Urgent care: A&E, NHS 24 and Minor Injury Assessment Units

You should now phone NHS 24 on 111 (24 hours a day) to access all urgent care. NHS 24 will provide an initial assessment by phone so you can be directed to the right care, in the right place, at the right time, before travelling anywhere. This change aims to reduce overcrowding at A&Es and Minor Injury Units (MIU) and help to protect patients and staff during the Covid-19 pandemic.

If NHS 24 decide you need further clinical consultation, you’ll be referred to the Lothian Flow Centre so your care can be provided through video or face-to-face consultation. This means that you could receive an appointment for a Call MIA video consultation with a Minor Injuries Nurse Practitioner, an appointment to attend a Minor Injury Unit, or a time to attend an Emergency Department. Children under 12 should still be taken direct to A&E, if you feel it’s needed.

A&Es are open for life-threatening conditions: if you do go to A&E or MIU, you’ll still be triaged and treated as appropriate.

These are the kinds of things you can go to an MIU for:

• Patients must be 12 years old and over
• Must be able to make own way to MIU
• Injuries must have happened in the last 14 days

– Something stuck (a foreign body) in your nose or ear
• Wounds less than 24 hours old where any bleeding is controlled, with or without a foreign body
• Crush injury to fingers or toes with no wound
• Ring removal from fingers or toes
• Minor burns or scalds (not involving hands, face or genitals)
• Head and face injuries, apart from those listed below
• Eye injuries, apart from those listed below
• Limb injuries (below shoulder or below knee)
• Animal bites including insect bites & stings
• Patients with a fracture that needs reviewing, after being treated outside NHS Lothian
• Animal bites with localised swelling and no evidence of allergic reaction

You can’t go to an MIU if any of these apply to you:

• Patients 11 years old or under
• Patients who need transport to or from MIU
• Injuries that happened more than 14 days ago – you’ll need to see your GP
• Wounds that happened over 24 hours ago– you’ll need to see your GP
• Head injuries with loss of consciousness, vomiting / disturbed vision / altered behaviour.

– If you have underlying haematological conditions or take anticoagulants
• Human bites
• Injury with a dangerous cause – for example falling from more than your own height or a road accident at over 40 mph
• Intoxication or overdose
• Minor burns and scalds to neck, face and genitals, and chemical or circumferential burns (where a full thickness burn affects the entire circumference of a digit, extremity, or even the torso)
• Eye injuries with visual disturbance or penetrating injury
• Insect bites with swelling in places other than where you got bitten, or evidence of allergic reaction
• Injury or foreign body to abdomen, chest or back
• Unsafe environment / social circumstances