My View, Dr Nick Tupper - The pressure on hospital A&E

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You may have heard the term ‘unplanned care’ used by NHS staff and wondered what it meant. Quite simply, it refers to services available if you need health care at short notice and includes for example, the 8am to 8pm health centre, minor injuries units and A&E.

One of our key roles as a clinical commissioning group is to arrange local services and we’re currently reviewing the borough’s unplanned care services to see what changes need to be made to bring about improvements for patients. We’re currently working up some ideas which I’ll be able to share with you in the future as they start to get firmed up.

This is happening because A&E services are under massive pressure. They are designed to deal with serious and life-threatening conditions and the specialist skills of the staff working there reflect that.

Every year over 110,000 Doncaster patients visit A&E – more than 2,000 a week. The vast majority genuinely need hospital care, but unfortunately some think A&E stands for ‘anything and everything’. They arrive with conditions that could easily be treated by their GP, or by buying over-the-counter medicines from a pharmacist. It leads to long delays which affect the patients who are really ill and waiting to be seen.

Examples of inappropriate use of A&E:

• Coughs and colds – just stay at home or see your pharmacist

• Old injuries or joint problems – are best seen by your GP, at least initially

• Medication questions – best dealt with by your GP

• Toothache – you need to see a dentist or the emergency dental service. Ring 101 for details

• Trying to use A&E to get a second opinion rather than using the GP service

Examples of appropriate use of A&E:

• Cuts which won’t stop bleeding or may need stitches to heal properly

• Burns which are large, or deep, and need dressings

• Limb injuries which are painful or swollen and could be cause by a broken bone

• Serious medical problems such as chest pain, collapse or heavy blood loss

I’ve been looking at data on when and why Doncaster people attend A&E. People living in Doncaster town centre are the biggest users, followed by Mexborough, Denaby Main, Lower Wheatley, Wheatley, Hyde Park, Intake and Edlington residents.

Monday is the busiest day in A&E and the peak time for patients to turn up is 11am to noon. The quietest period is between 2am and 6am.

Cuts and bruises are the main reason for people visiting, with around 12,000 such cases every year.

This is followed by about 8,000 dislocations, fractures and joint injuries.

Nearly half of those who attend A&E are discharged to their GP for follow-up treatment and, interestingly, around 5,000 patients a year leave the department before receiving any treatment.

* Dr Nick Tupper, Chairman, Doncaster clinical commissioning group