Hospital A&E departments are a vital piece of the NHS jigsaw, providing round-the-clock advanced care to patients with life-threatening conditions like heart attacks or major trauma.
They are there to deal with real emergencies, but often used as a walk-in centre for people with non-urgent minor ailments that could be dealt with by other local health services in Doncaster.
NHS Doncaster CCG has been reviewing the ‘unplanned care’ services we commission to see how we can improve them. These are services people need at short notice, when they feel unwell or are injured, such as minor injuries units and the GP out-of-hours service.
We’re currently developing the ideas and we’ll be talking to Doncaster people about them over the next few months, ahead of introducing them this year.
This is happening because Doncaster’s A&E service is under massive pressure. Every year over 100,000 people go to A&E at DRI, around 2,000 attendances each week. The vast majority genuinely need hospital-based care, but some people used the service inappropriately. They arrive with health conditions like eczema and sore throats that could be treated by their GP, or by buying over the counter medicines from a pharmacist.
Using A&E inappropriately delays treatment for patients who really need to access the service. I’ve been looking at new data which shows when and why people used the A&E service at Doncaster Royal Infirmary during 2014.
Where people live seems to have an impact on A&E activity. Those in the DN4 postcode area – which includes Balby, Bessacarr and Warmsworth – were the biggest users, at 16,000. The next biggest users were from DN5, including Cusworth, Scawsby and Sprotbrough, with 9,000 attendances. There were only 79 attendances from people living in the DN14 postcode area, which covers the eastern edge of Doncaster.
The day and time people attended was interesting. Sundays were the busiest days in A&E and Fridays had on average the least visits. On average, the peak time for attending was 5pm to 6pm. The quietest period was midnight to 8am.
Most people who attended were discharged to their GP for follow-up treatment but around 400 people left A&E before receiving any treatment.
Appropriate use of A&E includes cuts which won’t stop bleeding; large or deep wounds which need dressings; limb injuries which are painful or swollen and could be caused by a broken bone; serious medical problems such as chest pain, stroke, collapse or heavy blood loss.
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