12 hours in A&E

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Summary of report content

The Healthwatch Cheshire team of staff and volunteers visit the three A&E departments in Cheshire at the same time on one particular day in order to gain a snapshot of what is happening in our hospitals. On 11th February 2019, Healthwatch Cheshire assisted in engaging with people in the A&E departments across 12-hours from 9am until 9pm. This allowed Healthwatch to capture people coming in both the day time and evening.  The research took place on a Monday, as Healthwatch has evidence to suggest that this is a busy day for A&E departments - this can be after people become ill or injured over the weekend or decide that they have not got any better over the weekend, and so decide to go to A&E on the Monday.

Findings

In total 209 people responded to the ‘A&E Watch’ survey across the three A&E departments

Across the three A&E departments, a slight majority of people had tried to visit another service before attending A&E, at 52% of people overall. This is an increase on the January 2018 report, when only 41% had tried going elsewhere first.

Significantly, at the Countess of Chester Hospital the number of people visiting another service first has increased by 28% year on year. However, at Leighton Hospital, as the 2018 survey, there is still a larger number of people not attending another service before A&E – 42 people (56%) in 2019, and 20 people (57%) in 2018.

Of those who had visited another service before attending A&E, two-thirds had attended their GP Practice first, whilst one in five people had tried the NHS111 service.

Two-thirds of people who had first attended their GP Practice said that they were advised by their GP to attend A&E.

At the Countess of Chester Hospital and Leighton Hospital, the most common reason people gave for attending A&E without going elsewhere was that ‘It was too urgent/it was an emergency’ (65%). This is in line with the findings of the previous A&E Watch reports.

Across all three hospitals the second most common reason was ‘because it is more convenient’ (21%), which suggests A&E is more accessible for some people than other services.

The majority of people Healthwatch spoke to arriving at A&E by ambulance were at Leighton Hospital. There was a 95% five-star response rating for the care given by ambulance staff for people being taken to Leighton Hospital.

When asked whether they were being kept informed of timings and delays, there was a mixed response, with slightly more respondents at the Countess of Chester Hospital and Macclesfield Hospital saying that they were not being kept informed.

Across all three hospitals over half of people (54%) who responded rated their A&E experience as either 4 or 5 out of 5. Comparatively, in the January 2018 report 71% across the three hospitals rated the service as a 4 or a 5.

47% of people at the three hospitals stated that they had visited A&E in the last 12 months. This an increase on the 39% in 2018 and 36% in 2017.

There was a low response rate to the ‘After Your A&E Visit’ survey, with only 23 completed overall, and none completed by those initially surveyed at the Countess of Chester Hospital. Of those who did respond, when asked about their overall treatment times, almost 56% of people who responded at Macclesfield Hospital were treated and sent home within two hours, and at Leighton Hospital 38% were treated and sent home between 1-3 hours. 46% of people who responded at Leighton Hospital waited over 4 hours to be seen.

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General details

Report title 
12 hours in A&E
Local Healthwatch 
Healthwatch Cheshire East
Healthwatch Cheshire West and Chester
Date of publication 
Monday, 11 November, 2019
Date evidence capture began 
Monday, 11 February, 2019
Date evidence capture finished 
Monday, 11 February, 2019
Type of report 
Patient experience
Key themes 
Quality of staffing
Quality of treatment
Referrals
Staff levels
Waiting time to be seen once arrived at appointment
Healthwatch reference number 
Rep-5003

Methodology and approach

Was the work undertaken at the request of another organisation? 
No
Primary research method used 
Survey
How was the information collected? 
Survey

Details of health and care services included in the report

Urgent and emergency care services 
Accident & emergency

Details of people who shared their views

Number of people who shared their views 
209
Age group 
Not known
Gender 
Not known
Ethnicity 
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Yes
Does the information include staff's views? 
No
Does the information include other people's views? 
No
What was the main sentiment of the people who shared their views? 
Mixed

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
No

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.