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Navigating the NHS

A&E and urgent out of hours care

Hospital accident and emergency (A&E) departments are for people with serious or life-threatening conditions requiring immediate treatment. They are open 24 hours a day and provide a service not just for those in the surrounding area but also people passing through the district who require emergency care.

Around 18 million people a year go to accident and emergency (A&E) departments often arriving by ambulance as a result of a 999 call.

All A&E departments throughout the UK are financed and managed by the NHS and care is, therefore, free.

A&E may also be referred to as casualty or the emergency department.

Not all hospitals have an A&E department.

What is an emergency?

A&E is for 999 emergencies such as:

  • Unconsciousness
  • Heavy blood loss
  • Head injuries
  • Breathing difficulties
  • Suspected broken bones
  • Suspected heart attack or stroke
  • Persistent, severe chest or abdominal pain
  • Deep wounds, such as a stab wound
  • Severe pain that is not relieved by simple analgesia
  • Acute confused state
  • Severe burns
  • Severe allergic reaction
  • Serious eye injury or visual disturbance

At A&E a doctor or nurse will assess your condition and decide on further action. You usually have to wait before you are seen, particularly on Friday or Saturday nights. Patients are seen in order of clinical need and arriving in an ambulance does not mean you will be seen any quicker.

Most patients will be assessed and then passed to another area of the department, or another area of the hospital.

Urgent care

If you need urgent medical attention but don't think it's an emergency there are other options. You can, of course, still phone your GP surgery. If your call is outside normal surgery hours, you'll usually be directed to an out-of-hours service run by the local PCT (Primary Care Trust). In some areas of England, a new 111 number is available for urgent but non-emergency medical help.

Some PCTs provide care themselves, others provide care through external organisations. Out-of-hours cover may include GPs working in A&E departments or in minor injuries units. Different areas may have slightly different services.  

Minor injuries units (MIUs)

Not all areas have a MIU but where they are available, they are usually nurse-led services and an appointment is not necessary.

Not all MIUs treat young children so it's worth checking in advance before arriving.

Minor injuries units can treat:

  • Sprains and strains
  • Broken bones
  • Wound infections
  • Minor burns and scalds
  • Minor head injuries
  • Insect bites
  • Animal bites
  • Minor eye injuries
  • Injuries to the back, shoulder and chest.

Walk-in centres

These are managed by primary care trusts in England (PCTs) and deal with minor illnesses and injuries.

These include:

  • Infection and rashes
  • Fractures and lacerations
  • Emergency contraception and advice
  • Stomach upsets
  • Cuts and bruises
  • Burns and strains.


NHS walk-in centres are usually managed by a nurse and are available to everyone. Patients do not need an appointment. Most centres are open 365 days a year and outside office hours. However, not all centres treat young children, so check before you set off.

WebMD Medical Reference

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