How did you get here? Responses to those arriving at the Croydon University Hospital Accident and Emergency Department

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Summary of report content

Between July and August 2019, Healthwatch Croydon asked those who were visiting Croydon University Hospital’s Accident and Emergency department how they got there. They wanted to understand the journey they took to get to A&E and what helped inform their choices. They undertook a survey to which 364 service users responded.

Over 50% of people use A&E as a first choice because they needed to see something quickly, their illness was too serious to be seen outside A&E , attending hospital was most convenient and they found it difficult to get an appointment with their GP.  Over three in five were sure where to go when they had an illness or injury when they chose A&E.

Of those who did not choose A&E first, three in five used GP services and the majority had a positive experience.  Despite pharmacy having a role in the pathway, very few used this service, or 111 online.

Severity of injury was main reason for attending A&E following first contact, with the referrals coming from the GP and NHS 111. There was a range of issues which people felt needed to be treated at A&E, some of which could have been managed at GP surgery or GP hub

15% of people attended A&E as there were no GP appointments, or they were busy or closed. Most people agree that it is difficult to get a GP appointment apart from those between 19-25 and over 65.

For those who did not go directly to A&E, their choices are varied, but did not always follow the pathway of calling 111, GP or GP Hub and then A&E. Age and gender may have an influence on choices: 19-25 year olds are more likely to contact 111 than their own GP first, 26-40 year olds are more likely to contact their GP before attending A&E. Those looking after under 12s were the surest where to attend when they required care. More males than females prefer to go directly to hospital and strongly agreed that hospital was most or more convenient. More males strongly agreed they wanted to see someone quickly and saw their condition as too serious to be seen elsewhere.

There were five recommendations about changing the pathway to reflect real patient use of services, communicating alternatives to A&E, the need for GPs to focus improving capacity so that people only go to A&E if they need to go there; understanding more why people choose the option that they do and communicating the revised pathway with clarity.

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General details

Report title 
How did you get here? Responses to those arriving at the Croydon University Hospital Accident and Emergency Department
Local Healthwatch 
Healthwatch Croydon
Date of publication 
Thursday, 26 November, 2020
Date evidence capture began 
Monday, 1 July, 2019
Date evidence capture finished 
Saturday, 31 August, 2019
Type of report 
Report
Key themes 
Access
Booking appointments
Communication between staff and patients
Information providing
Service delivery organisation and staffing
Healthwatch reference number 
Rep-7949

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
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
GP practice
Urgent and emergency care services 
Accident & emergency
NHS 111
Urgent care services

Details of people who shared their views

Number of people who shared their views 
364
Age group 
All
Gender 
All
Ethnicity 
All
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? 
Yes
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
No
Is there evidence of impact external to the report? 
Not known

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.