Health chiefs say public uses ERI ‘like McDonald’s’

NHS Lothian medical director David Farquharson said the hospital was struggling to hit waiting time targets because of the number of people who turn up for instant treatment for “coughs and colds”.

He said young people in particular viewed the A&E at Little France – already the busiest in the country – as being the medical equivalent of a fast food restaurant.

The health board has consistently failed to hit targets for A&E waiting times, which specify that 98 per cent of patients should be seen within four hours of arriving.

Mr Farquharson said: “The main challenge is in the increasing number of the public accessing A&E in the first place. Often they are not going to the GP and they are using A&E as primary care.

“There’s a number of young people who don’t have GPs, who like to use this as instant access to healthcare – much as they go for an instant meal in McDonald’s, they go to A&E for instant healthcare delivery.

“There are people using A&E for coughs, colds, bee stings. They can be really very minor.”

A&E is intended specifically for health problems that are “urgent and emergencies”. The NHS is keen to direct more patients to the minor injuries unit at the Western General, which is open every day and offers faster treatment for injuries including cuts, burns, sprains and simple fractures.

In the past year, the only month in which NHS Lothian hit the 98 per cent target was August.

Mr Farquharson said the NHS also had to make changes to cut A&E waiting times, getting more patients directly into wards or outpatient services where possible.

He added: “I think it’s important to look at the flow of patients through the hospital itself.

“It’s not just an A&E problem, this is something that everybody working within the Royal Infirmary needs to take some responsibility for.”

His frustration was echoed by Eddie Egan, vice-chairman of the NHS Lothian Board, at the health board’s annual review. He said: “The Royal Infirmary is a key challenge. For somebody coming out of A&E, the bed needs to be there.”

He said patients also needed to pay more heed to the word “emergency”.

He said: “The clue is in the name. We still have significant numbers of people who arrive at A&E across Lothian who don’t need to be at A&E.”

Margaret Watt, chairwoman of the Scotland Patients Association, said the NHS should get tough with people abusing A&E services.

She said: “We have got to educate them, to say ‘these are the kind of things you take to your doctor’. We should be saying ‘you have to be registered with a GP and you can’t be accessing treatment from the NHS unless you’re registered with a GP’.”