A&E Watch July 2021

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Summary of report content

Healthwatch Cheshire undertook a snapshot view of A&E departments in the county in July 2021, after an approach by members of the local A&E delivery board in the context of very high numbers of people attending A&E.  They wanted to understand the reasons for this.  Engagement took place from 19 to 23 July 2021 and they spoke to 266 people.

Over seven in ten people had not tried to contact NHS111 before attending A&E. Many were unaware that this was the process they were meant to follow. People who had been given an appointment to attend by NHS111 reported that they were told upon arrival in A&E that due to pressures on the department they would not be following appointments and people would have to wait the same as people who had just gone straight to A&E. It is noted that NHS111 offer a time of arrival rather than a specific appointment as A&E are unable to keep to specific appointments.

Over half had not attempted to go anywhere else before coming to A&E. People said this was for reasons such as a perception they would be sent to A&E anyway, or they thought it was more convenient and would be seen quicker, and a perception that they would not be able to get a GP appointment.

Of those who had attempted to go elsewhere before A&E, nearly three quarters had first tried to access their GP. Some of these people said that the GP themselves had advised them to go to A&E. Other people mentioned being advised by receptionists to go to A&E due to a lack of GP appointments.

Across all three hospitals, nearly seven in ten had not previously attended A&E in the past 12 months, suggesting that the majority of people are not repeat attendees.

Generally people complimented the staff on their attitude, and were understanding of the busy conditions they were working in.

This year’s A&E Watch took place on what turned out to be the hottest week of the year so far. Of the three A&E departments, only the Countess of Chester had air conditioning in the department, which contributed to a difficult experience for people in waiting areas in Leighton and Macclesfield Hospitals, with long wait times and busy departments.

It did not appear that COVID-19 social distancing protocols put in place by the hospitals were being followed successfully due to a large number of people attending the departments. Waiting rooms were often full, exceeding the limits on the number of people allowed at any one time that were self-imposed by the departments. Signs not to sit on seats were being moved by people so that they could sit down, and no cleaning of seats was taking place in between patients.

The report doesn’t contain recommendations, but there are responses from providers to the findings.

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General details

Report title 
A&E Watch July 2021
Local Healthwatch 
Healthwatch Cheshire East
Healthwatch Cheshire West and Chester
Date of publication 
Wednesday, 18 August, 2021
Date evidence capture began 
Monday, 19 July, 2021
Date evidence capture finished 
Friday, 23 July, 2021
Key themes 
Building and facilities
Car parking access
Cleanliness hygiene and infection control
Communication between staff and patients
Information providing
Quality of care
Quality of staffing
Service delivery organisation and staffing
Waiting time to be seen once arrived at appointment

Methodology and approach

Was the work undertaken at the request of another organisation? 
What type of organisation requested the work 
Service Provider
Primary research method used 
If an Enter and View methodology was applied, was the visit announced or unannounced? 

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 
Age group 
1-15 years
16-17 years
18-24 years
25-64 years
65-85 years
Asian / Asian British
Black/ African / Caribbean / Black British
Mixed / multiple ethnic groups
Other ethnic group
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
Not known
What type of impact was determined? 
Implied Impact

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.