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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.

There are around 21 million visits to NHS A&E departments each year, often arriving by ambulance as a result of a 999 call.

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 at traditionally busy times such as on Friday or Saturday nights. Patients are seen in order of clinical need and arriving in an ambulance does not necessarily mean you will be seen any quicker.

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

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 clinical commissioning groups (CCGs) in England 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.

NHS helplines

If you're in England, call 111. 

In Wales, call NHS Direct Wales on 0845 46 47. 

After describing your symptoms to a specialist call handler you will usually be phoned back by a nurse who will advise you on what you should do next. If your call is considered an emergency the nurse is able to send an ambulance.

In Scotland, call 111. Callers will be directed to either an experienced nurse for assessment or a health information advisor for information. Where it is thought that the clinical condition requires a GP visit, NHS 24 will pass details on so an out-of-hours GP can be dispatched to the caller's home. Patients may also be referred to a Primary Care Emergency Centre (PCEC) where they will see either a nurse or a doctor.

Patients in Northern Ireland do not have a service similar. Instead if you require out of hours medical care in Northern Ireland when your GP surgery is closed you should dial your nearest GP Out-of-Hours. You can usually find the phone number on your surgery's answering machine or your call may be transferred directly.

Many calls can be dealt with over the telephone but sometimes you will be asked to attend an Out-of-Hours centre. Attendance at GP Out-of-Hours centres is by appointment only so you need to phone first.

WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on July 31, 2014

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