Health bosses aren’t lovin’ it: A&E treated “like a McDonald’s”

David Farquharson said patients are treating A&E "like a Mcdonald's"

A TOP hospital boss has lashed out at patients for using his accident department “like a Mcdonald’s”.

David Farquharson criticised the growing number of people seeking emergency treatment Edinburgh Royal Infirmary who are suffering only from “coughs and colds”.

He claimed that young people in particular seemed to view the emergency department as the medial equivalent of the fast-food business.

And he complained that the hospital was struggling to meet its waiting time targets as a result of being clogged with trivial cases.

Mr Farquharson, medical director at NHS Lothian, said: “The main challenge is in the increasing number of the public accessing A&E in the first place.

“Often they are not going to the GP and they are using A&E as primary care.”

He added: “There’s a number of young people who don’t have GPs, who like to use this as instant access to healthcare – much as they go for an instant meal in McDonald’s, they go to A&E for instant healthcare delivery.

“There are people using A&E for coughs, colds, bee stings. They can be really very minor.”

Mr Farquharson said moving patients to other areas of the hospital was key to slashing waiting times.


He added: “I think it’s important to look at the flow of patients through the hospital itself.

“It’s not just an A&E problem, this is something that everybody working within the Royal Infirmary needs to take some responsibility for.”

The vice-chairman of the NHS Lothian Board, Eddie Egan, agreed with Mr Farquharson. At the health board’s annual review he said patients also needed to pay more heed to the word “emergency”.

He said: “The clue is in the name. We still have significant numbers of people who arrive at A&E across Lothian who don’t need to be at A&E.”

Margaret Watt, chairwoman of the Scotland Patients Association, said the NHS should crack down on abuses of A&E services.

She said: “We have got to educate them, to say ‘these are the kind of things you take to your doctor’. We should be saying ‘you have to be registered with a GP and you can’t be accessing treatment from the NHS unless you’re registered with a GP’.”

The Accident and Emergency department is designed to care for people with problems which are “urgent and emergencies”.

The health board treats minor injuries such as cuts, burns, sprains and simple fractures at a dedicated facility at the Western General Hospital.

Government guidelines on waiting times state that 98% of patients should be seen within four hours of arriving at A&E, but the health board has consistently failed to meet these targets.

In the past year, the only month in which NHS Lothian hit this target was August.

Mr Egan agreed echoed Mr Farquharson’s views in his review.

He said:  “The Royal Infirmary is a key challenge. For somebody coming out of A&E, the bed needs to be there.”

Last year it was reported that the NHS is wasting millions of pounds treating the “worried well”

Dr Iona Heath, the president of the Royal College of General Practitioners, said hospitals had to focus on people who were actually ill rather than try and prevent illness.

And doctors at Ninewells Hospital in Dundee last year accused hypochondriacs of clogging up the A&E by coming in with trivial complaints

Dr Morrison, head of the Scottish branch of the College of Emergency Medicine, said patients bypassing their GP to ask for treatment at A&E was resulting in an extra 130,000 visits every year.

More than 1.5 million patients visit accident and emergency departments each year.

The cost of the service rocketed in the three years between 2008 and 2010 by £3million to almost £150million.