Background: Urgent and emergency care attendances in babies and young children have increased in the past ten years. Infants under one year of age represent a large proportion of Paediatric Accident and Emergency (A&E) attendances. Many infant A&E attendances are low acuity or can be managed in the community. Improving health literacy is a high impact area in the Healthy Child Programme and may provide an opportunity to reduce infant A&E attendances.This project aimed to explore low acuity infant A&E attendances in a busy district general hospital and gain feedback from parents/carers on strategies to improve health literacy. Engaging service users is a powerful tool for service improvement and is central to National Health Service (NHS) service design.Method: A retrospective review of infant Paediatric A&E presentations over a six-month period between June 2024 and December 2024 was completed. Data was collected by reviewing electronic patient records. Low acuity cases were defined as A&E attendances with discharge description of “treatment complete”.Questionnaires on help-seeking behaviours and preferred methods to improve health literacy were collected from service users in General Practice (GP) and Paediatric A&E settings between April and September 2025. In the primary care setting, questionnaires were sent to parents/carers with children under one year of age via text message. In the A&E setting, questionnaires were given to parents/carers presenting with children under one year of age.Results: Over the six-month period, 10,741 children under 16 years of age presented to A&E. 2205 (20.5%) of those presentations were infants. Of infant A&E presentations, 1565/2205 (71%) were discharged from A&E with a discharge description of “treatment complete”. Of these infants, 856/1565 (54.7%) were male and 709/1565 (45.3%) were female. The most common diagnoses were:- Acute bronchiolitis/Bronchiolitis (17.8%)- No abnormality detected/well baby/well but worried (15.9%)- Acute Upper Respiratory Tract Infection (URTI)/Viral URTI/Upper Respiratory Infection (15.1%) 119/1565 (7.6%) were coded as having an investigation.36 responses were obtained for GP questionnaires and 26 for A&E questionnaires. Responses revealed that 19/62 (30.6%) would consider A&E as one of the first points of call when seeking help if they were concerned about their child. In both settings, most carers reported they would like to receive information about common problems in children under one year of age (47/62; 75.8%). 23/47 (48.9%) reported they would prefer this after their child is born and 25/47 (53.2%) would like to receive this information as written information (for example leaflets, online website).Conclusions: Infants represent a large proportion of Paediatric A&E presentations, with the majority being low acuity and discharged from A&E without any investigations. Parents/carers would like more information about common problems in children under one year of age and resources are already available for information sharing (for example Healthier Together).Evidence suggests community health literacy interventions may improve parental health literacy. Signposting to resources to improve health literacy at early contact points such as six week check may provide an opportunity for early intervention which may reduce non-urgent Paediatric A&E attendances. Further projects would aim to introduce this.
