10 ways to avoid A&E: use alternative NHS services

10 ways to avoid A&E (Accident and Emrgency): use alternative NHS services

We all know about the very long waits in A&E, and all the patients on trolleys in corridors. Is A&E the only place open? (no). So what are the 10 alternatives to A&E, especially out of hours?

Community

• For non-life-threatening conditions, make an appointment with your GP
• They provide expert advice, diagnosis, and treatment
• You may have to wait to see the GP you like best
• You can still get face-to-face (F2F) appointments and be examined – just ask.

Note. GPs will often now have a paramedic working with them who can visit frail or elderly patients in their home, and discuss the person with their GP. Again, just ask.

• Many pharmacies offer advice and treatment for minor conditions like colds, flu, and skin and urinary tract infections
• Many have a Pharmacy First service, where a clinical pharmacist (with access to your notes) can diagnose and treat you, without seeing your GP
• Here are their many other services: what services are provided at your local pharmacy. They can also do emergency prescriptions
• They are usually walking distance from where you live, and you don’t need an appointment. You can just walk in
• So they are a good place to start for healthcare – as they can direct you to the best place to go in the NHS if they cannot provide the service
• Like MyHSN, they are good at navigating people through the (very complicated!) NHS. Many are open late and at weekends too [“Like MyHSN!” Ed].

• If you have a long-term condition (like diabetes), community nurses (e.g. district nurses) and GP practice nurses, can see you, and provide advice and treatment.

• If your GP is closed, use out-of-hours GP services for urgent advice and treatment. They are GPs that can come to your house if needed
• They will communicate with your GP in the morning, or on Monday.

Telephone / online

• Take care of yourself by getting plenty of rest, staying warm and managing stress
• You don’t have to eat if you are not hungry, but keep drinking (mixture of water, squash, tea and coffee is best; if you are on a fluid restriction (e.g. for heart failure, or CKD) talk to a doctor first).

Note. A good rule of thumb, is the ‘two week rule’ – i.e if you have a new problem (and you don’t think it is serious), wait two weeks, and see if it gets better of its own accord. Many conditions (e.g. many causes of back pain) will do.

• Be aware of serious symptoms like chest pain, shortness of breath, and severe headache with neck stiffness.
• If you experience these, go to A&E or call 999. Here are 20 important red flag symptoms.

Bonus community services

There are now several services that are linked to GP, that you can access, without going through your GP. These include:

1. NHS Talking Therapist (previously called an IAPT). You can get courses of counselling. This may be useful if you think you have anxiety, depression or mild OCD, for example
2. ‘First contact physio’ (musculoskeletal, MSK). They are good for assessing and treating back, hip, knee, shoulder and other bone or joint pains. They can request x-rays, CTs and MRIs, and refer you to a surgeon if they think an operation will help.

Note. To find whether your area/GP has access to these, Google them, or ask your GPs receptionist, or your local Integrated Care Board (ICB) website. An ICB is the local (roughly county sized) level of NHS administration in England. There are 42 within 7 NHS England regions.

Summary

We have described 10 alternative ways to avoid going to A&E (Accident and Emergency). We hope it has been helpful.