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Pain and anxiety key indicators of public usage of urgent and emergency care

23 March 2017

Preliminary findings by University of Southampton researchers and leading local clinicians have found that people using urgent and emergency care services do so because their level of pain is unmanageable and anxiety has reached a tipping point. The initial findings form part of a national study, led by Dr Joanne Turnbull and colleagues at the University of Southampton’s faculty of health sciences, to help find out more about the use of out-of-hours GPs, minor injuries units, NHS walk-in centres, NHS 111, ambulance services and hospital emergency departments.

The findings - which were revealed last week at a public advisory board of healthcare professionals, academics, and citizens - highlight how people experience feeling anxious, helpless or being unsure of what to do and which services to contact when needing urgent care.

People struggle to determine the difference between emergency care services and urgent care services often leading to the ‘inappropriate’ use of service choice, according to NHS policy.

A 2013 review of urgent and emergency care published by NHS Medical Director Professor Sir Bruce Keogh found that the source of this confusion is policy initiatives that have developed a range of different services - ‘walk-in centres’, ‘minor injury units’, ‘urgent care centres’, NHS 111 - to meet increasing demand for NHS services but this has created a fragmented, complex service, which is confusing for both patients and NHS staff.

Last month, health secretary Jeremy Hunt announced plans to look at new ways of managing the use of EDs, with some hospitals piloting a streaming system which sees staff assess patients on arrival and direct them to alternative services if they do not require hospital care.

The research team are calling for people to share their views and experiences of urgent and emergency care services.

"We are doing this research to find out what people think about urgent and emergency care services in England and how and why they use them," explained Dr Gemma McKenna, a research fellow in NHS urgent care at the University of Southampton.

"The NHS offers a range of different urgent and emergency services and research suggests people can be confused by what different services offer and how and when to access them, so we are hope that understanding patients’ choices will help the NHS manage services better for patients."

Professor Robert Crouch, a consultant nurse in the emergency department at University Hospital Southampton NHS Foundation Trust and an honorary professor of emergency care at the University of Southampton, added: "This is a really important opportunity for people who have used various urgent and emergency care services to share their views and help frame the way these are organised in the future.

"There has been much national focus on the use of urgent and emergency care services and more work needs to be done to simplify messages and help reduce confusion for patients accessing treatment - this work should help that process."

The researchers are looking to talk to 100 people about their experiences. Anyone interested in finding out more about the project or taking part can call the team on 023 8059 8841 or email


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