds, earaches, headaches and
digestive issues.
“Across the NHS, we encourage you to look at the Choose Well website so that you and your family get the best treatment for your needs.”
What is the Welsh Government doing?
The Welsh Government’s Choose Well campaign encourages people to make the right choices for non-emergency treatment this winter.
It forms part of support for NHS Wales which also includes providing an additional £30m for health boards, the ambulance service and local authorities to help them add communitybased, hospital bed and social care capacity in preparation for the increased winter pressures.
Health Minister Vaughan Gething said: “Emergency departments and ambulance services have had their busiest year ever so far. Winter brings with it additional challenges, including cold and icy conditions, flu, increased hospital admissions for older people and more people using GP and urgent care services.
“The pressures are actively felt by our staff as well as patients and their families. It is vital that we all make sure we choose the right health services for symptoms that are not life-threatening.
“Evidence suggests around one in five people who go to their local emergency department don’t need to be there. Choosing alternatives such as the online symptom checker and telephone services of NHS Direct Wales or visiting a local pharmacist means people are able to access advice and reassurance more quickly.
“Professional health advice from a pharmacist can free up under-pressure frontline health workers in emergency departments to help the people who need them most. The majority of high street opticians can also provide advice and care for eye conditions, just look out for the NHS logo.”