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Croydon peoples’ views help improve A&E access and hospital signage

  • Patients found A&E pathway unclear with confusion about role of NHS 111.
  • Croydon NHS has improved patient journey in response to patient need with NHS 111 having a defined role.
  • Mystery shoppers found Croydon University Hospital signage was confusing, with little support if lost or confused.
  • New materials have been produced and there is a commitment to new signage as well as digital kiosks to help people find their way.

Before COVID-19, Healthwatch Croydon worked with Croydon University Hospital (CUH) on two projects: one was to gain views on the journey people took to get to Accident & Emergency (A&E), and the other was about about how effective signage was.

We spoke to over 360 visitors to A&E to track their journey there. For the signage project, we worked with volunteer mystery shoppers who took some example letters and then walked through the hospital site to see how easy it was to find the right department.

Our reports, How did you get here? Responses to those arriving at the Croydon University Hospital Accident and Emergency Department and Experience of using signage at Croydon University Hospital, published today, said the following:


  • 50% of people use A&E as a first choice with severity of injury was main reason for attending A&E after first contact.
  •  60% used GP services and majority had a positive experience. 15% of people attended A&E as there were no GP appointments, or GP was busy or closed.
  •  62% were sure where to go when they had an illness or injury when they chose A&E, but Customer journeys are varied and individual and didn’t follow the usual NHS pathways.


  • Signage found to be unclear or difficult to follow with a majority finding the letters unclear as well.
  • There was little support if lost or confused.
  • Better route planning for those with mobility issues. While lifts were available but confusion about public access.

Here are our recommendations:


  • Realign the pathway to reflect real patient use and understand more about influence behind choices. Communicate the revised pathways to services with clarity.
  • Communicate alternatives to A&E with an emphasis on speed of response such as NHS 111.
  • GPs need to focus improving capacity so that people go to A&E who need to go there.


  • Make signage easier to read and ensure step-free access routes to all locations.
  • Review and test patient letters and direct patients on the best entrance to use.
  • Support visitors who are lost.

Gordon Kay, Healthwatch Croydon Manager, said:

“These projects were focused working in partnership with Croydon University Hospital to find out more about how patients had experienced services on visiting the hospital. We knew that many people arrived at Accident and Emergency who may have been better served in another location and that there was a real confusion about the best pathway to use. For outpatients, our mystery shoppers found it difficult to negotiate a complex physical site and the connection between letters and signage. We welcome the commitment made by the Trust to make these improvements which bring clarity to the patients on how they can best access the services they need and where they need to go. This should enhance the patient experience for all Croydon residents.”

Matthew Kershaw, Croydon Health Service NHS Trust Chief Executive and Place Based Leader for Health said:

On A&E: “It is good to know that the majority of people surveyed knew to come to our Emergency Department if they needed life-critical care and trusted that they would be seen quickly in Croydon. However, we agree that more is needed to promote the alternatives available to get urgent care for less serious conditions in our borough. Since this report, we have expanded NHS 111 in Croydon and launched a new campaign to encourage people to phone ahead or check online before coming to A&E.

“Trained health advisors, including Croydon doctors, nurses and paramedics are now available 24/7 on NHS 111 for help and advice to direct people to the best urgent care available to them. Depending on an individual’s clinical needs, this could include call back from a local GP, a virtual consultation, or a same day booked appointment in the Emergency Department or Urgent Treatment Centre at CUH.

“All of this is to help people access the right care first time, help us to reduce waits in A&E and help us protect patients and staff from COVID-19 with fewer people in waiting rooms for safe social distancing.”

On hospital signage: “We are investing more than £180,000 this year to reset and improve all of our hospital signage. We are also looking at new ways to help our patients find their way around our services, including interactive digital maps.

“Since this report, we have produced new material to guide patients through the changes we have made to protect them from coronavirus (COVID-19), and there is much more in the planning. We are constantly listening and acting on the feedback from patients to improve their experience of our care, and we look forward working closely with Healthwatch to make sure our patient voices continue to be heard.”

Both reports from can viewed at