Emergency Department – Worcestershire Royal Hospital

Emergency Department – Worcestershire Royal Hospital

Welcome to the Emergency Department
We understand coming to the Emergency Department (ED) can be a stressful experience. Our team is here to help and support you.
The Emergency Department helps people who are seriously hurt, have had an accident, or suddenly feel very unwell. If, after an initial assessment, you are not considered to have an emergency
condition, you may be either streamed or redirected, depending on your needs.

• Streaming is when you are directed to the most appropriate on-site service, such as the Early Pregnancy Assessment Unit (EPAU) or Same Day Emergency Care (SDEC), based on your
  symptoms and the urgency of your condition.
• Redirection is when you are offered the option to attend amore suitable off-site service, such as a community pharmacy or dental service. This is not a formal transfer of care – it is
  your choice whether to follow the advice.
  
  GP referrals
  Your GP may ask you to go to the Emergency Department for further checks or to be seen by a specialist. If this happens, please let the receptionist or nurse know when you
  arrive and bring any notes or letters your GP has given you.
  You will still have an initial assessment by the ED team to determine how urgent your condition is. Depending on your needs, you may be:
• Treated in the Emergency Department
• Referred to a hospital specialist – please note that you may need to wait to be seen, depending on how busy the specialist team is. Unfortunately, this is outside the control of the ED.
• Directed to a more appropriate service
  While a GP referral helps the team understand your situation, it does not guarantee that you will be seen more quickly. Care is provided based on the urgency of your condition.
  111 Referrals
  We do not offer scheduled appointments for patients referred via 111. If you have been given a time, please note that this is an estimated arrival time, not a confirmed appointment.
  
  Alternative support services
• If you have been feeling unwell or have a medical problem for more than 48 hours, please try to contact your GP surgery or call NHS 111 first.
• NHS 111 is the free, 24/7 non-emergency helpline for urgent health advice when it’s not life-threatening.
• Pharmacy – Pharmacists can help you treat many common illnesses like colds, flu, tummy bugs, and aches and pains. Most minor issues can be treated at home with their advice and support.
• Minor Injuries Units (MIUs) – MIUs provide quick and expert care for injuries that are not serious enough to need the Emergency Department. You should go to an MIU for small cuts, grazes, sprains, strains, minor burns, or some broken bones.
• There are five MIUs in Worcestershire, all open 7 days a week:
• Bromsgrove (08:00 – 20:00)
• Evesham (09:00 – 21:00)
• Kidderminster (08:00 – 22:00)
• Malvern (09:00 – 21:00)
• Tenbury (09:00 – 17:00)
• Please note that X-ray opening hours vary between units – please check times before attending.
  
  On arrival at ED
  Walk-in patients
  On arrival, patients go to the reception desk to check in. As part of the check-in process, you may be asked to complete a short form, in line with national guidelines. The reception team will give
  you a wristband to wear and some notes to pass on to the triage nurse. Your wristband will also show the name you prefer to be called – this is your #CallMe name.
  Please tell the reception team if you have any allergies.
  If you have no allergies, you will be given a white wristband. If you do have allergies, you will be given a red wristband.
  After checking in, you’ll wait in the waiting area until a nurse calls you for a quick health check. This is called an initial assessment. If you’d prefer to wait outside or need any extra help, please tell
  the receptionist.
  Arriving by ambulance
  If you come to the Emergency Department by ambulance, a nurse will see you shortly after you arrive.
  They will assess how urgent your condition is using a nationally recognised system and take you to the most appropriate area of the department. This could be: Resus (for very serious
  emergencies), Majors, Ambulatory Majors or the Waiting Room.
  You may have tests, such as blood tests or X-rays, and you might also be given treatment like pain relief if needed.
  
  Waiting in the Emergency Department
  Our Emergency Department is extremely busy – we care for over 200 patients every day and work hard to treat everyone as quickly and safely as possible.
  How we prioritise care
  We follow a national triage system, which means the most seriously ill or injured patients are seen first – regardless of their arrival time. You may notice others being called in before you; this is due to the severity of their condition, not the order of arrival.
  Patients who arrive by ambulance are assessed and treated in a separate area, so the waiting room may not reflect how many patients are being seen at any given time.
  Waiting times and delays
  We understand that waiting can be frustrating. Staff aim to keep you updated, but delays may occur during busy periods, emergency situations, or when there are ambulance handover delays. If you feel you’ve been waiting a long time without any update, please speak to a member of our team — we’ll do our best to provide information when possible.
  Support while you wait
  There is a team of nurses and healthcare assistants in the waiting room to help keep you safe and comfortable. If you feel unwell, have concerns, or your condition gets worse while waiting, please
  speak to them directly. They are usually based in the corner of the waiting area.
  
  Hospital capacity
  Our hospital wards are currently very full. This sometimes means patients remain in the Emergency Department longer than usual while waiting for a hospital bed. As a result, some patients may be treated in areas such as corridors or assessment rooms. We apologise for any discomfort or inconvenience this may cause and thank you for your understanding.
  Please note:
  During busy periods, seating in our waiting areas may be limited. We kindly ask that family members and friends accompanying patients be prepared to offer their seat to a patient in need. Your understanding and cooperation help ensure comfort and care for everyone.
  Respect for staff
  Our staff are here to help and care for you. Please treat them with kindness and respect.
  We understand that coming to the Emergency Department can be stressful, but we do not tolerate any form of abuse, aggression, or violence.
  Anyone who is threatening, aggressive, or damages Trust property may be asked to leave by security. Serious behaviour may lead to prosecution or being excluded from
  services at this Trust.
  Thank you for helping us keep everyone safe.
  
  Initial assessment
  A nurse will call your name and ask questions about how you feel. This is the initial assessment, where we check how serious your illness or injury is. You may be given pain relief if needed. The
  nurse will also check your temperature, pulse, blood pressure, and oxygen level. If needed, you may be asked to give a urine sample.
  You might be sent for tests, like blood tests, an ECG (to check your heart), or X-rays. We will arrange these separately.
  If you are vomiting or have diarrhoea, please tell the nurse straight away.
  Before any treatment or procedure, staff will confirm your identity. They will ask your name, date of birth, and allergies. They will look at your ID band. If you don’t have an ID band, they will ask where you live. If we forget, please remind us — this keeps you safe.
  If your GP has referred you to a specialist, the nurse will let them know you are here. If there isn’t a bed available, the specialist will come to see you in the Emergency Department. They may be delayed because they are caring for other patients.
  After your initial assessment, the nurse may decide you don’t need to stay in the Emergency Department. You might be directed to a service that can help you more appropriately. This could include:
• Minor Injuries Unit – We have a Minor Injuries stream within the Emergency Department, and you will be called when it’s your turn to be seen. If the wait is long, you may choose to
  visit a nearby Minor Injuries Unit instead – see page 7 for more information.
  
• A hospital GP – you will stay in the waiting area until you are called.
• Ambulatory Emergency Care – you will stay in the hospital and be called when it’s time to go.
• Your own GP – you may be advised to make an appointment and leave the department.
• Emergency Dental Service – you may be given contact details to arrange an appointment elsewhere.
  You will then go back to the waiting area. A Doctor, Emergency Nurse Practitioner, or GP will see you next. They have separate queues, so someone else may be called before you – this is normal.
  Babies and children wait in the Children’s Emergency Department (CED), where they are cared for by specialist children’s Nurses and Healthcare Assistants (HCAs), but are seen by the same team of
  Doctors as adults.
  If you have any questions or need help, please ask any member of our staff. We are here to keep you safe and comfortable.
  
  Managing your care and comfort
  Pain relief
  If you’re in pain or discomfort, please inform a staff member immediately. We’re here to help and can provide appropriate pain relief.
  Your own medication
  If you take time-critical medications, such as those for Parkinson’s disease, epilepsy, diabetes, or take long-term steroids, please inform the Nurse in Charge. We want to ensure you receive your medication on time.
  Pressure area care
  To help protect your skin while waiting in the Emergency Department, try to change your position regularly and use any available cushions or footrests to elevate your legs and offload your heels. These small actions can help reduce the risk of skin break down and pressure damage. If you need assistance or have concerns, please inform the waiting room staff.
  Eating and drinking
  Staying comfortable while you wait is important. In most cases, eating and drinking is fine. However, if you’re likely to need surgery or certain procedures, you may be asked to avoid eating or drinking. If you’re unsure, please ask the nurse who assessed you. They can advise whether it’s safe for you to eat or drink at this time.
  
  We provide light refreshments such as sandwiches and hot drinks for patients, along with biscuits and hot drinks for accompanying relatives. As our supply of sandwiches is limited, they are primarily
  for patients; however, with discretion, we can offer sandwiches to relatives or children when needed. Vending machines are also available in the waiting area. Please help us keep the space tidy by
  disposing of any packaging or leftovers in the bins provided.
  If you have diabetes or any dietary needs, let a member of staff know so we can support you appropriately.
  Smoking
  Smoking and vaping are not allowed on our premises or grounds. If you need to smoke, please use the designated smoking area away from entrances. Bins are provided for your
  convenience.
  If you would like assistance with quitting smoking, please ask a member of staff for advice on smoking cessation.
  
  Privacy, dignity and your rights
  Mobile phones, videos and
  photography
  We know mobile phones are important for staying in touch. Please use your phone politely so you don’t disturb others.
  Phones can affect medical equipment, so follow any staff instructions about phone
  use. Recording videos or photos is not allowed to protect everyone’s privacy. If you want to record something, please ask a member of staff first.
  
  There are locked boxes behind the nurses’ station where you can charge your phone for free, with charging cables provided.
  However, very old phones may not be compatible, so bringing your own cable might be useful.
  Looking after your valuables
  Please avoid bringing valuables into the hospital. If you need to store any valuables, feel free to ask us to lock them in the
  Emergency Department safe. Please note that we cannot accept responsibility for any items or valuables brought into the hospital.
  Care provided by students
  We support the training of medical, nursing and allied health students, including physiotherapists, occupational therapists, radiographers and paramedics. If you prefer not to have students
  involved in your care, please inform your doctor or nurse. Your decision will not affect the treatment you receive.
  
  Chaperones during examination
  You can request a chaperone before any examination. For intimate examinations a chaperone will always be present. If you prefer a chaperone of the same gender, we will make every effort to
  accommodate this request. However, availability may vary and in such cases, we can offer a trained healthcare assistant, medical or nursing student, or another clinician as your chaperone. If you
  choose not to have a chaperone present, please be aware that for intimate examinations, this may not be appropriate.
  Sharing your information
  We routinely share information about child attendances with paediatric health visitors. We will only share your information with the police if there is a legal obligation to do so (e.g. in the case of a Road Traffic Accident) or if we have your written consent. Your privacy is a priority, and we handle your information with care.
  Leaving before seeing a doctor (self-discharge)
  If you no longer think your condition is an emergency and wish to leave before seeing a doctor, please tell a nurse first. They’ll check to ensure it’s safe. You’ll receive clear advice on how to care for yourself at home, when to return if you need to and where to seek help, like from your GP, pharmacist, dentist, or NHS 111.
  Our aim is to make sure you leave with confidence and the right support in place. If your condition worsens, please return to the Emergency Department immediately.
  
  Support for patients with additional needs
  Accredited Assistance Dogs
  Accredited Assistance Dogs (ADUK) are welcome at our hospital. These dogs are specially trained, regularly assessed and insured. Dogs must wear their working coat and lead, and owners should bring a mat for the dog to rest comfortably. Please carry your Assistance Dog ID Booklet, as staff may ask to see it.
  For hygiene and safety, assistance dogs must not be fed on Trust premises. Additionally, walking and toileting remain the owner’s responsibility, as staff cannot assist with these tasks.
  Some areas (e.g. X-ray or scanner rooms) may restrict dog access for safety reasons. Our staff will assist with alternative arrangements if needed.
  Carer support
  If you have a carer accompanying you, please inform staff so we can ensure appropriate support is provided during your visit.
  Interpreting and communication support
  We offer a range of interpreting and communication services to assist patients who speak little or no English, or who are D/deaf or hard of hearing:
• Video, telephone and face-to-face interpreting
• Alternative formats (Large Print, Easy Read, Braille and Moon Services)
• British Sign Language (BSL)
• Wordskii-on-Wheels (WoW): A mobile device that connects patients with an interpreter for real-time conversations with clinical staff, available 24/7.
  Please let us know your preferred method of communication upon arrival.
  Support for learning disabilities
  We are committed to providing equal access to healthcare for individuals with learning disabilities. To support you during your visit:
• Hospital passport: If you have a hospital passport, please present it during triage. It provides essential information about your healthcare needs and preferences.
• Lanyard identification: Wearing a lanyard or wristband can discreetly signal that you may need extra support or time.
• Distraction techniques: Our Play Specialists offer various distraction methods and sensory equipment to support better communication.
• Reasonable adjustments: We will make reasonable adjustments to information, communication, and time to improve your experience.
• Learning disability liaison nurses: Are available to assist patients with learning disabilities and their families.
  
  Mental health support
  If you’re experiencing a mental health crisis, whether it’s a sudden worsening of an existing condition or you’re facing challenges for the first time, immediate help is available.
  24/7 Mental health helpline
   0808 196 9127
  Freephone, available 24 hours a day, 365 days a year.
  Trained mental health professionals are ready to listen and assist you.
  NHS 111 – Mental health option
   Call 111 and select the mental health option (Option 2) to speak with a trained advisor. This service is available 24/7.
  If you’re D/deaf or hard of hearing, you can access support through NHS 111 via Relay UK at https://www.relayuk.bt.com
  Support for children and young people
  Childline:
   0800 1111 (free and confidential, available 24/7).
  This number will not appear on your phone bill.
  YoungMinds: Visit www.youngminds.org.uk for resources and support.
  Additional support services
  Samaritans
   116 123 or email [email protected] for confidential support.
  
  Shout Crisis Text Line
  Text “WOO” in Worcestershire or “HERE” in Herefordshire to 85258 for free, 24/7 support.
  Mind
  Visit www.mind.org.uk for information and support.
  If you’re already receiving mental health support. Please contact your usual mental health team first, unless it’s outside of their working hours. If you’re unsure, the helpline staff can guide you to the appropriate support.
  
  When you’re ready to go home
  Once we confirm it’s safe for you to leave, we’ll let you know and send an electronic letter to your GP. This letter will outline your visit, including all treatments, tests, and any further care or
  investigations needed.
  Outpatient appointments
  If you require a follow-up appointment – like for a fracture clinic – please speak to our reception team before you leave. They can help book it for you.
  Prescriptions and medication
  You’ll typically go home with enough medication to last 5-7 days.
  If a prescription is needed, this will be included in your GP letter.
  Please arrange a repeat prescription from your GP before your hospital supply runs out. Remember, some GP surgeries need up to 48 hours to process requests.
  Getting home
  The hospital is well-served by public transport; however, we are unable to provide transport home for most patients, including those who arrived by ambulance. You will need to arrange your
  own transport.
  Our reception team can assist with local bus timetables or taxi numbers, and the Nurse in Charge can help if you need to use a phone. There’s a free taxi phone in the waiting room for you to use whenever you need it. We’re really sorry, but we’re not able to cover taxi fares, so these will need to be paid by the patient.
  
  Before you leave
  If you have any concerns about your treatment or discharge, please speak to the Nurse or Doctor in Charge. We’re here to help and want to ensure you leave feeling safe and informed.
  What to do if your condition doesn’t improve
  If you continue to feel unwell or if your condition worsens after going home, please take action:
• Contact your GP or call NHS 111 for advice.
• In an emergency, call 999 immediately.
  
  Patient experience
  We’re here to support you
  We understand that being in the hospital can be a stressful and uncertain time for you and your loved ones. If you have any questions or concerns at any point, please speak to a member of staff in the department. They are here to help, answer your questions, and provide reassurance.
  Your feedback matters
  Your feedback is very important to us. It helps us understand what we are doing well and where we can improve. There are several easy ways to share your experience:
• Complete a Friends and Family Test (FFT) card, available from any member of staff.
• Visit www.worcsacute.nhs.uk/FFT
• You will also receive a text message 24 hours after you are discharged from the Emergency Department inviting you to share your thoughts.
  Thank you for taking the time to help us improve our services.
  
  Patient Advice and Liaison Service (PALS)
  If you have any concerns or questions about your care, please speak first with the nurse in charge or the department manager.
  They are best placed to resolve any issues quickly.
  If your concern is not resolved, you can contact the PALS team.
  They provide informal help, advice, and support on any aspect of hospital services and experiences. PALS can also liaise with different hospital departments on your behalf if needed, and refer
  you to outside support when appropriate.
  If you remain unhappy, you can contact the Complaints Department. Complaints can be made verbally, by email or in writing. The PALS team will guide you through the complaints
  process.
  How to contact PALS
   0300 123 1732
   [email protected]
  Opening Hours: Monday to Friday: 8:30am to 4:00pm
  You may need to leave a voicemail message, but we aim to return your call within one working day.
  Need help understanding this leaflet?
  If you have difficulty understanding this information, please ask a member of staff for assistance.
  
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