Congratulations to Brent Patient Voice in succeeding with their complaint to the Advertising Standards Authority regarding Brent Clinical Commissioning Group's poster telling residents to use A & E only for 'life threatening emergencies':
This is the full finding:
Ad
A poster and claims on the advertiser's website www.rightcare4u.org.uk, seen on 5 October 2015:
a.
The poster stated "For emergency use only ... A&E is for
life-threatening emergencies only ... Other NHS services are available
that will help you more quickly. For more information visit:
www.rightcare4u.org.uk".
B. The website stated "For emergency use
only ... A&E is for life-threatening emergencies only ... If you use
A&E when you could get help somewhere else, you are taking NHS
staff time away from life-threatening cases. Other NHS services are
available that will help you more quickly ...".
Issue
Brent
Patient Voice challenged whether the claim "A&E is for
life-threatening emergencies only" was misleading and potentially
harmful, because patients with serious medical conditions/injuries that
were not necessarily life-threatening may be wrongly discouraged from
going immediately to their nearest hospital A&E.
CAP Code (Edition 12)
Response
Department
of Health trading as Brent Clinical Commissioning Group (BCCG)
explained that the ads focused specifically on diverting unnecessary
cases away from local A&E departments to more appropriate settings,
such as Urgent Care Centres and Minor Injuries Units. They said the
primary aim of the ads was patient safety. They had based the core
message on nationally available NHS information, in particular the NHS
Choices website. They provided an extract from that website which listed
some examples of life-threatening emergencies and included loss of
consciousness, persistent severe chest pain, breathing difficulties and
severe bleeding that could not be stopped.
BCCG said that in contrast to
A&E departments, Urgent Care Centres could treat sprains and
strains, broken bones, wound infections, minor burns and scalds, minor
head injuries, insect and animal bites, minor eye injuries and injuries
to the back, shoulder and chest.
BCCG said they had received
clinical approval for the campaign. They accepted that there may be a
few exceptions, for example, the ones cited by Brent Patient Voice,
regarding some specific situations which might require A&E treatment
in non-life-threatening situations. They said that was why there were
well-established protocols in place in order to safely refer all
patients requiring A&E treatment who presented at Urgent Care
Centres. They believed the question was one of risk and, in the case of
the ad campaign, communicating clearly to a whole patient population
about the appropriate use of A&E overall, given the potentially
serious and significant impact on those patients who genuinely required
A&E treatment by those patients who would be better off (both for
themselves and others) reporting to non-A&E services. They said it
was important to emphasise that it was not their intention to present
misleading information. They were seeking to educate people who might
consider going to A&E for situations which were non-life-threatening
and who could be treated more appropriately elsewhere.
They
offered to remove the word "only" from the claim, in order to provide
for those few situations which might require A&E treatment for
non-life-threatening emergencies in the context of the A&E service
overall being for life-threatening situations, as set out on the NHS
Choices website. They believed their amendment was a reasonable and
proportionate response to the complaint.
Assessment
Upheld
The
ASA understood from Brent Patient Voice and BCCG that there were
certain medical conditions and injuries that were not life-threatening
but nevertheless required treatment in A&E, for example, some broken
bones (e.g. ankle), facial injury requiring maxilla-facial surgery,
saddle paraesthesia and serious eye injuries. We understood that those
conditions and injuries could not be treated in Urgent Care Centres or
Minor Injuries Units. We acknowledged that the intention behind the ad
campaign was to encourage the appropriate use of A&E services, so as
to ensure the proper allocation of NHS resources and patient safety,
and was not to deter individuals from accessing A&E services if they
genuinely required them. However, we noted that the claim "A&E is
for life-threatening emergencies only" was an absolute claim, even
though there were exceptions, and we were concerned that individuals
presenting with the conditions listed above might be deterred from
seeking urgent treatment at A&E as a result of seeing the ads. We
considered that the amended claim, which omitted the word "only", did
not resolve the complaint because there were certain conditions and
injuries that were not life-threatening but which nevertheless required
treatment in A&E. For those reasons, we concluded that the claim
"A&E is for life-threatening emergencies only" was misleading and
potentially harmful.
The ads breached CAP Code (Edition 12) rules 1.3 (Social responsibility), 3.1 and 3.3 (Misleading advertising).
Action
The
ads must not appear again in their current form. We told Brent Clinical
Commissioning Group to take care not to inadvertently make misleading
and potentially harmful claims about the scope of A&E services in
future.
