Pathways to Emergency Departments and Urgent Treatment Centre's

What we heard:

• 76% patients had used one or more health services for support with the condition that brought them to ED/UTC before attending.
• GPs, NHS 111 and GP practice reception teams made up 60% of all services used by patients prior to attending ED/UTC.
• 38% patients made their own decision to attend ED/UTC, with the most common referrers/signposting services being GPs and NHS 111.
• 21% patients felt they could have been treated elsewhere, with 10% telling us they tried to get a GP appointment but were unable to.
• 25% patients did not know whether they were using Emergency Departments or Urgent Treatment Centres when attending the hospital. 

What we did: 

Our Healthwatch authorised representatives visited the waiting rooms and engaged with patients at both acute hospitals (Eastbourne District General Hospital and Conquest Hospital) in two phases, in July/August 2024 and October/November 2024.

We used a standard set of questions to:

1. identify any services people used before attending
2. determine which services were signposting or referring them to ED/UTC
3. explore whether patients felt ED/UTC were the most appropriate services for their needs

Engagement in each phase took place across a two-week block of time, and for two hours on each day, with the times varying across the days of the week. 

Our recommendations: 

From our findings, we made 10 recommendations, three for East Sussex Healthcare NHS Trust (ESHT) who operate the ED/UTCs we visited, three for NHS Sussex who commission local GP services, and three for Healthwatch East Sussex to share our insight with decision-makers.

These included: 

• Improving public facing communications on what services are available to patients and how and when to use them to minimise unnecessary use of ED/UTC.
• More engagement between primary care providers, such as GP surgeries and hospital trusts such as ESHT, to improve consistency in the process of practices referring and signposting to ED/UTC.
• Continued exploration of patient’s experiences of using emergency and urgent treatment services at ESHT sites to help understand people’s decisions. 

Next Steps: 

• This report and our recommendations will be shared with ESHT, NHS Sussex, Healthwatch England and the public, to raise awareness of what we’ve heard and to support exploration of how changes or improvements may be delivered.
• Healthwatch East Sussex will continue to monitor the feedback we receive on emergency and urgent treatment services and where appropriate share our findings with ESHT, NHS Sussex, the Care Quality Commission and others.