We are open 24 hours a day, 365 days a year for the treatment of serious and potentially life threatening conditions.
Urgent advice: Our emergency department is very busy
If you need urgent medical help for something that isn't an emergency, remember A&E isn't your only option.
- Call 111
- Visit an urgent treatment centre or minor injury unit
- Speak to your local pharmacy
Your visit to the emergency department
The following information explains the stages you will go through during your visit to our emergency department. This Includes guidance on what to do when you arrive, triage and your assessment, through to discharge and follow up appointments.
Arrival and booking in
- The front door nurse does an infection control screen and directs patients with injuries to the urgent treatment centre (UTC), children to paediatrics, and infectious patients to our amber area.
- Next, please book in at reception.
- The receptionist checks your details on the computer and confirms why you are here
- Please let us know if you have been referred by your GP to a speciality team (e.g. surgery, medicine, gynaecology etc.)
- If you have not been referred then you will be seen by the emergency medicine staff.
- You then wait for triage.
- We try to minimise the wait for triage but when a lot of patients arrive quickly this might be delayed as there are only 2 or 3 triage staff.
- While you are waiting, you may have an observations, an ECG or a urine test taken by the health care assistants (HCAs).
- ECGs and observations are reviewed by doctors to check that you are ok to wait.
- The triage nurse will order blood tests for certain conditions.
- If tests are ordered then a physicians assistant (PA) will call you from the waiting room to do the blood test.
- They usually put a tiny plastic tube, called a cannula, into your vein. This is in case we need to give you any intravenous medicine.
- The cannula must be removed if you are discharged, so please let us know to take it out if you are discharged.
- The triage nurse will ask details about your condition.
- This enables us to prioritise who needs to be seen most urgently.
- If you have been referred to a speciality team by your GP, or by a hospital doctor, we will contact them and organise any tests that you need.
- There are speciality assessment unit elsewhere in the hospital, e.g. the surgical, medical and cancer assessment units and gynae clinics. We may stream you to these areas if you are to be seen by their doctors, if there is space.
- Non-referred patients will be seen by the emergency department doctors, in priority.
Uniforms you may see
- Our different groups of staff wear different colour scrubs.
- Nurses wear blue scrubs, darker blue for more senior nurses.
- Emergency department doctors wear green scrubs.
- The nurse in charge of the department wears dark blue scrubs
ACPs and ENPs
- You may be assessed by a emergency nurse practitioner (ENP) or an advanced care practitioner (ACP) rather than a doctor.
- These staff are highly experienced, and are trained and accredited to see specific groups of emergency department patients.
- The doctor or ACP working in Area D will call you when it is your turn.
- They assess you and look at the results of tests already done (blood tests, urine dip, XRs, ECG)
- They may be able to treat and discharge you.
- They may need to order more tests or scans to diagnose your illness. They will explain what these are for and how long they take.
- If they think you will need to stay in hospital, they will refer you to a speciality team. You might wait in the emergency department to see them, or be sent to a speciality assessment unit.
Sick notes and discharge medication
- You can sign yourself off for five working days. If your illness or injury will clearly require longer off then the doctor can provide a sick note. Please ask them.
- If you are prescribed medicines to take home please collect these from Rowlands in the main outpatients department. Opening hours are 0900-1800 monday –Friday, 0900-1300 on Saturday and Sunday.
- If you need medicine outside of these times we may write you a prescription or dispense medication from our stock.
Follow up appointments
- You may be told to book an outpatient clinic appointment, eg for
- Medical ambulatory care
- Fracture clinic
- ENT, Eye or other clinic
- Please go to Reception team at the front desk to book your appointment.
Before you go, have still got a cannula in?
- Before you leave please make sure we have removed your cannula. We will should always check, but if we have not done so please prompt us!
Emergency departments have become busier, resulting in long waits for assessment, and for admission. We try and see everyone as quickly as we can. Unfortunately when workload is high in resus, the ambulance areas and the paediatric department we have to move doctors to these areas.
We aim to see all patients and get them discharged or transferred to a ward within four hours of patients arriving in the emergency department.
How long will I have to wait?
- We are not able to say exactly how long you will have to wait.
- This is partly because sicker patients who arrive after you elsewhere in the department may need to be prioritised.
- This may leave only one doctor for the waiting room, which rapidly increases your waiting time.
- Speciality patients may also be seen before (or after) Emergency Medicine patients.
- You can ask the waiting room nurse for updates on the waiting time and how many patients are currently ahead of you in the queue.
Why are waiting times long?
- The number of patients coming to the emergency department has increased by about 15% over the last two years.
- Our doctor staffing levels are on average only three quarters of what they should be, mainly due to unfilled shifts.
- The wait to see a doctor on average is about 2 and half hours, but this increases in the evening and overnight.
- Monday is our busiest day, when patients stay the longest.
Can my family wait with me?
- The Trust allows relatives to attend with patients.
- However due to the lack of space we can only allow one relative in per patient. This is the case in all areas of the emergency department.
- When we run out of space and chairs for patients we will ask relatives to leave, unless they are accompanying a confused patient or providing nursing care.
- This is so we can observe, nurse and treat our patients and keep them safe.
- Please be understanding with the emergency department staff who have to enforce this Trust policy.
Feeling worse while waiting?
In pain or feeling sick?
- If you need painkillers or your condition is getting worse while you are waiting, please let the waiting room nurse know. They look after the waiting room patients and carry out any treatments you need.
- Your ECG will be taken and checked as soon as possible. Tell the nurse or HCA if your pain gets worse so we can repeat your ECG.
Been asked for a urine test?
- Give your sample to the nurse or HCA for testing.
Food and refreshments
- Our housekeeping team will bring a tea trolley and sandwiches at mealtimes from 0900 to 1700.
- There is a water dispenser and vending machine in the waiting room.
- There is also food available in the hospital concourse:
- M&S : Monday to Friday 0830-2100
- Costa : Open 24 hours
- Burger King : 1100-2300
- If you do leave the department to get some refreshments then please let the nurse in charge of the waiting room know.
Waiting for admission
If you are being admitted to hospital, you wait until a bed is available. Waits can be prolonged, up to 24 hours for certain types of bed.
- There are typically 20-30 patients waiting in the ED for beds, some on trollies and some in the waiting room.
- If you are waiting for admission and need to lie down please let us know. We will find you a trolley space as soon as we can.
- We have limited trolley spaces (47 in the whole ED) and we also use these to offload ambulance patients, so there may be a delay until we can find a space for you. Please let the nurse know if you feel more unwell while waiting.
- We understand that the wait to be reviewed by a clinician can be very long, and much longer than we wish.
- If you decide that you would like to leave before being seen by a doctor then please discuss this with one of the nurses so that they can check this is safe for you. If needed they will check with a doctor.
- The nurses will also ask you to sign a form confirming that you accept the risks if you do leave.
- If you discharge yourself your GP doesn’t receive a discharge letter or your test results. However you can access your own results via MyChart.
*** Please do not leave without telling one of the nurses so that we can check that it is safe for you to do so ***
About the emergency department
Routes to the emergency department
Patients come to emergency department from:
- GPs – some patients are referred direct to speciality teams
- Walk-in self referrals, or advised to come by 111
- Specialty clinics –for admission
- Other hospitals –for admission or speciality review
- The wait times for specialties varies depending upon their workload elsewhere in the hospital
- If you are waiting to see a Specialty team you may be seen more quickly than an emergency department patient, or more slowly. This one reason why some patients in the waiting room wait longer than others who arrived after them.
Areas of the emergency department
We look after patients in the following areas:
Resuscitation area (7 trolley spaces)
This is where we assess and treat the sickest patients who need immediate resuscitation or intensive care treatments.
Paediatric emergency department (8 bed spaces)
Our children's emergency department.
Ambulance bay (3 assessment spaces)
Patients are offloaded from ambulances and assessed.
Areas A, B, C and D (26 trolley spaces for majors and ambulance patients)
Patients from ambulances are assessed here if they are too unwell for the waiting room. Patients waiting admission wait here until hospital beds are available for them.
Area D is also where waiting room patients are seen. There are 14 trolley spaces, used for assessments and treatments.
Urgent treatment centre (UTC - Clinic 9)
We have two GPs in our UTC located in clinic 9. They are open from 8am until 11pm. If your condition is suitable, we may send you there. After assessing you, the GP may send you back here for tests or for a speciality team review.
Most patients with injuries are assessed by emergency nurse practitioners (ENPs), who are based in the UTC. They are open from 8am to half past midnight. Most x-rays can be done in the UTC, but a few (spinal x-rays, jaws and shoulders) have to be done in the main department. If you have an injury you may be sent for x-ray then moved to the UTC.
At midnight any patients waiting in the UTC will be moved back to the emergency department waiting room to be seen in turn by the emergency department night doctors.
Complaints and raising concerns
- Patient Advice and Liaison Service (PALS)
- Drop-in: we are located near the main Addenbrooke's Hospital reception
- 12:00 to 16:00 Monday to Friday
- Closed weekends and Bank Holidays