North Middlesex University Hospital NHS Trust provides acute and emergency services primarily to local people in Enfield and Haringey with the Trust reporting high levels of Accident and Emergency (A&E) presentations.
In January 2018, over a period of one week, Healthwatch Enfield engaged with more than 600 individuals attending the Accident and Emergency department at North Middlesex University Hospital NHS Trust. It was our aim to build an understanding of ‘routes’ bringing people to A&E whilst also engaging local residents in conversations about what would support their decision making going forward.
- Through utilising a robust methodology, we gathered an evidence base and identified a key driver that brings people to Accident and Emergency at North Middlesex University Hospital NHS Trust. The key driver is convenience of access to instant medical help and diagnostics.
- Despite the best efforts of the Trust and commissioners to deliver an efficient and effective urgent and emergency care service that complies with the national 4-hour waiting time standard, individuals’ choice to use Accident and Emergency as a ‘one stop shop’ to access healthcare support appears to have created a new model of demand that cannot be met by existing NHS structures.
- Local people told us there is a need to think outside of the box, e.g. to develop local ‘instant access and diagnostics centres’ that would prevent over 50% of respondents from choosing Accident and Emergency as a means of supporting their everyday healthcare needs. And there are also opportunities to look at what can be done differently, particularly where existing pathways and services are concerned, and also to enhance understanding of how primary care can better respond to individual’s needs.
We need to meet the ‘demand’ but we also need to re-educate that ‘demand’ to utilise services effectively and appropriately.