SCHOOLS refer as many patients to pressurised A&Es and Minor Injury Units in Worcestershire as the NHS 111 telephone service according to a 'stark' watchdog survey.

As A&E departments buckle under the strain, a survey shows that nearly a quarter of patients are referred to urgent care services by schools.

Five A&E consultants are leaving our hospitals and patients have been receiving care on trolleys in corridors because of the shortage of beds. Now an urgent care survey by Healthwatch Worcestershire sheds light on patient habits which may add to the pressures on urgent care.

There are A&E departments at Worcestershire Royal Hospital in Worcester and the Alexandra Hospital in Redditch and Minor Injury Units (MIUs) at Malvern, Evesham, Tenbury, Kidderminster and Bromsgrove.

An urgent care survey of a sample of 339 people at A&Es and MIUs in Worcestershire across September and October last year was carried out by the watchdog.

Of these 339 people, 43 people declined to take part, leaving a total sample of 296. Of these 296 patients 109 considered they had been referred to A&E (37 per cent of the sample) while the the majority - 187 people (63 per cent) self-referred. Only just over half (55 per cent) of those who self-referred considered it was an emergency.

Only 78 people (27 per cent of the total sample) tried to contact their GP before attending an A&E or MIU and only 38 people (13 per cent of the sample) had been unable to get an appointment with their GP

Tellingly nearly a quarter (23.9 per cent) of referrals had been advised to go to A&E or an MIU by the school, the same proportion as that advised to attend by NHS 111, the national 24 hour a day/365 day a year service for patients.

The findings of the survey were part of a presentation delivered at a meeting of Healthwatch at St Peter's Baptist Church in St Peter's, Worcester, on Wednesday.

Simon Trickett, chief operating officer of South Worcestershire Clinical Commissioning Group, said he wondered if the survey would produce the same results now as since it had been carried out there had been national publicity around the NHS 111 telephone number.

"As many people had been referred by their school as had been referred by NHS 111 which is a stark statistic really" he said.

Healthwatch spoke to patients who had made their own way to A&E/MIU rather than those who had been conveyed by ambulance as the decision to attend was deemed in these circumstances to have been taken by the NHS directly.

Only 66 per cent of the sample were aware of the GP out of hours service. The survey showed 71 per cent of patients were aware of NHS 111 but there was some confusion about what it was for. The survey showed 58 per cent of respondents were aware of MIUs but there was confusion as to opening hours, availability of xrays and in general what level of injury an MIU could deal with.