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A&E Report Overview

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A&E Enter and View Overview

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1. Introduction

What is Healthwatch?

Healthwatch is the independent champion for people who use health and social care services which exist to make sure that people are at the heart of care.

We listen to what people like about services and what could be improved then share their views with those with the power to make change happen. Helping people find the information they need about services in their area is another of our priorities.

In summary, Healthwatch’s main aims are to:

  • Help people find out about local care.
  • Listen to what people think of services.
  • Help improve the quality of services by letting those running services and the government know what people want from care.
  • Encourage people running services to involve people in changes to care.

What is the Healthwatch Humber Network?

The Healthwatch Humber Network (referred to as ‘The Network’ hereafter) is a collaboration of the four local Healthwatch teams, Healthwatch Kingston upon Hull, East Riding of Yorkshire, North Lincolnshire and North East Lincolnshire, each of whom deliver projects and community engagement across the Humber region.

Overview / Background

In September 2021, The Network was approached by the Humber, Coast and Vale (HCV) to ask whether we were able to conduct an Enter and View in Accident and Emergency (A&E) Departments in the following hospitals:

  • Hull Royal Infirmary.
  • Diana Princess of Wales Hospital.
  • Scunthorpe General Hospital.

We agreed the Enter and View would take place at each hospital on up to four separate occasions, across a two week period, in order to capture as many patients’ journeys and experiences as possible.

From our engagement with patients, we were hoping to understand the following:

  • Why patients have come to A&E.
  • Whether patients were aware of alternative options for treatment.
  • What the experience was like of patients when attending A&E.

Following our engagement, we provided patients with a variey of options for them to feedback to us using our ‘Follow Up Survey’ and where possible, arranged to contact them to discuss their experience.

By the end of the project, The Network spent a collective total of 148 hours so we could:

  • Plan the design and delivery of the project.
  • Design and deliver specialised training to Volunteers.
  • Conduct 11 Enter and View Visits across 3 different A&E departments.
  • Capture the views of 153 patients in A&E.
  • Complete 18 Follow Up Surveys.
0
Hours Spent
59
On Planning
28
On Training
54
In A&E
7
On Follow Up Surveys

2. Initial Survey

Across the three A&E departments, The Network conducted a total of 11 Enter and View visits and engaged with 153 patients regarding their journey to and reason for attending A&E.

0
Patients Engaged With
76
Hull
43
Scunthorpe
34
Grimsby

Our Findings:

0
Patients advised to attend A&E

41.6%

of these patients advised alternative services could have provided treatment instead of A&E.

18.8%

also advised they attended as they could not get an appointment with their GP.

Patients were also more likely to be advised to attend A&E by their GP.

% of patients advised to attend by GP
Hull 28.8%
Scunthorpe 51.5%
Grimsby 60%

We found some of the following reasons were behind patients decisions to attend A&E:

My dad has diabetes and has had a stroke. He has fallen and broken his arm and he’s been really poorly. We tried to see the GP but couldn’t get an appointment until 30th November so I rang 111 and they said to come here. My dad’s sugar levels are really high and he’s feeling poorly.

I first contacted NHS 111, advised an appointment was made at Urgent Care Louth. When I arrived, I was made aware there was no doctor available and I would need to attend A&E in Grimsby.

I have PTSD and I didn’t know what else to do at the moment of my episode.

Advised to call ambulance by NHS111 – have spoken to GP who referred to Brocklehurst Centre and prescribed antibiotics, antifungal but foot is so bad I can’t sleep, been like this three months.

3. Follow Up Survey

After speaking with patients in A&E, we asked patients if they wanted to complete a follow up survey about their recent experience at A&E. In total, 18 patients completed the follow up Survey.

0
Follow Up Surveys Completed
9
Hull
6
Scunthorpe
3
Grimsby

Our Findings:

0
% Patients Satisfied

72.2%

rated their experience as ‘Very Good’ or ‘Excellent’.

50%

told us how their experience could have been improved.

77.8%

told us about things that went well during their visit to A&E.

17.8%

felt the information they were provided could have been better.

We were told some of the following were the reasons felt either satisfied or unsatisfied with their experience:

Waiting in the cold queuing up, no nurse to see who need to be seen or prioritising, disgrace how I was spoken too, not child friendly whatsoever. totally understand there understaffed, but all gathered speaking to each other rather than patients. Receptionist diagnosing before been seen.”

Experience was fine; however, daughter was transferred to another department without notifying and father was sat waiting. Eventually he asked where she had gone and what was happening.

Once we saw a Doctor I would give the service a 5. She was lovely. However, we had to wait 5 hours. We were triaged after 1 hour and told that my son would be given an electrocardiogram (ECG) straight but this didn’t happen.

When we got in to see the GP she told us they had forgotten the ECG and arranged for my son to have one straight away.

Patients provided Healthwatch with some suggestions on how their overall experience could have been improved:

I don’t know what the answer is but I think that GPs should find out more about what Urgent Treatment Centres can offer and look into sending more patients there rather than putting it all on A&E.

Discharge process to be improved to prevent waiting.

Extra staff when entering the building, better support for parents as I was spoken to like rubbish (was upset due to my son been poorly), staff need training and more compassion.

4. Individual Experiences and Emerging Themes

Following our Enter and View Visits, Healthwatch analysed the information and experiences gathered to find whether there were any particular experiences or themes which identified where recommendations for improvement could be made.

0
Experiences Identified
0
Themes Identified
0
Recommendations Made