Findings from the most recent British Social Attitudes Survey, which involved interviews with more than 3,800 adults in Britain between July and October 2018, has revealed significant differences in perspectives of emergency care by a range of socio-demographic factors.
“There are lessons in these findings which will help government to better support those least confident in using health services”
One academic commenting on the new findings, published today, suggested that marked differences in attitudes and understandings across different social groups in Britain, could “contribute to the over-use of critical emergency care functions”.
In the first ever large-scale research of its kind, carried out by the National Centre for Social Research and funded by the National Institute for Health Research, more than a third of the public reported that they preferred NHS services where they did not need to make an appointment.
The research found those living in the most deprived areas (48%) and those with no educational qualifications (48%) were most inclined to hold this view, while 27% of people living in the least deprived areas and 30% of graduates expressed this opinion.
In addition, 17% of respondents said they preferred accident and emergency departments to GPs, because they could “get tests done quickly”. This figure rose to 29% from people in the most deprived areas and down to 11% for people who lived in the least deprived areas.
“This research highlights that more public education is needed so that patients know where to turn when they become ill ”
By the same token, the survey found those with no qualifications were twice as likely (26%) as degree holders to prefer A&Es to GPs to get tests done quickly (13%).
When looking at the public’s perception of GPs versus A&E doctors, researchers identified that 65% had confidence in GPs, while 11% stated they “did not have much” confidence.
Overall, 19% of participants reported that doctors at A&Es were more knowledgeable than GPs.
In addition, the study highlighted that “nearly everyone” asked in the survey believed that too many people used A&E and 999 ambulances when they are not needed.
According to the researchers, 86% of respondents thought too many people used A&E services “unnecessarily”.
When asked whether they had accessed A&E services in the previous 12 months for themselves or others, 32% of the public and more than half of parents with a child under five, reported they had done so at least once.
Meanwhile, 29% of those without young children in the household said they had visited A&Es in the same period.
“The ‘problem’ of increasing demand is not going away no matter where patients are treated”
Also 51% of participants reported that it was “hard” to get an appointment with a GP. According to the results, those with children under five (65%) and those living in the most deprived areas (59%) were most likely to agree.
Commenting on the research, Alicia O’Cathain, director of the medical care research unit at the University of Sheffield, said the findings highlighted “marked differences in attitudes and understanding between different social groups” with regard to views on access and confidence in A&Es and GPs.
She said that this may “contribute to the over-use of critical emergency care functions”.
“It’s clear that there are lessons in these findings which will help government to better understand and support those least confident in using health services and shape policy moving forward,” she said.
Professor Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said: “What this research highlights is that more public education is needed so that patients know where to turn when they become ill – and it gives useful insight into where this could be directed for the best possible impact.”
She also earmarked the internet as a “great source of knowledge” on health conditions and advice on self-care, when using reliable UK-based websites.
According to the survey, 58% of participants with internet access said they would look online to help understand a health problem, while 47% would use the internet to decide what to do about it.
However, researchers found substantial gaps between demographic groups in that young people aged 18 to 24 were twice as likely (62%) to research health problems online, compared to those aged 75 and over (30%).
Also commenting on the research, president of the Royal College of Emergency Medicine, Dr Taj Hassan said: “Patients are now recognising what staff and this college have been saying repeatedly for a long time; emergency departments are seriously overcrowded.”
Dr Hassan added: “The ‘problem’ of increasing demand is not going away no matter where patients are treated and, as this survey makes very clear, staffing desperately needs to be expanded throughout the entire health system but especially in emergency departments.”
He flagged an urgent need to “adequately resource the ‘front door’ of emergency care” and to also increase the capacity of the acute bed base.
Source: Gareth Harmer
“This will reduce the risk of harm to patients and attrition amongst staff caring for them in a crowded and stressful environment,” he said.
The Royal College of Nursing also highlighted the need for staffing amid increasing demands.
RCN director for England, Patricia Marquis, said: “A&E departments across the country are crammed because people are forced to go where the lights are on when they can’t get the treatment they need elsewhere.”
“Staffing levels aren’t improving and yet demand is continuing to rise,” she said. “This survey demonstrates the need for proper concerted investment across the whole of health and care services and accountability for safe staffing levels set in law.”