"The Right Care in the Right Place"

My husband recently injured his leg with a rusty screw in the garden.  We cleaned the wound and checked NHS Inform in relation to the need for a Tetanus injection. The NHS Inform advice was to phone NHS 24 on 111, which we did.  We selected the ring back option and received a call back at an hour. The NHS 24 call handler went through the assessment and we waited to speak to a nurse for about 20 minutes. The NHS 24 nurse then carried out their assessment and we received an outcome of referral to GG&C and to wait on their phone call.  Both the call handler and nurse were pleasant and kept us informed.

We received a call back from GG&C hub within 6 minutes and were advised that as virtual appointments were full we were being sent to A&E at IRH. The member of staff advised my husbands that his details and contact with NHS 24 and GG&C hub would be sent to A&E at IRH, he would be added to the list and they would be aware he was coming. 

My husband arrived at A&E 30 minutes after the call from GG&C hub and checked in at reception, explaining he had been sent via the GG&C hub.  The waiting time advised at A&E at that point was 4 hours.  

We have no concerns with the NHS 24 or GG&C hub contact. Both were handled professionally.

After four and a half hours he was still waiting to be seen and asked a member of staff  on reception how much longer he would be and again that he was sent there via NHS 24/GG&C hub.  They advised that it didn't matter if you went via NHS 24/GG&C hub or were a walk-in through the door, everyone waited the same time. 

Posters all throughout the A&E department noted that A&E was for emergencies only and if your condition was not life threatening you may be redirected to another healthcare service better suited and that you should call 111 if your condition was not life threatening.  This then begs the question of what is the point in phoning NHS 24 on 111 and following the process to access The Right Care in the Right Place if it makes no difference when you do this?  Ultimately we could have went straight to A&E ourselves and been seen and saved an hour and a half on the phone following the process that NHS Inform and the A&E department itself tells you to follow.  

At this point the waiting time then changed to 6 hours after he spoke to the member of staff on reception.

6 hours after arriving at A&E, he was finally seen by a doctor who then told him he should have went to his own GP in the morning, again completely contradicting the system that we followed to access The Right Care in the Right Place via the appropriate channels.  He was finally given a Tetanus injection and sent home.

Therefore can GG&C advise us what the correct process is that we should have followed.  Do we just turn up at an A&E as a walk-in, or do we go via NHS 24 on 111 as is advertised on NHS Inform, on the GG&C A&E website, within GG&C's own departments and by mainstream media?  

My understanding was that the process of going via NHS 24 and GG&C hub was to ensure patients accessed the most appropriate care quickly and safely and also to help protect the Accident & Emergency Departments (A&E). However, if as the member of staff on reception says, it doesn't matter if you come via NHS 24 or a walk in you'll be treated the same, then in all honesty in future we will skip the wait on the phone to NHS 24 and just attend the department as a walk-in.