Welcome to the Emergency Department at Gloucestershire Royal Hospital

What is Triage?

‘Triage’ is where a health care professional will discuss the reason for your attendance and determine how urgently you need to be seen by a clinician, and which service or clinician is the most appropriate for you. We aim to triage everyone within 15 minutes of arrival at the department; however, the wait may be longer at busier times. Please let the triage team know at this time if you require pain relief.

If your pain increases after you have been seen in triage, please let a member of staff know. Patients are called into triage in time order, unless we have immediate concerns. If you feel you cannot wait to have a triage assessment (for example, if you need urgent pain relief) please let the reception team know. There are a number of different services that deliver emergency care in addition to those provided by the ED, including the out of-hours GP service and your own GP.

The triage team may discuss these with you if one of these services would offer you more specialist or timely care.

What if I have an injury?

If you have an injury and do not have another medical problem requiring care in the ED, you will be referred to our Minor Injury Unit (MIU). The triage nurse will give you directions to the MIU. This is temporarily located in the Out-patients Department to make sure that patients can socially distance safely. If you are unable to walk to the MIU yourself we will arrange a wheelchair for you.

What if the patient is a child (up to 16 years)?

After registering at reception, children will be asked to wait in the children’s waiting area. They will be assessed by a triage nurse, who may refer them to the Paediatric Assessment Unit (PAU) or the Minor Injury Unit (MIU). If your child has an injury, they may be referred directly from Reception to our Minor Injury Unit where there is a separate waiting area for children. You will be given directions to MIU or PAU.

What happens after Triage if I stay in ED for my care?

After you have been seen by the triage team you will then be assessed by a clinician. This may include a doctor, nurse practitioner or physicians associate.

You will be seen in order of clinical urgency, which has been determined during your triage assessment. If, after triage, you feel your symptoms have worsened, please inform a member of staff. If you are in the main waiting area you should speak to the receptionist. If you are waiting inside the department, please ask any member of our nursing or medical staff.

The clinician will ask some of the same questions as the triage nurse asked you, but in much more detail. We repeat the questions to make sure that the information is accurate. Please remember we do not have access to all of your hospital notes and clinic letters.

What if I have a mental health need?

If you attend the department with mental health needs the process outlined before may change slightly.

The triage team may ask you a few more questions regarding the nature of your symptoms, your thoughts and your emotions. This will help us establish what support you need. These questions may seem personal but they help us prioritise our needs in the same way we would for a person with a physical health problem.

After triage, you will be seen by a clinician who will ask a number of questions designed to help decide what ongoing mental health support is required. We may ask you to wait for an assessment by the Mental Health Liaison Team; they are a specialist team of clinicians dedicated to assessing patients with mental health needs in the ED. It may take some time for the team to come and see you, but we will try to give you an idea of how long this may be.

If at any point during your wait you feel that you need to leave, or feel that your symptoms are becoming distressing or unmanageable, please let one of the ED team know. If you are in the main waiting area, please let the receptionist know. If you are inside the department, please tell any member of our nursing or medical staff.

We know the ED can be a difficult and noisy place to wait; we will try to support you as much as possible during this time. If you feel that you need a quieter space, please let us know and we will do our best to arrange this for you. If you need to leave before being assessed, please let a member of staff know so that we can help to make sure you are safe after you leave the ED. We can also offer you further information about resources and organisations to support you.

What happens after I have been assessed by a clinician?

If you are to be discharged

The clinician will make a plan with you regarding the care and treatment you need. If you are to be discharged home the clinician will write a letter to your GP detailing your attendance. This letter can take a few days to reach your doctor. We do not routinely provide copies of this letter to patients. If you would like a copy please mention this to your clinician who will be happy to provide you with one. 

If you are to be admitted to hospital

If you are admitted we will ask you to consent to a Covid-19 swab to make sure you are cared for safely. We will transfer you to a bed on a ward as soon as one becomes available. The waiting time for a bed will vary depending on demand in the hospital at the time. If you require anything during your wait, such as pain relief or food and drink, please let a member of staff know. Although we may be very busy, your comfort is important to us, so please ask.

Can I bring a family member, friend or carer into the ED with me?

Due to Covid-19, our visiting regulations are being updated regularly. We continue to maintain social distancing within the department. They will be allowed to wait with you until you have been seen by the triage team; after this they will be asked to leave the department. One parent or guardian may accompany a person under the age of 16 to the Emergency Department.

We appreciate for some people it is very important to have someone with them; for example, those with cognitive impairment or a disability. Please discuss this with a staff member. Visitors are permitted on the wards, but the visiting slot must be booked in advance. This can be done by contacting the ward. We have cards available in the department with contact details for the wards.

What if I wish to leave before I am assessed?

We would like you to stay until you are assessed but understand that sometimes this is not possible. If at any stage you feel that your symptoms or circumstances have changed and you wish to leave the ED before being seen by a clinician, please let one of the ED team know so that we can address any concerns. This is particularly important if the patient is a child.

How do I give feedback about the care I have received in the Emergency Department?

Your feedback is really important to us. You will be asked to complete a Friends and Family Test in which you can rate the care you have received, via text message. We would be grateful if you could take the time to complete this, as it provides invaluable feedback which can help us to improve the care we provide.

If you would like to provide any suggestions as to how we can improve our service, raise a concern or offer a compliment about your experience, please contact our Patient Advice and Liaison Service (PALS) at ghn-tr.pals.gloshospitals@nhs.net or call 0800 019 3282.