Huge increase in people going to A&E with back pain, earache and even hiccups

A&Es are dealing with a rising number of people seeking emergency care for coughs, headaches and even hiccups, insomnia and backache.

The figures also reveal an increasing number of people attending A&E to request medication.

More than a quarter of a million (257,915) A&E attendances in 2023/24 were due to earache – a 10% rise on the previous year.

There was a 13% increase in the number of attendances for people seeking help for backache, up from 324,443 in 2022/23 to 365,327 in 2023/24.

Cases where headache was the chief complaint rose 12% between 2022/23 and 2023/24 – from 379,127 cases to 423,297.

The data further revealed that complaints for cough rose 15%, from 322,500 A&E attendances in 2022/23 to 369,264 in 2023/24.

A&Es saw a 15% rise in attendances for insomnia – with medics seeing 1,544 cases in 2023/24 compared to 1,343 in 2022/23.

And there were 963 cases of hiccups – an 18% rise on the previous year.

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There was an 11% rise in the number of cases of nasal congestion, from 16,115 in 2022/23 to 17,827 in 2023/24.

Some 61,936 nose bleeds were dealt with in A&E last year, a 10% rise compared to the previous year, while the number of cases of constipation and diarrhoea also rose.

Meanwhile, 351,785 A&E visits last year were attributed to vomiting while 18,126 attendances were because of nausea.

And 324,550 attendances were due to a sore throat.

Overall, almost 8.6 million A&E attendances in 2023/24 resulted in the patient being discharged with written advice.

In total, the NHS in England recorded 24,664,177 unplanned attendances for which there is a specific record in A&E departments in 2023/24.

Health officials estimate that up to two-fifths of A&E attendances are avoidable or could be better treated elsewhere.

The figures come as the NHS braces for what is expected to be a challenging winter as infections in communities rise and temperatures plummet – which can exacerbate a number of pre-existing medical conditions.

Dr Adrian Boyle, president of The Royal College of Emergency Medicine, said: “The various diagnoses should be taken with a grain of salt, for instance, nosebleeds can be dangerous in older people or people taking blood-thinning drugs.

“However, the fact remains that people are coming to A&E with issues that we would have not traditionally considered as requiring emergency care.

“This is symptomatic of issues that permeate the entire healthcare system. Just like our emergency departments, which are routinely overcrowded – primary and community-based services are massively overstretched.

“It is therefore no surprise that people turn to A&E for treatment of more minor issues.

“However, this in turn places additional demand on emergency care teams who are already dealing with the extra pressures that come with winter, combined with an under-resourced social care system that means discharges are delayed.

“This is a vicious cycle which means there is less capacity to treat the people who are most in need of urgent care.

“To stop this cycle, the government must deliver on its promise to fix the healthcare system, and it is imperative that this is felt in every part of the system, in every part of the country.”

Saffron Cordery, deputy chief executive at NHS Providers, said that pressure on A&E departments is “only likely to intensify in winter”.

“The NHS is there for anyone who needs it – 999 and A&E services for life-threatening emergencies and serious injuries or NHS 111 can be used for urgent help and advice with all sorts of problems,” she said.

“Ninety-six per cent of trust leaders say they’re worried about the effect of winter pressures on an already stretched NHS. We’ve just seen a record number of A&E attendances in the past year.

“Pressure on urgent and emergency care services including A&E departments is only likely to intensify in winter, regularly the toughest and busiest time of year for the NHS. But trusts continue to work flat out to see patients as quickly as possible.”

The previous Conservative government launched its Pharmacy First scheme in January this year.

Under the scheme, patients were encouraged to seek help from a pharmacist for seven common conditions without needing to see a GP.

These conditions include sinusitis, sore throat, earache, infected insect bites, impetigo, shingles and uncomplicated urinary tract infections in women under 65.

Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said: “We know that confidence among patients in their ability to access care is reducing. This means that they will often use acute services especially if long waiting times mean they are no longer able to tolerate their symptoms.

“They will access any care they can in desperate times and have often sought alternatives before presenting.

“The collective action of GP colleagues may exacerbate this in the short term further adding to the strain of overcrowded and under-resourced urgent and emergency care services this winter.

“However, it is essential that patients continue to seek care if they develop symptoms. The drive to divert patients to other services is pertinent; but only if these respond in a timely manner.

“Patients may not understand the significance of their symptoms and should be supported in finding expert care. It is essential that action is taken that helps restore the confidence of patients and staff over the next few months.”

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Professor Julian Redhead, national clinical director for urgent and emergency care for NHS England, said: “We are seeing record levels of demand at our A&Es and while hospitals are already working close to capacity as we move into winter, it is important that the public plays their part by following NHS advice – only using emergency services for serious injuries or life-threatening emergencies.

“NHS 111 online and the NHS website can give you advice on how to treat yourself at home, or direct you to the most appropriate NHS service for things like headaches and a sore throat, while calling NHS 111 should be your first port of call for any other pressing conditions – which could mean you are seen quicker and in the right place, while allowing our emergency care staff to support those who need it most.”

The figures come as some health commentators warned hospitals are running “red hot”, with some predicting winter could be “one of the worst the NHS has faced”.

Health Secretary Wes Streeting has recently ordered health service leaders to “prioritise patient safety” as winter approaches.

Amanda Pritchard, chief executive of the NHS in England, said: “Patient safety must be paramount.”

Meanwhile, the data show that emergency departments are also dealing with a large number of delicate complaints such as fainting while urinating, fractured penises and people being unable to remove a “foreign object” from an intimate area.

The figures show emergency doctors treated a number of illnesses which many people would assume have been eradicated in the UK last year including six cases of smallpox; 34 cases of plague and 286 cases of typhoid fever.