Using Accident & Emergency (A&E) departments appropriately
It is often difficult to know the best place to go when faced with different medical problems.
When you or someone in your family is unwell quite understandably you want help as soon
as possible. Sometimes it is easy to think that going to the local Accident & Emergency
department is the quickest way to obtain medical assistance.
However this is often not the case. A&E departments most definitely have their place for
serious medical problems but often there are other options which are more appropriate to
give you the care you need.
What are A&E departments?
The answer is in the question – ACCIDENT and EMERGENCY departments! They are
hospital departments specializing in this area of medicine. They are sometimes called
Casualty or Emergency Departments. People are able to attend 24 hours a day without
appointment for a number of accidents and emergencies to be seen by a variety of trained
staff. On arrival in the department patients are triaged or ‘prioritised’ depending on the
urgency of their condition.
Examples of when it is appropriate to attend A&E
It is categorically appropriate to attend A&E with any of the following conditions;
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Major injuries such as from road traffic accidents
Falls from a considerable height
Collapse
Severe breathing difficulty
Severe chest pain
Suspected stroke
Extensive burns
Severe bleeding that will not stop
Poisoning
Fits that will not stop
Please note that this list is not exhaustive and in some emergencies it may be appropriate to
dial 999 for an ambulance.
What sort of conditions is it inappropriate to attend A&E for?
People who attend A&E with non-serious conditions risk overloading the services that are
primarily intended for delivering emergency care for people who are critically ill. We should all
remember that “one day it could be us” who need that life-saving care. Some doctors believe
that people who attend hospital A&E departments are likely to be seen by junior staff, are
more likely to undergo non-essential tests and are more likely to end up being admitted to
hospital than if they are seen by experienced doctors such as GPs. The following conditions
generally do not need attendance at A&E departments although again this list is not
exhaustive);
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Flu-like illnesses, coughs, earache
Sore throats
Minor breathlessness or wheezing
Tummy pain (unless extreme or associated with collapse)
Urinary difficulties (unless completely unable to pass water)
Vaginal bleeding (unless very heavy and associated with faintness)
Rashes (unless it appears like spontaneous bleeding under the skin or the person
is very unwell)
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Backache
Diarrhoea and vomiting
Simple bites and stings
Social problems
Emergency contraception
Dental problems (except major trauma)
It is also much more expensive to attend A&E than some of the alternatives listed below. It
costs the NHS between £60-120 to attend A&E compared with around £25 to see a GP. So
attending A&E with a sore throat could cost the NHS nearly £100 more than seeing a GP.
Some people will say “I pay my taxes and it was urgent to me”, but we all have a
responsibility to make best use of limited resources. Money spent on non-essential A&E
attendance means less money to spend on other services or developing new ones which are
crucial in these times of change for the health service.
What are the alternatives to A&E?
Herefordshire has Minor Injuries Units (MIUs) at community hospitals in Ledbury, Leominster,
Kington and Ross-on-Wye. They are able to deal with cuts, grazes, wounds, sprains, strains,
minor burns and broken bones. Their waiting times are generally much shorter than at
Hereford or Worcester Accident & Emergency departments.
Ledbury MIU – Community Health and Care Centre. 01531632488. Open 24 hrs a day
except public/bank holidays.
Leominster MIU – Community Hospital. 01568614211. Open Mon-Fri 8.30am-5.30pm
except public/bank holidays.
Kington MIU – Kington Court & Social Care Centre. 01544232333. Open daily 8am-8pm
except public/bank holidays.
Ross-on-Wye MIU – Community Hospital. 01989562100. Open Mon-Fri 8.30am-5.30pm
except public/bank holidays.
Tenbury A&E – Worcester Road Tenbury. 01584810643. Open 8am-8pm.
Nunwell Surgery – we are open from 8am to 6pm and can provide treatment for most
conditions including some minor injuries. Everyday at the surgery we have appointments for
urgent cases. Outside of these hours Primecare (same number as surgery 01885483412) can
provide the same service.
Walk in centres – Hereford (ASDA 8am-8pm) and Worcester (Farrier Street 8am-8pm) have
walk in centres.
Pharmacies – most pharmacies can offer advice on simple conditions.
NHS direct – can be useful for advice on simple conditions and information such as
emergency dentist details. 08454647.