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Research Report
Urgent and Emergency Care - Research Among Residents
Prepared for: Barking and Dagenham, Havering and Redbridge Clinical Commissioning Groups
Urgent and Emergency Care - Research Among Residents
Prepared for: Barking and Dagenham, Havering and Redbridge Clinical
Commissioning Groups
Prepared by: Steve Handley, Research Director
Date: March 2016
Produced by BMG Research
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Table of Contents
1 Introduction .................................................................................................................... 4
1.1 Context ................................................................................................................... 4
1.2 Methodology ........................................................................................................... 4
1.3 Weighting the data .................................................................................................. 4
1.4 Interpreting the data ................................................................................................ 5
2 Key findings ................................................................................................................... 6
2.1 Service awareness .................................................................................................. 6
2.2 Service usage ......................................................................................................... 6
2.3 Advice and signposting ........................................................................................... 7
2.4 Interest in personalised IT solution .......................................................................... 7
2.5 Views on over-use of Accident and Emergency ...................................................... 8
3 Service awareness and usage ....................................................................................... 9
3.1 Service awareness .................................................................................................. 9
3.2 Service use ........................................................................................................... 15
4 Accident and Emergency Visitors ................................................................................. 17
4.1 Visitor profile ......................................................................................................... 17
5 Urgent Care Centre Visitors ......................................................................................... 22
6 Walk In Centre Visitors ................................................................................................. 23
7 GP Hub Visitors ........................................................................................................... 25
8 Interest in personalised IT solution ............................................................................... 26
9 Anticipated response to care and advice scenarios ...................................................... 29
9.1 Non urgent scenario .............................................................................................. 29
9.2 Urgent scenario .................................................................................................... 30
9.3 Emergency scenario ............................................................................................. 32
10 Suggested reasons for over-use of Accident and Emergency Departments ............. 33
11 Sample profile .......................................................................................................... 35
11.1 Barking and Dagenham ........................................................................................ 35
11.2 Havering ............................................................................................................... 37
11.3 Redbridge ............................................................................................................. 39
12 Appendix: Statement of Terms ................................................................................. 41
Urgent and Emergency Care - Research Among Residents
2
Table of Figures
Figure 1: Have you heard of the following services where you can get help with treatment, or
advice for urgent and emergency care? (All responses) ...................................................... 10
Figure 2: Awareness of location of Nearest NHS walk in Centres/Urgent Care Centres (All
responses) .......................................................................................................................... 14
Figure 3: Profile of A&E visitors (All visitors in last 6 months -respondent or household
members) ............................................................................................................................ 17
Figure 4: Thinking about your last visit to A&E did you seek any advice on the best place to
go for care and treatment before you went? (All visitors to A&E in the last 6 months) ......... 18
Figure 5: And again thinking about your last A&E visit, had you...? (All A&E visitors in the last
6 months) ............................................................................................................................ 20
Figure 6: Please now think about your last visit to A&E. What was your main reason for
going to A&E? (All A&E visitors) .......................................................................................... 21
Figure 7: Thinking about your last visit to An Urgent Care Centre did you seek any advice on
the best place to go for care and treatment before you went? (All visitors in the last 6
months) ............................................................................................................................... 22
Figure 8: Profile of Walk in Centre visitors (All visitors in last 6 months respondent or
household members) .......................................................................................................... 23
Figure 9: Thinking about your last visit to Walk In Centre did you seek any advice on the
best place to go for care and treatment before you went? (All visitors in the last 6 months) 24
Figure 10: Thinking about your last visit to a GP Hub did you seek any advice on the best
place to go for care and treatment before you went? (All visitors in the last 6 months) ........ 25
Figure 11: Potential users of IT solution (All responses) ...................................................... 26
Figure 12: What do you think would be the main advantages of such site/app? (All those
who think they would use it) ................................................................................................ 27
Figure 13: Can you explain why you would be unlikely to use such a website or mobile
phone app? (All those who think they would not use it) ....................................................... 28
Figure 14: Suggested response to non-urgent scenario – David’s cough (All responses) ... 29
Figure 15: Suggested response to urgent scenario – Rosie’s cough (All responses) .......... 30
Figure 16: Suggested response to urgent scenario – Sarah’s accident (All responses) ....... 32
Introduction
3
Table of Tables
Table 1: Area analysis ........................................................................................................... 5
Table 2: Service awareness by borough (All responses) ..................................................... 11
Table 3: Service awareness among particular resident groups (All responses) ................... 12
Table 4: Awareness of sources of treatment and advice for urgent and emergency care by
A&E use in the last 6 months (All responses) ...................................................................... 13
Table 5: Use of services for urgent and emergency care in the last 6 months – respondent or
household member (All responses) ..................................................................................... 15
Table 6: Use of services for urgent and emergency care in the last 6 months – by borough
(All responses) .................................................................................................................... 16
Table 7: Use of prior advice among A&E visitors by age (All visitors to A&E in the last 6
months) ............................................................................................................................... 19
Table 8: Suggested response to urgent scenario (Rosie’s breathlessness) by age (All
responses) .......................................................................................................................... 31
Table 9: Suggested reasons why people tend to go to A&E when they have non-emergency
issues (All responses) ......................................................................................................... 34
Urgent and Emergency Care - Research Among Residents
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1 Introduction
1.1 Context
In February 2016 BMG Research was commissioned by Barking and Dagenham,
Havering and Redbridge (BHR) Clinical Commissioning Groups to undertake a
residents’ survey using a telephone methodology.
This survey was designed to explore awareness among residents of the three
boroughs (1,000 per borough) of urgent and emergency care services and current
levels of service usage. The research was commissioned to provide evidence of how
residents currently negotiate through the complexity of urgent and emergency care
provision and to identify how non-emergency cases might be diverted away from A&E
departments given that these resources are currently over-used by individuals with
non-emergency conditions. Along with accompanying qualitative insight this
quantitative research will be used to support the process of urgent and emergency
care transformation.
1.2 Methodology
The results in this report are based on a survey of 3,002 telephone interviews
conducted from a sample of Ashfield residents between 2nd & 21st March 2016. 1001
interviews were completed with Barking and Dagenham and Havering residents and
1000 were completed among Redbridge residents. Interviewing targets were set in
such a way that the data collected per borough is representative in its own right. Per
borough, interviewing targets were set by ward to ensure geographical coverage and
by age and gender. Ethnicity was also monitored per borough. Targets were set with
reference to the 2011 census data available per borough.
Interviews were conducted using a mix on randomly generated numbers for the three
boroughs, supplemented by telephone numbers attributable to these locations, e.g.
mobile numbers known to be held in residents of these boroughs. The inclusion of the
latter helps to ensure that younger residents and those without landlines are not
unnecessarily excluded from the research.
1.3 Weighting the data
The extent to which results can be generalised from a sample depends on how well
the sample represents the population from which it is drawn. As for all surveys of this
type, although a random sample of telephone numbers was selected, the achieved
sample was not perfect.
Under these circumstances, inferences about the views of the population can be
improved by calculating weights for any under or over-sampling of particular groups.
Weights are assigned by comparing the sample proportions for particular groups with
known population characteristics from other sources for the same groups. Each
observation is then multiplied by its weight to ensure that the weighted sample will
conform to the known population characteristics.
Introduction
5
To ensure that data set is representative the data has been weighted by ward, age,
gender and ethnicity at a borough level. A final weight has then been applied based on
the relative population size (18+) of each borough to ensure that the data set is
representative of the overall survey area.
1.4 Interpreting the data
On an observed statistic of 50%, a sample size of 3,002 is subject to a maximum
standard error of +/-1.8% at the 95% level of confidence. This means that if all
residents in BHR had responded to the survey, we are 95% confident that a figure of
50% in this report would actually have been between 51.8% and 48.2%.
At a borough level the data has a maximum standard error of +/-3.1% at the 95% level
of confidence. This is still highly robust.
Results have been presented rounded to 0 decimal places – this may mean that some
totals exceed 100%. This also has implications regarding how summary percentages
appear. For example, if 25.4% of residents state they are very satisfied and 30.3% of
residents are fairly satisfied, these figures are rounded down to 25% and 30%
respectively. However, the sum of these two responses is 55.7%, which is rounded up
to 56%, whereas the individual rounded responses suggest this total should be 55%.
This explains any instances of where summary text does not match a graph or table it
is referring to.
Given the sample size and the number of wards within the sample it is not appropriate
to view the data at ward level. For analysis purposes wards in immediate proximity to
hospitals/A&E departments have been grouped together as shown by Table 1.
Table 1: Area analysis
Wards closest to hospitals /A&E
Chadwell Heath, Whalebone, Seven Kings, Chadwell, Aldborough, Newbury, Brooklands, Romford Town, Hylands, Eastbrook
Wards further from hospitals /A&E
All other wards
Further analysis by Locality (further ward groupings) within each borough is also
planned later within this data analysis process.
Urgent and Emergency Care - Research Among Residents
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2 Key findings
Analysis of the 3,002 surveys identifies the following key findings.
2.1 Service awareness
Only half (51%) of residents overall are aware of NHS Choices as a source of
advice about urgent and emergency care. Even among those who state that they
have internet access, this proportion only rises to 55%. On this basis it appears
that there is potential to increase awareness of this signposting resource.
While awareness of Walk In Centres is high at 94% awareness of Urgent Care
Centres at 37% is 59-percentage points lower than the awareness of A&E
departments (96%) despite these two resources being co-located.
Any focus on raising awareness of GP Hubs and GP Out of Hour’s services
should focus on Barking and Dagenham and Redbridge. Havering residents are
more likely to be aware of Out of Hours GP services (81%) than residents of both
Barking and Dagenham (77%) and Redbridge (76%). Havering residents are also
more likely to be aware of GP Hubs (51%).
A&E users in the last 6 months do not have significantly lower awareness of other
urgent and emergency care services than non-users. Indeed, where significant
variations do exist, these show that A&E visitors have a higher awareness of
some of the other providers of urgent and emergency care than non-users. On
this basis, it would appear that it is not simply the case of ignorance of other
services driving A&E attendance. The reality is likely to be a more complex mix of
awareness and understanding of what each service can offer and when these
services can be accessed.
2.2 Service usage
In the last 6 months A&E is the third most commonly used source of urgent and
emergency care after GPs and chemists. Residents are most likely to have used
their Doctor/GP in the last six months (72%), followed by a chemist/pharmacy
(69%). Accident and Emergency was the third most commonly used by
respondents or their households at 31%. Within this, 18% of A&E users within the
last 6 months only went on one occasion, the highest proportion across all of the
listed services. The proportion who visited A&E in the last 6 months is 8 times
larger than the proportion that went to an Urgent Care Centre (4%).
The proportion of those who state that either they, a household member, or
someone they care for has been to A&E in the last 6 months is significantly
higher among the 18-34 age group (38%) and among those aged 35 to 54
(33%). Parents with children aged 0-5 (41%), those with a long term illness or
disability (35%) and those with caring responsibilities (41%) are all significantly
Key findings
7
more likely to have visited A&E than those who do not have these
roles/conditions.
2.3 Advice and signposting
Where NHS advice/signposting is sought for heath issues the advice received is
followed in the majority of cases. Among those who visited A&E in the last 6
months and sought prior advice either from an NHS information source such as
111 or NHS Choices or from a healthcare professional 87% said that the advice
they received was to go to A&E. Similar proportions are seen among Urgent Care
Centre visitors (91% of those who sought NHS advice were advised to go here),
those who went to a Walk In Centre (87%) and those who went to a GP Hub
(86%).
When considering scenarios where advice and treatment would be required there
is evidence of younger residents being more likely to seek information prior to
treatment. For example, in a scenario where someone with ongoing health issues
is experiencing breathlessness more than twice as many 18-34 year olds (37%)
would suggest phoning NHS 111 than those aged 65 and over (16%). This
younger age group are also most likely to suggest searching for advice online
(4%). Among older residents (aged 65+) the most common suggestion is calling a
GP.
Furthermore, among A&E visitors in the last 6 months, analysis by age shows
that those aged 18-34 and 35-54 are most likely to have sought advice from an
NHS information source prior to their attendance at A&E (26% and 24%
respectively).
2.4 Interest in personalised IT solution
Looking to the future residents were asked to state whether they would be
interested in a personalised IT solution to help them access healthcare locally.
All were asked:
If the local NHS had a website or app which held all your health information,
where you could get advice, chat with a doctor or nurse if necessary or book
yourself into appointments with your GP or a clinic, do you think you would you
use it?
A clear majority of 79% express an interest in such a solution, suggesting they
would use it, while 21% said they would not use it. Breaking these responses
down further shows that among those with access to the internet 84% would be
interested in such a website or app compared to 47% of those who do not have
internet access.
Urgent and Emergency Care - Research Among Residents
8
2.5 Views on over-use of Accident and Emergency
When asked why they think that people tend to go to A&E when they have non-
emergency issues the key themes that emerge are:
o Awareness of the alternatives;
o Resource/capacity issues with other services;
o Speed/convenience;
o Reassurance/trust issues;
o Personal circumstances or characteristics;
o Uncertainty;
o Habit; and,
o Referrals.
Within these comments there are two responses that are particularly prevalent.
The first is that individuals cannot get an appointment with a GP or other care
services (33%). This includes comments on GP appointments taking too long to
get, GP practice hours and GPs being overworked. The second major suggestion
is that the public don't know of other services or are not well informed (31%). The
dominance of these two comments suggests that future strategies will need to
assess both capacity issues in care provision and information
provision/signposting in relation to urgent and emergency care. The other
comments suggest that awareness raising will need to develop trust in the
alternatives in terms of both the quality of care and its availability.
Service awareness and usage
9
3 Service awareness and usage
3.1 Service awareness
Before residents were asked any questions on the subject matter all were provided
with definitions of urgent and emergency care. These definitions were:
Emergency care is provided in a medical emergency when life or long term
health is at risk, such as serious injuries or blood loss, chest pains, choking or
blacking out.
Urgent care is defined as care needed the same day. This could include cuts,
minor injuries, and mild fever or wound infections.
The purpose of providing these definitions was to ensure that residents answered
within the same broad level of understanding throughout the subsequent questions. In
this context residents were first of all asked whether they had heard of fourteen
possible sources of treatment or advice for urgent and emergency care. The list of
services was randomised in the survey to avoid order basis in the responses given.
While near universal awareness is evident for services such as 999, (97%) A&E
(96%) and GPs (96%) providing advice and treatment in the urgent and emergency
context, levels of awareness of other services vary considerable. While this may have
been expected there are notable findings from within these responses.
Firstly, only half (51%) of residents overall are aware of NHS Choices as a source of
advice about urgent and emergency care. Even among those who state that they have
internet access, this proportion only rises to 55%. On this basis it appears that there is
potential to increase awareness of this signposting resource.
Secondly, the awareness of Walk in Centres is high at 94%. This awareness is nearly
twice as high as that for appointment based, but same day service of GP Hubs (49%).
Thirdly awareness of Urgent Care Centres at 37% is 59-percentage points lower than
the awareness of A&E departments (96%) despite these resources being co-located.
Urgent and Emergency Care - Research Among Residents
10
Figure 1: Have you heard of the following services where you can get help with treatment, or advice for urgent and emergency care? (All responses)
Unweighted sample base: 3,002
49%
66%
14%
6%
4%
22%
64%
51%
6%
63%
4%
3%
76%
39%
51%
34%
86%
94%
96%
78%
36%
49%
94%
37%
96%
97%
24%
61%
NHS Choices website
Non-NHS health advice websites
NHS 111 telephone helpline
Chemist/Pharmacy
Doctor/ GP
Out of Hours GP Services
Mental Health Direct telephone helpline
GP Hubs where you can get same day appointments in the evening or at weekends with local doctors
Walk in Centre
Urgent Care Centres (UCCs)
Accident and Emergency (A&E)
999 (London Ambulance Service)
Community Treatment Team
Emergency dentists
No Yes
Service awareness and usage
11
Breaking the responses down spatially shows some significant variations in awareness
by borough. Levels of awareness that are significantly different to at least one other
borough are denoted by bold figures in Table 2. Among these variations the most
notable are:
Havering residents are significantly less likely to be aware of the NHS Choices
website (47%). This may reflect the fact that this borough has an older population
relative to Barking and Dagenham and Redbridge.
Havering residents are more likely to be aware of Out of Hours GP services
(81%) than residents of both Barking and Dagenham (77%) and Redbridge
(76%). Havering residents are also more likely to be aware of GP hubs (51%).
Redbridge residents are significantly less likely to be aware of the Community
Treatment Team as a provider of urgent/emergency care (21%).
Table 2: Service awareness by borough (All responses)
Total
Barking and Dagenham Havering Redbridge
NHS Choices website 51% 52% 47% 54%
Non-NHS health advice websites 34% 32% 35% 34%
NHS 111 telephone helpline 86% 85% 88% 84%
Chemist/Pharmacy 94% 93% 96% 94%
Doctor/ GP 96% 96% 96% 97%
Out of Hours GP Services 78% 77% 81% 76%
Mental Health Direct telephone helpline
36% 39% 37% 33%
GP Hubs where you can get same day appointments in the evening or at weekends with local doctors
49% 47% 51% 49%
Walk in Centre 94% 96% 95% 91%
Urgent Care Centres (UCCs) 37% 39% 35% 37%
Accident and Emergency (A&E) 96% 95% 98% 95%
999 (London Ambulance Service) 97% 97% 98% 97%
Community Treatment Team 24% 26% 27% 21%
Emergency dentists 61% 61% 68% 56%
Unweighted sample base 3002 1001 1001 1000
Urgent and Emergency Care - Research Among Residents
12
Service awareness among the particular resident sub-groups this research sought to
focus on are shown in the table below, with significant variations highlighted. This
suggests that parents have significantly higher awareness of online sources of
advice/signposting than non-parents. This is likely to be interrelated with variations in
online access/use by age. Parents are also more likely to be aware out Out of Hours
GP services and GP Hubs. Analysis among those who state that they have caring
responsibilities (unpaid, for a friend or family member, who cannot cope without their
support) shows these individuals are significantly more likely to be aware of the more
specialist services asked about, namely the Mental Health Direct helpline (44%) and
the Community Treatment Team (33%).
Table 3: Service awareness among particular resident groups (All responses)
PARENT
LONG TERM HEALTH PROBLEM/DISABILITY CARER
Yes No Yes No Yes No
NHS Choices website 57% 47% 44% 52% 52% 51%
Non-NHS health advice websites
36% 32% 27% 35% 32% 34%
NHS 111 telephone helpline 87% 85% 89% 85% 91% 85%
Chemist/Pharmacy 94% 95% 95% 94% 94% 95%
Doctor/ GP 97% 96% 96% 96% 97% 96%
Out of Hours GP Services 81% 76% 74% 79% 80% 78%
Mental Health Direct telephone helpline
34% 37% 38% 35% 44% 35%
GP Hubs where you can get same day appointments in the evening or at weekends with local doctors
53% 47% 47% 50% 54% 49%
Walk in Centre 94% 93% 92% 94% 93% 94%
Urgent Care Centres (UCCs) 38% 36% 36% 37% 39% 37%
Accident and Emergency (A&E)
96% 97% 97% 96% 96% 96%
999 (London Ambulance Service)
97% 98% 99% 97% 97% 97%
Community Treatment Team 24% 25% 33% 23% 33% 23%
Emergency dentists 62% 61% 54% 63% 63% 61%
Unweighted sample base 1194 1791 585 2408 389 2601
Service awareness and usage
13
Further analysis shows that A&E users in the last 6 months do not have significantly
lower awareness of other urgent and emergency care services than non-users. This is
demonstrated by the table below. Indeed, where significant variations do exist, these
show that A&E visitors have a higher awareness of some other providers of urgent and
emergency care than non-users. On this basis, it would appear that it is not simply the
case of ignorance of other services driving A&E attendance. The reality is likely to be a
more complex mix of awareness and understanding of what each service can offer
plus when and how these services can be accessed.
Table 4: Awareness of sources of treatment and advice for urgent and emergency care by A&E use in the last 6 months (All responses)
% aware A&E user in last 6 months
Yes No
NHS Choices website 52% 50%
Non-NHS health advice websites 34% 34%
NHS 111 telephone helpline 88% 85%
Chemist/Pharmacy 96% 94%
Doctor/ GP 96% 97%
Out of Hours GP Services 80% 77%
Mental Health Direct telephone helpline 37% 35%
GP Hubs where you can get same day
appointments in the evening or at weekends
with local doctors
50% 49%
Walk in Centre 95% 93%
Urgent Care Centres (UCCs) 40% 35%
Accident and Emergency (A&E) 100% 95%
999 (London Ambulance Service) 98% 97%
Community Treatment Team 25% 24%
Emergency dentists 62% 61%
Unweighted sample base 916 2086
Urgent and Emergency Care - Research Among Residents
14
Given that Walk in Centres and Urgent Care Centres are likely to be key resources in
attempts to reduce residents with non-emergency issues presenting at A&E, a further
follow question was asked in relation to these centres. Any individual who stated that
they are aware of these centres were asked if they knew the location of their nearest
centre. In response, 79% of those aware of Walk in Centres know the location of their
nearest one. This equates to 74% of the total sample. Among those who say they have
previously heard of Urgent Care Centres 57% know the location of their nearest one.
This equates to 21% of the full sample of 3,002 residents.
While there is no significant spatial variation in awareness of the location of Urgent
Care Centres, there are significant variations in awareness of the location of Walk in
Centres. Among Redbridge residents who have heard of Walk in Centres the 70% who
are subsequently knowledgeable about the location of their nearest one is significantly
lower than in the other two boroughs. It is also notable that those living in closest
proximity to hospitals are significantly less likely to know the location of their nearest
Walk in Centre (75%) than those further afield (80%), (based on those with prior
awareness of this care service).
Figure 2: Awareness of location of Nearest NHS walk in Centres/Urgent Care Centres (All responses)
Unweighted Bases in parentheses
79%
86%
83%
70%
75%
80%
Total (2819)
Barking and Dagenham (957)
Havering (950)
Redbridge (912)
Wards closest to hospitals /A&E (517)
Wards further from hospitals /A&E (2302)
Walk In Centre
57%
55%
61%
55%
61%
56%
Total (1110)
Barking and Dagenham (391)
Havering (348)
Redbridge (371)
Wards closest to hospitals /A&E (211)
Wards further from hospitals /A&E (899)
Urgent Care Centre
Service awareness and usage
15
3.2 Service use
Any residents who said they were aware of any of the above providers of treatment
and advice for urgent and emergency care were then asked how often they, a
household member, or someone they care for had used that service during the past 6
months. These results are shown on a full sample base below in order to illustrate the
total proportion of the population who have used each service in the last six months.
This illustrates that residents are most likely to have used their Doctor/GP in the last
six months (72%) followed by a chemist/pharmacy (69%). Accident and Emergency
was the third most commonly used by respondents or their households at 31%. Within
this, 18% of A&E users within the last 6 months only went on one occasion, the
highest proportion across all of the listed services. The proportion who visited A&E in
the last 6 months is 8 times larger than the proportion who went to a UCC (4%).
Table 5: Use of services for urgent and emergency care in the last 6 months – respondent or household member (All responses)
Not aware
Aware of but
not used
1 visit
2 visits
3 visits
4 visits
5 or more visits
Total user %
NHS Choices website 49% 33% 6% 5% 2% 1% 4% 18%
Non-NHS health advice websites
66% 24% 2% 3% 1% 1% 2% 10%
NHS 111 telephone helpline
14% 62% 13% 6% 3% 1% 2% 24%
Chemist/Pharmacy 6% 25% 10% 12% 10% 5% 32% 69%
Doctor/ GP 4% 25% 17% 16% 10% 7% 23% 72%
Out of Hours GP Services
22% 62% 9% 4% 2% 1% 1% 16%
Mental Health Direct telephone helpline
64% 33% 2% 1% *% *% *% 3%
GP Hubs where you can get same day appointments in the evening or at weekends
51% 36% 6% 3% 2% 1% 1% 13%
Walk in Centre 6% 68% 15% 6% 3% 1% 1% 26%
Urgent Care Centres (UCCs)
63% 33% 3% 1% *% *% *% 4%
Accident and Emergency (A&E)
4% 66% 18% 7% 3% 1% 2% 31%
999 (London Ambulance Service)
3% 85% 8% 2% 1% *% *% 12%
Community Treatment Team
76% 22% 1% *% *% *% 1% 3%
Emergency dentists 39% 56% 5% 1% *% *% 0% 6%
Urgent and Emergency Care - Research Among Residents
16
Breaking the responses down by Borough shows that:
The proportion of residents using A&E does not vary significantly on a borough
by borough basis. More detailed spatial analysis also shows no variation in A&E
attendance between residents who live in the wards neighbouring local hospitals
and those further afield, with 31% of each group stating they or a household
member have used A&E in the last 12 months.
Use of Out of Hours GP services is most commonly seen in Barking and
Dagenham (18%). This is significantly higher than in both other boroughs. GP
Hubs are most commonly used by Redbridge residents (15%).
The 21% of Redbridge residents who have used a Walk in Centre is significantly
lower than the 28% of Havering residents and the 31% recorded among Barking
and Dagenham residents.
Table 6: Use of services for urgent and emergency care in the last 6 months – by borough (All responses)
Total
Barking and
Dagenham Havering Redbridge
NHS Choices website 18% 19% 15% 18%
Non-NHS health advice websites 10% 9% 9% 11%
NHS 111 telephone helpline 24% 26% 24% 23%
Chemist/Pharmacy 69% 69% 68% 70%
Doctor/ GP 72% 73% 68% 74%
Out of Hours GP Services 16% 18% 15% 15%
Mental Health Direct telephone helpline
3% 4% 4% 2%
GP Hubs where you can get same day appointments in the evening or at weekends
13% 13% 11% 15%
Walk in Centre 26% 31% 28% 21%
Urgent Care Centres (UCCs) 4% 5% 4% 4%
Accident and Emergency (A&E) 31% 32% 30% 31%
999 (London Ambulance Service) 12% 14% 12% 11%
Community Treatment Team 3% 2% 3% 2%
Emergency dentists 6% 7% 5% 6%
Unweighted sample base 3002 1001 1001 1000
Accident and Emergency Visitors
17
4 Accident and Emergency Visitors
Given that understanding the reasons for use of A&E when it may not be necessary is
a fundamental component of this research, any residents who said either themselves,
a household member, or someone they care for had been to A&E in the last six
months were asked some additional follow up questions. These questions sought to
examine how commonly residents seek advice before presenting at A&E and the
extent to which these visits are driven by one off problems or more long standing
issues.
4.1 Visitor profile
Using the responses to the previous question on service use it is possible to identify
which resident groups are more likely to have visited A&E in the last 6 months. It must
however be recognised that this analysis takes into account the characteristics of the
individual completing the survey, and that these individuals could have said that
another member of their household or someone they care for attended A&E in this
period.
Figure 3: Profile of A&E visitors (All visitors in last 6 months -respondent or household members)
Unweighted sample bases in parentheses
31%
32%
30%
31%
38%
33%
21%
21%
30%
32%
41%
35%
35%
34%
27%
35%
29%
41%
29%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Total (3002)
Barking and Dagenham (1001)
Havering (1001)
Redbridge (1000)
18 to 34 (866)
35 to 54 (1151)
55 to 64 (406)
65+ (579)
Male (1326)
Female (1676)
Parent -child 0 to 5 yrs (608)
Parent -child 6 to 10 years (521)
Parent -child 11 to 15 years (419)
Parent -child 16 to 18 years (258)
Non-parent (1791)
Long term illness/disability (585)
No log term illness /disability (2408)
Carer (389)
Non carer (2601)
Urgent and Emergency Care - Research Among Residents
18
With this caveat in mind it is still notable that significant variations in those who say
they or a member of their household had been to A&E in the last 6 months. As shown
by the figure above the proportion using this service is significantly higher among the
18-34 age group (38%) and among those aged 35 to 54 (33%). Parents with children
aged 0-5 (41%), those with a long term illness or disability (35%) and those with caring
responsibilities (41%) are all significantly more likely to have visited A&E than those
who do not have these roles/conditions.
Among those who indicate either themselves, a household member or someone they
care for have been to A&E in the last 6 months, two in five (39%) did not seek any
prior advice before attending, with a further 19% being taken to A&E directly by
ambulance. A further two in five however did seek some form of prior advice either via
a NHS information source such as 111 or NHS Choices (23%) or via a healthcare
professional (22%). Please note that more than one response was possible at this
question.
Figure 4: Thinking about your last visit to A&E did you seek any advice on the best place to go for care and treatment before you went? (All visitors to A&E in the last 6 months)
Unweighted sample base: 916
23%
22%
7%
39%
19%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Yes - from an NHS information source such as 111/ NHS choices
Yes - from a healthcare professional such as a doctor, chemist
Yes - from a non-NHS source e.g. other website/friends family
No - I did not seek advice
I was taken to A&E by ambulance
Accident and Emergency Visitors
19
Breaking down these responses by age shows that those aged 18-34 and 35 to 54 are
most likely to have sought advice from an NHS information source prior to their
attendance at A&E (26% and 24% respectively). Those aged 65 and over were least
likely to have sought advice prior to going to A&E due to this group being most likely to
having gone to A&E by ambulance (46%).
Table 7: Use of prior advice among A&E visitors by age (All visitors to A&E in the last 6 months)
Total 18 to 34 35 to 54 55 to 64 65+
Yes - from an NHS information source such as 111/ NHS choices
23% 26% 24% 16% 12%
Yes - from a healthcare professional such as a doctor, chemist
22% 22% 21% 17% 23%
Yes - from a non-NHS source e.g. other website/friends family
7% 10% 5% 3% 7%
No - I did not seek advice 39% 39% 43% 41% 26%
I was taken to A&E by ambulance
19% 11% 15% 30% 46%
Unweighted Bases 916 330 381 85 120
Among those who said that they sought advice on the best place to go from an NHS
information source or a healthcare professional, 87% said that this advice was to go to
Accident & Emergency. On this basis it is possible to infer that 13% went to A&E
despite the advice suggesting an alternative course of action.
Urgent and Emergency Care - Research Among Residents
20
Among those who indicated that their visit to A&E was because of a new/one off
problem the extent to which advice was sought beforehand is not notably different to
the level seen in Figure 4 for the total sample of A&E visitors. This is a reflection of the
fact that 74% of A&E visitors in the last 6 months; i.e. a majority of this cohort; said that
their visit was in response to a new /one off problem. This is shown by the figure
below.
Figure 5: And again thinking about your last A&E visit, had you...? (All A&E visitors in the last 6 months)
Unweighted sample base: 916
The proportion of residents who stated that they had been treated somewhere else
with their problem before (23% of A&E visitors) does not vary by age or gender.
However, this proportion does rise to 32% among those with a long term illness or
disability compared to 21% among those who do not.
77%
63%
74%
26%
23%
37%
26%
74%
Been treated somewhere else with this problem before
Seen a GP with this problem before
Been to A&E with this problem before
This was a new/one off problem
No Yes
Accident and Emergency Visitors
21
Probing the reasons for A&E attendance shows that 49% of recent users state that
they had an urgent condition or injury and/or that they were taken by ambulance. A
further 24% said that they were referred by someone. The remaining 28% gave
responses that suggest that going to A&E was perhaps not the most appropriate
course of action. One in eight (13%) said they went because it was the nearest/most
convenient place, 8% said nowhere else was known to be open and 7% said that they
did not know of any alternatives.
Figure 6: Please now think about your last visit to A&E. What was your main reason for going to A&E? (All A&E visitors)
Unweighted sample base: 916
24%
13%
8%
7%
49%
0% 10% 20% 30% 40% 50% 60%
Referred by someone
Nearest/most convenient place
Nowhere else known to be open
Didn't know of any alternatives
Urgent injury/condition / taken by ambulance
Urgent and Emergency Care - Research Among Residents
22
5 Urgent Care Centre Visitors
In total, 127 of the sample indicated that they had visited an Urgent Care Centre in the
last 6 months. This small sample size does not allow us to examine the profile of
visitors in the same way as is shown in the previous chapter for A&E visitors. However,
among users of this service it is evident that slight majority of 56% sought some prior
advice before going to the Urgent Care Centre, while 44% did not.
Figure 7: Thinking about your last visit to An Urgent Care Centre did you seek any advice on the best place to go for care and treatment before you went? (All visitors in the last 6 months)
Unweighted sample base: 127
Where advice was sought either from an NHS information source or from a healthcare
professional, 91% of visitors suggested that the advice they received was to go to an
Urgent Care Centre. The majority therefore followed the signposting/advice they were
given.
35%
25%
8%
44%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
Yes - from an NHS information source such as 111/ NHS choices
Yes - from a healthcare professional such as a doctor, chemist
Yes - from a non-NHS source e.g. other website/friends family
No - I did not seek advice
Walk In Centre Visitors
23
6 Walk In Centre Visitors
The fact that 786 residents in the sample have visited a Walk in Centre in the last 6
months allows some examination of the visitor profile for this service. As shown by the
figure below, as well as Walk in Centre use being more common in Barking and
Dagenham and Havering, (as already noted previously), this service is more
commonly used among those aged 18-34 (34%) and 35-54 (29%). Alongside this
parents are significantly more likely than non-parents to have used Walk in Centres,
but the other variations in the figure below are not statistically significant.
Figure 8: Profile of Walk in Centre visitors (All visitors in last 6 months respondent or household members)
Unweighted sample bases in parentheses
26%
31% 28%
21%
34% 29%
17% 13%
27% 25%
34% 32%
34% 35%
21%
23% 27%
29% 26%
0% 5% 10% 15% 20% 25% 30% 35% 40%
Total (3002)
Barking and Dagenham (1001) Havering (1001)
Redbridge (1000)
18 to 34 (866) 35 to 54 (1151)
55 to 64 (406) 65+ (579)
Male (1326) Female (1676)
Parent - child 0 to 5 yrs (608) Parent - child 6 to 10 years (521)
Parent - child 11 to 15 years (419) Parent - child 16 to 18 years (258)
Non parent (1791)
Long term illness/ disability (585) No- long term illness/ disability (2408)
Carer (389) Non- Carer (2601)
Urgent and Emergency Care - Research Among Residents
24
More than six in ten (64%) visitors to Walk in Centres did not seek prior advice before
presenting. Among those who sought advice from an NHS source 87% state that the
advice they were given was to go to a Walk in Centre.
Figure 9: Thinking about your last visit to Walk In Centre did you seek any advice on the best place to go for care and treatment before you went? (All visitors in the last 6 months)
Unweighted sample base: 786
15%
19%
10%
64%
0% 10% 20% 30% 40% 50% 60% 70%
Yes - from an NHS information source such as 111/ NHS choices
Yes - from a healthcare professional such as a doctor, chemist
Yes - from a non-NHS source e.g. other website/friends family
No - I did not seek advice
GP Hub Visitors
25
7 GP Hub Visitors
Among the 394 residents who visited a GP Hub in the last 6 months a majority of 67%
did not seek advice on the best place to go beforehand. Among the 33% who did, one
in five (20%) said they sought advice from a healthcare professional. Again more than
one response was possible at this question.
Figure 10: Thinking about your last visit to a GP Hub did you seek any advice on the best place to go for care and treatment before you went? (All visitors in the last 6 months)
Unweighted sample base: 394
In 86% of cases those who sought NHS advice (either from an information source or a
professional) said that the advice they received was to go to a GP Hub, again
illustrating that advice is being followed in the majority of instances.
11%
20%
5%
67%
0% 10% 20% 30% 40% 50% 60% 70% 80%
Yes - from an NHS information source such as 111/ NHS choices
Yes - from a healthcare professional such as a doctor, chemist
Yes - from a non-NHS source e.g. other website/friends family
No - I did not seek advice
Urgent and Emergency Care - Research Among Residents
26
8 Interest in personalised IT solution
Looking to the future residents were asked to state whether they would be interested in
a personalised IT solution to help them access healthcare locally. All were asked:
If the local NHS had a website or app which held all your health information, where you
could get advice, chat with a doctor or nurse if necessary or book yourself into
appointments with your GP or a clinic, do you think you would you use it?
A clear majority of 79% express an interest in such a solution, suggesting they would
use it, while 21% said they would not use it. Breaking these responses down further
shows that among those with access to the internet 84% would be interested in such a
website or app, compared to 47% of those who do not have internet access. In terms
of demographics residents aged 18-34 most commonly say that they would use such
as solution (91%). Although this proportion drops to 54% among those aged 65 and
over, it should be noted that this still represents a majority of this age group.
Figure 11: Potential users of IT solution (All responses)
Unweighted sample bases in parentheses
79%
80%
75%
82%
91%
85%
70%
54%
81%
78%
84%
47%
86%
75%
66%
82%
74%
80%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Total (3002)
Barking and Dagenham (1001)
Havering (1001)
Redbridge (1000)
18 to 34 (866)
35 to 54 (1151)
55 to 64 (406)
65+ (579)
Male (1326)
Female (1676)
Internet access (2576)
No internet access (426)
Parent (1194)
Non-parent (1791)
Long term illness/disability (585)
No long term illness/disability (2408)
Carer (389)
Non-carer (2601)
Interest in personalised IT solution
27
Among those who would use a personalised website or app the most commonly
identified advantages of this are advice being available all the time/outside of working
hours (31%), access not being location specific (29%) and the site/app being a single
source of information (18%). Other advantages commonly mentioned include
personalisation (12%) and speed (12%). This question was asked in an unprompted
way with the responses given grouped into themes after the completion of data
collection. The full range of themes identified is shown in the figure below. Many of the
themes listed are related to speed/time saving and convenience.
Figure 12: What do you think would be the main advantages of such site/app? (All those who think they would use it)
Unweighted sample base: 2,348 * denotes less than 0.5%
31%
29%
18%
12%
12%
9%
9%
5%
4%
4%
3%
3%
3%
2%
2%
2%
2%
1%
1%
1%
1%
1%
1%
*%
*%
4%
4%
0% 5% 10% 15% 20% 25% 30% 35%
Available all the time/ outside of working hours
Can be accessed anywhere
Single source of information
Personalised/responses based on my health records
Speed (all mentions)
Ease of use/convenience/user-friendly
Provides me with instant advice/guidance/information
Direct access to a GP/healthcare professional
Would be able to book an appointment
Quicker response/faster communication (incl. fewer queues )
Less waste of time (for both medical and personal time)
Flexible appointment times (incl. being seen faster)
Would stop people using A&E/shorter waiting times
For peace of mind/reassurance
Directs me to the correct place
Able to stay in own home/don't have to visit the GP
It would stop people using the GP
Saves money
Greater efficiency/better organised
No need to go through receptionists/less queuing
Ability to access my medical records
Get treated/diagnosed faster
Saves on NHS resources
It's an alternative option
Offers a choice of services
Other
Don't know
Urgent and Emergency Care - Research Among Residents
28
A question was also asked to identify what barriers or concerns might exist among
those who would not use this possible IT solution. Among this cohort the most
commonly cited issues are the preference to speak to someone in person (33%), a
lack of confidence with technology (24%) and/or a lack of access to the internet and
the required technology (22%). A further 16% of this group express concern about the
security of personal data and health records.
Figure 13: Can you explain why you would be unlikely to use such a website or mobile phone app? (All those who think they would not use it)
Unweighted sample base: 654
33%
24%
22%
16%
6%
3%
3%
3%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
5%
2%
0% 5% 10% 15% 20% 25% 30% 35%
Would prefer to speak to someone in person
Do not feel confident with technology/ would not know how to use
Do not have internet access/computer/ smartphone
Concern about security of personal data/ health records
Use existing online GP booking systems
It would take too long (incl. Calling them would be quicker and easier)
Prefer to access GP/easier to access GP(unspecified)
Don't see the point/there's no need to go online
Data charges/cost to access
Don't want/like to use the internet or computers
Don't access healthcare/ only access when needed
Lack of information (incl. inaccurate information and advice)
Could lead to misdiagnosis
Cannot be diagnosed/examined over the phone or online
Old age
Reliability of technology (incl. Breakdowns)
Disability/health problems
Receive services from elsewhere
Poor quality service
Staff lack knowledge/experience
Lack of knowledge about the app
Other
Don't know
Anticipated response to care and advice scenarios
29
9 Anticipated response to care and advice scenarios
In the next section of the survey residents were asked to consider which options for
care and advice are most appropriate for specified health issues. Three scenarios
were read to residents (in a random order) and for each one residents were asked to
state what the first course of action should be. Although residents taking part in the
survey were advised that there were no right or wrong answers, the objective of these
questions was to determine what proportions might suggest using services that are
inappropriate for the severity of the issue described.
9.1 Non urgent scenario
The non-urgent scenario described to residents was as follows:
David works long hours and has to take time off work to get an appointment with his
GP. He has had a persistent cough for several weeks. His wife persuades him to get
some help. What should he do?
The range of responses to this scenario are shown by the figure below. Over half
(54%) of residents suggest that David should call his GP, with a further 13%
suggesting seeking advice online (3%) or by phone (9%). A quarter (26%) would
suggest a visit to an NHS Centre they can walk into without an appointment, while 4%
would suggest a visit to A&E. While this last percentage is small, it does demonstrate
that even for non-urgent issues some residents have a tendency to default to A&E as
their first port of call.
Figure 14: Suggested response to non-urgent scenario – David’s cough (All responses)
Unweighted sample base: 3,002
9%
3%
54%
26%
4%
2%
1%
*%
Phone NHS 111
Search for advice online
Call his GP
Go to an NHS centre you can walk into without an appointment
Go to an accident emergency department
Go see a chemist/pharmacist
Use out of hours GP service/GP Hubs
Something else
Urgent and Emergency Care - Research Among Residents
30
The proportion who would suggest that David goes to A&E about his cough peaks at
6% among those aged 65 and over, a proportion that is significantly higher than in any
other age group. It is also notable that those living closest to hospitals more commonly
suggest going to A&E than those who live further from hospitals (5% cf. 3%), with this
difference again statistically significant.
Any resident who suggested that seeking advice and care from A&E first would be
appropriate were asked why this is the case. In this non-urgent scenario 32% of those
who suggested A&E said this was most appropriate for this health problem, while 25%
said that they did not know enough about the other services., Among the other
responses given, 5% said it takes too long to get a GP appointment and 4% said A&E
was appropriate to make sure that he is seen. The remaining 32% gave other reasons.
9.2 Urgent scenario
The second scenario in the survey was an urgent one:
Rosie has a number of health issues and sees her GP regularly. Today she has been
feeling breathless and is worried. What should she do?
In response to this scenario the most common suggestions are calling a GP (33%),
closely followed by phoning NHS 111 (27%). The third most common suggestion is
that Rosie goes to A&E. The 17% who suggest this is 3-percentage points higher than
the proportion who suggest she goes to a walk in centre (14%), which is the more
appropriate choice in this situation. This perhaps illustrates ambiguity between urgent
and emergency issues.
Figure 15: Suggested response to urgent scenario – Rosie’s cough (All responses)
Unweighted sample base: 3,002
27%
3%
33%
14%
17%
5%
1%
Phone NHS 111
Search for advice online
Call her GP
Go to an NHS centre you can walk into without an appointment
Go to an accident emergency department
Ring 999/call an ambulance
Something else
Anticipated response to care and advice scenarios
31
While such ambiguity is understandable, it is interesting to note the variation by age
regarding seeking advice and information. More than twice as many 18-34 year olds
(37%) would suggest phoning NHS 111 than those aged 65 and over (16%). This
younger age group are also most likely to suggest searching for advice online (4%).
Among older residents (aged 65+) the most common suggestion is calling a GP. The
44% of this age group who suggest this action is significantly higher than the 23% of
those aged 18-34 who advocate this response. Despite these variations, the proportion
who suggest that Rosie go to A&E is consistent in each age group at between 16%
and 18%.
Table 8: Suggested response to urgent scenario (Rosie’s breathlessness) by age (All responses)
Total 18 to 34 35 to 54 55 to 64 65+
Phone NHS 111 27% 37% 27% 21% 16%
Search for advice online 3% 4% 2% 1% 1%
Call her GP 33% 23% 33% 39% 44%
Go to an NHS centre you can walk into without an appointment
14% 15% 13% 16% 14%
Go to an accident emergency department.
17% 16% 18% 16% 18%
Ring 999/call an ambulance 5% 4% 5% 6% 6%
Something else 1% 2% 2% 1% 1%
Unweighted Bases 3002 866 1151 406 579
Among those who would suggest A&E was appropriate for Rosie (181 respondents)
the perception that this is most appropriate for this health issue (57%) clearly exceeds
the lack of awareness of other sources of care (15%).
Urgent and Emergency Care - Research Among Residents
32
9.3 Emergency scenario
The third scenario for consideration was as follows:
Sarah is cycling to work when she is involved in an accident. She is briefly
unconscious but feels well enough to make her way to continue her journey. On
arrival, she feels dizzy and decides she needs to get herself checked out. What should
she do?
In response to this 54% suggest that A&E would be most appropriate for Sarah, with a
further 17% suggesting visiting a walk in centre. This suggests that generally residents
would act appropriately to an emergency scenario although 15% suggest that Sarah
should get advice via NHS 111 initially. Echoing previous results the proportion who
suggest using the NHS 111 resource is significantly higher among those aged 18 to 34
(20%).
Figure 16: Suggested response to urgent scenario – Sarah’s accident (All responses)
Unweighted sample base: 3,002
15%
1%
5%
17%
54%
8%
1%
Phone NHS 111
Search for advice online
Call her GP
Go to an NHS centre you can walk into without an appointment
Go to an accident emergency department
Ring 999/call an ambulance
Something else
Suggested reasons for over-use of Accident and Emergency Departments
33
10 Suggested reasons for over-use of Accident and Emergency
Departments
In order to complete the survey all residents were asked directly about the issue of
NHS Accident and Emergency Departments commonly treating people whose injuries
or illnesses could be treated just as well elsewhere. All were asked why they think that
people tend to go to A&E when they have non-emergency issues. This question was
asked in an open and unstructured manner allowing individuals to give their views in
their own words. Having reviewed the comments given by the 3,002 survey
participants, key themes emerge. These are:
Awareness of the alternatives;
Resource /capacity issues with other services;
Speed/convenience;
Reassurance/ trust issues;
Personal circumstances or characteristics ;
Uncertainty;
Habit; and
Referrals.
The range of comments types within these over-arching themes are shown in the table
overleaf. Within these comments there are two responses that are particularly
prevalent. The first is that individuals cannot get an appointment with a GP or other
care services (33%). This includes comments on GP appointments taking too long to
get, GP practice hours and GPs being overworked. The second major suggestion is
that the public don't know of other services or are not well informed (31%). The
dominance of these two comments suggests that future strategies will need to assess
both capacity issues in care provision and information provision/signposting in relation
to urgent and emergency care. The other comments suggest that awareness raising
will need to develop trust in the alternatives in terms of both the quality of care and its
availability.
Urgent and Emergency Care - Research Among Residents
34
Table 9: Suggested reasons why people tend to go to A&E when they have non-emergency issues (All responses)
Awareness of alternatives
Awareness: They don't know of other services/not well informed (incl. services are new)
31%
Resource /capacity issues with other services
Can't get an appointment with the GP or other services (incl. take too long/are closed/overworked)
33%
A&E have more resources/facilities 1%
Can’t get help from the chemist/pharmacist *%
Speed/convenience Speed: To get treatment/advice as quickly as possible 18%
They know they will be seen/get treatment (incl. open 24/7) 7%
Ease/convenience 7%
It’s the nearest place to them/ease of access 3%
Personal circumstances or characteristics
They are stupid/lazy (incl. other negative characteristics of the public)
6%
They are not registered with a GP 3%
They are foreign 1%
Due to the age of the patient (i.e., child, elderly person) 1%
They are drunk/homeless 1% They are ill/had an accident/injury *%
Reassurance/ trust issues
They panic/get scared/are worried 12%
Think they get better care/reassurance then at the GP/walk-in centre/NHS 111
6%
Think it's the best place to get help 2%
A&E are more professional *%
They want to see a doctor 2%
They feel safe/have faith in/trust A&E (incl. peace of mind) 3%
NHS 111 doesn’t work/is no good/a waste of time 1%
Habit It's the first option that comes to mind/habit/common practice/everyone knows it (incl. historical) 9%
Uncertainty Varying definition of emergency/they are not certain of their illness/injury (incl. misunderstanding of what A&E is for)
11%
Referrals They have been referred/advised to go 2%
*Denotes less than 0.5%
Sample profile
35
11 Sample profile
The tables below show the sample profile per borough prior to the application of
weights.
11.1 Barking and Dagenham
Ward Count %
Abbey 53 5%
Alibon 44 4%
Becontree 68 7%
Chadwell Heath 66 7%
Eastbrook 67 7%
Eastbury 61 6%
Gascoigne 58 6%
Goresbrook 64 6%
Heath 63 6%
Longbridge 68 7%
Mayesbrook 60 6%
Parsloes 50 5%
River 61 6%
Thames 41 4%
Valence 59 6%
Village 57 6%
Whalebone 61 6%
Urgent and Emergency Care - Research Among Residents
36
Age Count %
18 to 24 85 9%
25 to 34 250 25%
35 to 44 301 30%
45 to 54 96 10%
55 to 59 57 6%
60 to 64 52 5%
65 to 74 81 8%
75+ 79 8%
Gender Count %
Male 439 44%
Female 562 56%
Ethnicity Count %
English/Welsh/Scottish/Northern Irish/British 513 51%
Irish 8 1%
Other White 91 9%
White and Black Caribbean 11 1%
White and Black African 4 0%
White and Asian 1 0%
Other Mixed 11 1%
Indian 51 5%
Pakistani 48 5%
Bangladeshi 39 4%
Chinese 3 0%
Other Asian 14 1%
African 139 14%
Caribbean 25 3%
Other Black 9 1%
Arab 2 0%
Any other ethnic group 22 2%
Prefer not to say 10 1%
Sample profile
37
11.2 Havering
Ward Count %
Brooklands 57 6%
Cranham 64 6%
Elm Park 62 6%
Emerson Park 58 6%
Gooshays 43 4%
Hacton 60 6%
Harold Wood 53 5%
Havering Park 48 5%
Heaton 43 4%
Hylands 58 6%
Mawneys 65 7%
Pettits 63 6%
Rainham and Wennington 46 5%
Romford Town 50 5%
South Hornchurch 55 6%
Squirrel's Heath 61 6%
St Andrew's 56 6%
Upminster 59 6%
Urgent and Emergency Care - Research Among Residents
38
Age Count %
18 to 24 68 7%
25 to 34 154 15%
35 to 44 217 22%
45 to 54 154 15%
55 to 59 81 8%
60 to 64 79 8%
65 to 74 134 13%
75+ 114 11%
Gender Count %
Male 435 44%
Female 566 57%
Ethnicity Count %
English/Welsh/Scottish/Northern Irish/British 824 82%
Irish 9 1%
Other White 39 4%
White and Black Caribbean 5 1%
White and Black African 3 0%
White and Asian 5 1%
Other Mixed 7 1%
Indian 32 3%
Pakistani 10 1%
Bangladeshi 8 1%
Chinese 4 0%
Other Asian 6 1%
African 20 2%
Caribbean 10 1%
Other Black 1 0%
Arab 0 0%
Any other ethnic group 11 1%
Prefer not to say 7 1%
Sample profile
39
11.3 Redbridge
Ward Count %
Aldborough 60 6%
Barkingside 48 5%
Bridge 43 4%
Chadwell 51 5%
Church End 39 4%
Clayhall 49 5%
Clementswood 44 4%
Cranbrook 51 5%
Fairlop 49 5%
Fullwell 49 5%
Goodmayes 45 5%
Hainault 47 5%
Loxford 57 6%
Mayfield 46 5%
Monkhams 41 4%
Newbury 44 4%
Roding 45 5%
Seven Kings 54 5%
Snaresbrook 37 4%
Wanstead 51 5%
Urgent and Emergency Care - Research Among Residents
40
Age Count %
18 to 24 98 10%
25 to 34 211 21%
35 to 44 272 27%
45 to 54 111 11%
55 to 59 79 8%
60 to 64 58 6%
65 to 74 81 8%
75+ 90 9%
Gender Count %
Male 452 45%
Female 548 55%
Ethnicity Count %
English/Welsh/Scottish/Northern Irish/British 397 40%
Irish 17 2%
Other White 74 7%
White and Black Caribbean 5 1%
White and Black African 1 0%
White and Asian 5 1%
Other Mixed 16 2%
Indian 184 18%
Pakistani 99 10%
Bangladeshi 45 5%
Chinese 10 1%
Other Asian 39 4%
African 40 4%
Caribbean 30 3%
Other Black 5 1%
Arab 4 0%
Any other ethnic group 16 2%
Prefer not to say 13 1%
Appendix: Statement of Terms
41
12 Appendix: Statement of Terms
Compliance with International Standards
BMG complies with the International Standard for Quality Management Systems
requirements (ISO 9001:2008) and the International Standard for Market, opinion and social
research service requirements (ISO 20252:2012) and The International Standard for
Information Security Management ISO 27001:2013.
Interpretation and publication of results
The interpretation of the results as reported in this document pertain to the research problem
and are supported by the empirical findings of this research project and, where applicable,
by other data. These interpretations and recommendations are based on empirical findings
and are distinguishable from personal views and opinions.
BMG will not be publish any part of these results without the written and informed consent of
the client.
Ethical practice
BMG promotes ethical practice in research: We conduct our work responsibly and in light of
the legal and moral codes of society.
We have a responsibility to maintain high scientific standards in the methods employed in
the collection and dissemination of data, in the impartial assessment and dissemination of
findings and in the maintenance of standards commensurate with professional integrity.
We recognise we have a duty of care to all those undertaking and participating in research
and strive to protect subjects from undue harm arising as a consequence of their
participation in research. This requires that subjects’ participation should be as fully informed
as possible and no group should be disadvantaged by routinely being excluded from
consideration. All adequate steps shall be taken by both agency and client to ensure that the
identity of each respondent participating in the research is protected.
With more than 25 years’ experience, BMG Research has established a strong reputation for delivering high quality research and consultancy.
BMG serves both the public and the private sector, providing market and customer insight which is vital in the development of plans, the support of campaigns and the evaluation of performance.
Innovation and development is very much at the heart of our business, and considerable attention is paid to the utilisation of the most up to date technologies and information systems to ensure that market and customer intelligence is widely shared.