Majority believe patients calling ambulances and using A&E unnecessarily

By Jemma Crew, Health and Science Correspondent14th August 2019News EnglandAccident and Emergency, Hospitals, News England, NHS, Primary Care / GP's

More than eight in 10 people believe patients are calling ambulances and using A&E services unnecessarily, a survey suggests.

Some 86% of people think A&E services and 999 ambulances are overused but half (51%) say they find it hard to secure an appointment with their family doctor.

Those saying they experience difficulties with GP appointments include 65% of parents with a child under five in the household and 61% of those who have visited A&E three or more times in the previous 12 months.

The study on attitudes towards emergency care, from the National Centre for Social Research, also found that patients living in deprived areas find it harder to see their GP and make higher use of emergency services than expected.

There are also potential differences across urban and rural populations due to the availability of A&E transport and attitudes to using services, with health professionals believing that urban populations have higher expectations of instant access.

The questions relating to health care were asked of 2,906 respondents to the British social attitudes (BSA) survey and commissioned by the University of Sheffield.

Around one in ten (11%) of those surveyed in Britain said they did not have much confidence in GPs at their surgeries.

Existing research has found that reasons for increasing emergency services demand include poor access to, and low confidence in, primary care, the need for reassurance, convenience, not having to make appointments, perceived need for hospital care and a lack of awareness of alternative services.

The BSA report said: “For some, the perception or experience of their local GP surgery may be acting as a ‘push factor’ towards A&E over and above their personal or area-based circumstances.

“Our analysis cannot confirm the direction of this relationship, nor shed light on the way in which attitudes may influence decisions about which source of healthcare provision people choose.

“However, other related research as part of this wider research project is investigating these research questions.

“At the overall level, the most striking finding is that as many as half the population perceive access to GP appointments to be difficult, suggesting that this issue is widespread.”

Almost a third (32%) of those surveyed and more than half of parents with a child under five (54%) said they had visited A&E in the last 12 months.

A total of 17% of respondents said they prefer A&E departments to GPs because they can get tests done quickly.

A recent study using routine data in England showed that 15% of A&E use was classified as “non-urgent” – suggesting people could have been treated at an alternative service such as general practice.

Professor Helen Stokes-Lampard, chairwoman of the Royal College of General Practitioners, said: “We understand our patients’ frustrations when they cannot secure a GP appointment when they need one and GPs and our teams share their concerns.

“However, patients should only ever go to A&E in an emergency – if they need to see a GP urgently, they should always be able to go through our routine service, urgent treatment centres and the GP out-of-hours service. We are working incredibly hard to ensure this happens and this is reflected in the most recent NHS figures.

“What this research highlights is that more public education is needed so that patients know where to turn when they become ill – and it gives useful insight into where this could be directed for the best possible impact.”

Ruth Thorlby, assistant director of policy at the Health Foundation, said: “While fixing primary care is an urgent priority, this alone won’t solve the problems facing A&E services.

“We need to see broader solutions that ultimately impact on the number of people in need of hospital care.

“This includes urgently finding a solution to the social care crisis and investing in services that prevent ill health in the first place.”

Nigel Edwards, chief executive of the Nuffield Trust, said: “It’s easy to see why the public are worried about the mounting pressure on the NHS, given that last month we saw the highest number of people on record coming to A&E.

“The NHS has actually built lots of minor emergency departments specifically for less urgent complaints, so it is entirely logical that more people are showing up.

“However, they seem to be used on top of major A&E departments and so haven’t taken the pressure off in the way that was hoped. But we also know that hospital beds are often at capacity, suggesting that the number of really ill people has significantly increased over a number of years.”

An NHS spokesman said: “There are genuine pressures on GP services, but it has never been easier to access the right urgent care in the right place, with the free, 24/7 NHS 111 phone and online service able to advise on and arrange the best and most appropriate option for you, your child or other family members – whether that’s seeing a pharmacist, a GP or urgent treatment centre.

“In the last seven years local NHS 111 services have taken 80 million calls and saved 12 million unnecessary trips to A&E, and as further improvements are made as part of the NHS Long Term Plan people will be able to access an even wider range of services and expertise, freeing up GPs and A&E staff to focus on those people who need them the most.”