Addressing the crisis at A&E

You don’t have to delve far into media coverage of A&E attendances, waiting times and the shortage of emergency beds to see that the crisis in emergency care in England is real and a very pressing concern, both for the NHS and for those of us who need to access those services.

The Independent states that there is 1‘a sustained threat to patient safety’ as hospitals across the country are swamped by record numbers in A&E’. They go on to say that NHS staff have revealed that ‘hospitals and ambulance services are being overwhelmed by the number of patients’ in their exclusive article. More worryingly, this report was written in June 2021. In summer. Whilst we are used to these headlines in the winter months, the figures for June are truly extraordinary.

There are some obvious solutions to this challenge – massive investment in emergency services, more A&E units across the country, more staff, strategic focus and development, and improved pathways of care from A&E to specialist hospital, community and home care, coupled with faster discharge. Whilst work is ongoing on most of the above there is an immediate need to address the numbers of emergency attendances and guide people to the correct NHS service for them.

HealthWeb Solutions has worked with NHS organisations in London and the south east of England to deliver targeted and data-driven communications campaigns to help and educate our communities on using the right service. We first developed the Use The Right Service campaign in south east London back in 2018, rolled out again in North Central London in 2018/19 and across Hampshire in 2019/20. Hampshire’s being the most current and the most developed, I will give you some information on what we did in Hampshire.

As a first step we brought together a coalition of partners – acute trusts, commissioners, GPs, private and voluntary and community organisations, ambulance service, local authorities and others. We drew up together a strategy to reduce inappropriate A&E admissions. This was based on data provided by the trusts and the CCG. We were able to use this to target specific areas and demographics with high presentation rates.

We built the website (which receives about 80,000 visitors a month and was rated as a ‘best new website’ by WebUser Magazine), commissioned targeted radio advertising, targeted social media, unified messaging across digital, social media and print, including posters in carparks, stations, the football stadium, clinics and GP practices (paper and digital screens), hospital waiting areas, council buildings and more. In addition we worked with partners to capitalise on their audiences across online materials, letters and mailings and printed media. Our equality and diversity leads worked with us to improve our reach with hard to reach and seldom heard groups.

It was a mammoth task and grew organically as each contact and partner passed us on to another. We pulled the data weekly to continually monitor the effectiveness of our targeting, messaging and reach. We were able to evidence the impact and provided regular feedback to the leads from the coalition of NHS organisations in Hampshire. The proof of the pudding, as they say, is in the eating, and we were able to show the impact of the campaign and witnessed reduced attendances at A&E, greater engagement with self care principles, with pharmacists and with primary care.

In light of the covid pandemic we must appreciate that both primary and secondary care has been put under immense pressure. Our targeted communications solutions are only one part of what must be a coordinated effort across the NHS to ensure the support and wellbeing of staff, adaptive ways of working post-covid and effective ways of educating and encouraging the public on how best to use NHS services.

1 Shaun Lintern, Health Correspondent, The Independent, 21 June 2021

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