A new report from Healthwatch Hounslow provides important insight into why babies and young children aged 0–4 are attending Accident & Emergency at West Middlesex University Hospital, and highlights where coordinated, system-wide action from all Hounslow Health and Care partners can help families access the right care, at the right time.
A consistent theme throughout the findings is the perceived difficulty of accessing GP appointments. Over half of parents (52%) did not attempt to contact their GP before attending A&E, often because they believed appointments would not be available quickly enough, particularly at weekends, or that they would be referred to hospital anyway.
A&E attendance was also commonly driven by everyday childhood symptoms, such as fever, cough, vomiting or rash. Nearly half of parents attended A&E for these reasons, reporting uncertainty about whether symptoms were serious or could be safely managed through primary care, NHS 111 or at home.
Alongside this, anxiety and the need for reassurance played a significant role in decision-making. Parents consistently described A&E as the fastest and safest option, offering immediate assessment, access to paediatric expertise and same-day reassurance. Fear that symptoms might worsen if they waited strongly influenced choices, particularly for very young children. The report also highlights low awareness and use of community and digital support. Services such as Family Hubs, Children’s Centres and online tools were underused, and very few parents were aware of or used the Healthier Together website to check symptoms before attending A&E.
Importantly, the majority of children attending A&E did not require hospital admission and were discharged home with advice, reassurance or simple treatment. This suggests that with earlier guidance, clearer pathways and improved confidence, some attendances could potentially be avoided.
Taken together, the findings point to a number of shared priorities across health, care and local authority partners in Hounslow. These include:
- Improving parental confidence and understanding of common symptoms in children aged 0–4
- Strengthening awareness of GP access, including same-day and out-of-hours provision across PCNs
- Embedding consistent signposting to NHS 111, community services and digital tools
- Ensuring clear, joined-up messaging at every point of contact, including GP practices, A&E, health visiting and family hubs
In anticipation of the report's findings, Hounslow launched its first borough-wide 0–4 campaign in winter 2025, encouraging parents and carers to check their child’s symptoms first using the Healthier Together West London website: https://healthiertogether.westlondon.nhs.uk/
The website provides:
- An easy-to-read symptom checker tailored for babies and young children
- Clear red–amber–green guidance on what to do and where to go
- Reassurance and practical advice to support informed decision-making.
Primary care also launched an additional 750 monthly GP appointments for children aged 0-4 years across Hounslow, and the Health Visiting Advice Team launched a series of online workshops for parents, plus there has also been increased health engagement with families via family hubs, places of worship, and community settings on the management of fever, and easy signposting for information and advice.
All colleagues are encouraged to actively support this work by:
- Promoting the Hounslow Healthier Together website in all contacts with families of children aged 0–4
- Reinforcing consistent messages about GP access, NHS 111 and out-of-hours care
- Embedding links and QR codes across services, settings and communications
By working together, the Hounslow BBP can support parents earlier, reduce avoidable pressure on urgent and emergency care, and improve experiences for families with young children.