People attending NHS accident and emergency (A&E) departments and urgent treatment centres in England are reporting poor experiences of care, with long waiting times compounded by a lack of information, support, and communication.
A&E: failing far too many people
These are the findings of a major survey of people attending type 1 and type 3 urgent and emergency care departments – such as A&E departments, urgent treatment centres, minor injuries units, and urgent care centres. The survey, coordinated by Picker for the Care Quality Commission, gathered more than 45,000 responses from people who sought treatment last winter – mainly in February 2024.
According to the survey:
- More than a quarter (28%) of people attending type 1 (A&E) departments waited for more than one hour for an initial assessment by a doctor or nurse. Only 29% had an initial assessment within the target time of 15 minutes (34% for walk-in patients visiting type 3 departments).
- Most patients were not told how long they would wait to be examined or treated in type 1 (74%) and in type 3 departments (61%). Patients who spent the longest in A&E departments were less likely to get this information: only 21% of patients who spent more than four hours in the department were told how long they would wait.
- The majority of patients who spent more than four hours in an A&E department said that they were not able to get help with their condition or symptoms whilst they waited (54%).
- Almost two in five patients attending type 1 (A&E) departments said that they did not or only “to some extent” had enough time to discuss their condition with a doctor or nurse (39%).
- Only 70% of patients attending type 1 departments and 81% attending type 3 departments said that they were treated with respect and dignity “all of the time”.
Disabled and older people hit hardest
The results also examine the relationships between different aspects of people’s care.
There was a clear association between waiting times and people’s overall experiences of care: in both type 1 and type 3 departments, people who waited more than 30 minutes for an initial assessment and those whose visit lasted more than four hours overall reported significantly worse experiences across almost all other aspects of care.
In type 1 departments, people aged under 50 years, people with frailty, and disabled people were also significantly less positive about their care across a wide range of measures.
‘Significant cause for concern’ over the state of A&E
Commenting on the results, Chris Graham, Group CEO of Picker, said:
Patient feedback provides significant cause for concern as to the quality of NHS urgent and emergency care services in 2024. Long waits in A&E and urgent care services have been well reported and are not surprising – but this survey demonstrates a clear link between timely access to care and people’s overall experiences.
People who wait longer for an initial assessment and who spend longer in urgent care departments overall have worse experiences of nearly all aspects of care. Long waits and associated problems are a barrier to providing the high quality, person centred care that the NHS aspires to offer.
The findings are particularly worrying as the NHS heads towards what is expected to be a challenging winter. A separate poll published this week by the Royal College of Emergency Medicine reported that 87% of A&E clinical leads are not confident that their departments will cope well this winter.
As it is likely that long waits will persist throughout the winter months, services should prioritise improving people’s experiences of waits – by communicating clearly about how long people can expect to wait; updating people as often as is practicable; and ensuring that support is available for people who are suffering with their conditions or symptoms as they wait.
Featured image via the Canary
