Dr Simon Gazeley, a GP at Springfield Surgery in the Canalside Healthcare Centre in Bingley, shares with The Hub readers exclusive advice on topical health issues and giving his tips for a healthy life.
When I was a junior doctor training in hospital, I did the usual 6 month job in A&E. It was quite a memorable experience, not too removed from the BBC show Casualty. It was busy, hard work, stressful, emotional, but very rewarding. For the most part, the majority of cases seen were either “Accidents” or “Emergencies”, just like on the TV show.
Things have changed dramatically in the past 10 years. Figures show the number of people attending A&E has grown by 50%. This is not because there are significantly more accidents or emergencies, it’s because people are choosing to go to A&E for more minor conditions. You don’t see this on Casualty, it wouldn’t make for exciting viewing, but that’s the reality of modern A&E.
Why do people choose to go to A&E?
We all live busy lives, many of us work, and may find it difficult to fit in appointments with the GP during working hours. Patients often report finding it difficult to make appointments with their GP. Others see A&E as a quick way of getting a referral or a second opinion.
What’s wrong with going to A&E?
The purpose of A&E is to treat those who have had accidents and need immediate attention, and/or to treat those with life-threatening conditions. Attending with minor cases makes it difficult for A&E staff to deal with the number of patients, and may delay urgent treatment to patients with a medical emergency.
There are also cost implications. Every time a patient attends A&E it costs the taxpayer an additional £57. If that same patient chooses alternatives to A&E, there will usually be no additional cost. I sometimes here phrases such as “I pay my taxes and it was urgent to me”. We all have a responsibility to uses public services appropriately, money spent on non-essential A&E attendances means less money to be spent elsewhere in the NHS e.g. on cancer drugs.
When should I go to A&E?
There are certain situations where it’s absolutely essential to go to A&E, and nobody should ever be afraid to do so. These include major injuries (such as traffic accidents, serious falls, head injuries, fractures), collapse, severe breathing difficulty, severe chest pain, severe bleeding, poisoning, and burns.
When should I think twice about going to A&E?
The following are sorts of conditions for which A&E is not usually appropriate; flu-like illnesses, coughs and colds, sore throats, ear problems, urinary problems (unless completely unable to pass urine), vaginal bleeding, rashes (unless it appears like bleeding under the skin or the person is very unwell), backache, diarrhoea, bites and stings, problems persisting many months, contraception or dental problems.
What are the alternatives to A&E?
I know all of the GPs in Bingley, none of us are perfect, but we’re all decent people who want to genuinely try to help patients who feel they have an urgent problem. Especially problems that don’t necessarily need the specialist skills of A&E. We appreciate appointments are not always easy to come by, but ring us first, explain to the receptionist you have an urgent problem, we’ll try our best.
All practices in Bingley offer “extended hours” appointments, either early morning, late into the evening, or sometimes at weekends. These are ideal for people who work and cannot attend during the day.
When we’re closed, there is always the deputising service, based at Airedale Hospital, who will give advice, appointments or home visits as required. If you ring your usual surgery number, you’ll be automatically redirected.
If you’re unsure what you need to do, ring 111. It’s an advice line that’s open 24/7. They will point you in the right direction, give advice, or book an urgent out of hours appointment.
Pharmacies are also a good first point of call, and can offer excellent advice and treatment for minor illnesses and injuries.
So the next time you’re considering a trip to A&E, just think for one minute whether you have an accident or emergency, or whether you might just be going for anything and everything….