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Worried people should never be criticised for turning up to emergency departments, says former RCN president

Nursing Children and Young People conference told that government is using the term ‘inappropriate attendances’ to mask under-funding of services

‘Inappropriate attendances’ by the public is just a line fed to healthcare workers by a government short-changing emergency departments, a former RCN president has said.


Former RCN president Andrea Spyropoulos. Picture: Neil O’Connor

Andrea Spyropoulos told delegates at the recent Nursing Children and Young People conference in Liverpool: ‘I think as professionals we are being sold a line from our government, because they are under-funding the service. That under-funding is being passed to patients in the message “you shouldn’t turn up”.

‘Well, when I was a young midwife, I told every parent that if you are worried, you know where the A&E department is, and if it turns out not to be urgent, they will send you away but with good advice.

‘It’s time we said to our government that there are no “inappropriate attendances”, we just have to change the service to accommodate people. We know people turn up because they are frightened and need information.’

Ms Spyropoulos is a clinical strategist at Alder Hey Children’s NHS Foundation Trust in Liverpool, where there is a nurse-led emergency unit that triages and treats children with minor illnesses. 

Her comments followed a talk at the conference by University of Northampton associate professor Sarah Neill.

Ms Neill said she wanted to ‘strike-through’ the term ‘inappropriate attendance’.

No attendance is ‘inappropriate’

‘We need to get rid of the idea that anybody’s presentation with a child is inappropriate – they are there because they are worried, because they don’t think they are able to look after their child unaided,’ she said.

‘“Do I or don’t I call the doctor?” That worry is ever-present in a society where we are criticised for using the wrong service.’

Ms Neill said more children die in the UK from preventable causes – such as sepsis and meningitis – than anywhere else in Europe.

She said she is helping to develop an app to help parents and staff spot the signs of serious conditions in children.

Victim of care delays

Fellow speaker and sepsis awareness campaigner Sue Morrish told delegates of the final 24 hours of her three-year-old son’s life.

Sam Morrish died of sepsis in 2010 after care delays at his local GP service, NHS Direct (now NHS 111), an out-of-hours GP service, and a minor injuries unit.

There was also a three-hour delay in giving him antibiotics after they were prescribed.

Listen to Ms Morrish tell Sam’s story on Nursing Standard podcast episode 5.


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