The government is preparing to launch a campaign to encourage those who are seriously ill to still come to hospital if they need to, amid concerns that some may be staying away because of the coronavirus crisis.

Data shows attendances to emergency departments were 1.53m in March, down 22% from February. It is the lowest number since NHS England began recording comparable data in 2010, and the health service said it was likely to be a result of the Covid-19 response.

A separate dataset from the Royal College of Emergency Medicine, released on 3 April, which collects figures from 50 NHS trusts in England, shows emergency attendances had fallen to 58,447 – down from 73,801 the previous week.

“We are concerned that this drop in attendance may mean that people with serious health problems are avoiding going to their emergency department for fear of getting coronavirus,” said the college’s president, Dr Katherine Henderson.

She added: “While this is the lowest number of attendances since 2010, it is the highest-ever level of admissions as a proportion of attendances – this of course reflects the high acuity of patients presenting with Covid-19 problems, but in fact is something that has been increasing for some time. Even before Covid-19, we knew that patients were getting sicker – people are living longer and acquiring more health problems.”

The government is now planning a major public awareness campaign to stress that the NHS is still there for those who need it. The advertising agency Saatchi & Saatchi is understood to be working on the campaign without payment and it is expected to be launched in the next few weeks.



Simon Ray, president of British Cardiovascular Society, said he welcomed a campaign to draw attention to the problem. “The biggest concern is that it seems there has been a uniform reduction in hospital attendances for heart attacks that has been noted in Italy, Spain and here. The magnitude looks the same everywhere: it’s around 40% down in terms of callouts for emergency treatment for heart attacks.”

He added: “Then there also seems to be substantial reduction in referrals in for with acute coronary syndrome, which is one step down from a heart attack, so people coming in with chest pain – those attendances also seem to have gone down a lot. That is harder to quantify, but the decrease in those is at least as large, and also seen across southern Europe and the US.”



”Anecdotally, and only anecdotally, a number of units have also reported people presenting late with complications due to having a heart attack that we don’t normally see. The concern is people sitting out symptoms rather than calling help.”

David Davis, a spokesman for the College of Paramedics said: “The NHS is still open for business, thanks to the sacrifice that everyone is making by staying at home.

“It’s really important that members of the public who are suffering with life-threatening emergencies like stroke, heart attack, severe bleeding or breathing difficulties still call 999. By having a long-lasting, nationwide lockdown it means that there are still paramedics available to provide emergency care.”

The number of people attending A&E with heart attack symptoms dropped from 300 per day at the beginning of March, to 150 by the end of March. Dr Sonya Babu-Narayan, a consultant cardiologist and associate medical director at the British Heart Foundation, said: “The coronavirus pandemic is extremely serious, but it’s concerning if it also means people’s fears about the virus are putting them off calling 999 when they suffer heart attack symptoms.

“These are uncertain times, and it’s understandable that people might feel apprehensive about having to go to hospital or putting unnecessary strain on the NHS. But heart attacks don’t stop for a global pandemic.

“Don’t delay because you think hospitals are too busy – the NHS still has systems in place to treat people for heart attacks and they are still a top priority … you should always dial 999 immediately if your chest pain is sudden, spreads to your arms, back, neck or jaw, and feels heavy or tight, or if you become short of breath or start to feel sick.”