Multiple A&E visits: Your experiences
Some patients are going to accident and emergency units in the UK more than 50 times a year, a BBC investigation shows.
Data obtained under the Freedom of Information Act from 183 sites reveals that nearly 12,000 people made more than 10 visits to the same unit in 2012-13.
Just over 150 of those attended more than 50 times.
Doctors warn that the issue, while confined to a minority of patients, is adding to mounting pressures on the system this winter.
BBC News website readers have been sharing their experiences and describing the issues that have lead them to become frequent visitors to A&E.
Sarah Hill, Hove
I have visited A&E over 140 times in the past two and a half years. I have a rare condition called hypocomplementemic urticarial vasculitis syndrome (HUVS - only 100 diagnoses per year worldwide), that sees my body react to itself several times per week requiring urgent medical treatment.
I am in A&E at the Royal Sussex three or four times a week for urgent intravenous drugs to bring my condition under control. Sometimes I'm admitted for weeks on end. Sometimes I'm in for treatment which lasts three to seven hours.
Even though I am constantly in the department, the staff have been and continue to be fantastic. They treat me with kindness, patience and respect.
I have worked all my life and continue to do so even with the illness. I can sometimes be in A&E until midnight and be at my desk the next day.
I think there are genuine patients, like me, who require constant urgent medical care but I have in my experience witnessed serial time wasters who for other reasons require the attention and kindness the staff offer.
It is a difficult situation but please do not automatically assume that those who attend A&E on such a frequent basis do not need to be there.
Virginia Turner, Feltham
My daughter is very often unwell with infections following a transplant. We have been to A&E a huge amount in the past few years, at least six to eight times per year. On two occasions she nearly died.
Her GP knows full well that she needs to be treated by her kidney and pancreas transplant team at Guy's & St Thomas' Hospital in central London but the present system does not allow her GP to send her straight to Guy's.
Sometimes she has been transferred from A&E at West Middlesex Hospital to Guy's. Sometimes she has been sent to casualty, then the high-dependency unit and then transferred to Guy's. Inevitably, she had to be transferred to Guy's because of the complexity of her transplant.
The staff at West Middlesex aren't always the same. We've not seen the same doctor more than once. Then it gets complicated involving loads of conference calls with Guy's. Sometimes we have had to wait five to eight hours at West Middlesex.
As I understand it, all unplanned hospital admissions have to go through A&E even when the GP knows admission is necessary. Why can't the system allow GPs to refer straight to a designated assessment ward?
The figures make it look like people are misusing A&E. Meanwhile my daughter is put into a highly contagious environment when she is very vulnerable.
Paul Osborne, Canterbury
I suffer from hemiplegic migraines which appear to be a stroke. As a consequence, I regularly find myself in A&E being checked out for a stroke about 15 times a year.
This is often not what I want to happen but it's hard to express this when you can't communicate adequately and well-meaning people call an ambulance or force me into a car to get me to A&E. After a few hours and some aspirin I am usually back to normal, if you discount the splitting headache part of the migraine.
Staff usually recognise me as the guy with migraines but, as they manifest as a stroke, they can't know it's not a stroke and I can't express what's happening. Then I'm on to the trolley, then on to a CT scan.
I've seen GPs and various experts. It's frustrating from my point of view. I end up being taken to A&E, rather than going there.
The BBC story is highlighting a failure in social services. We need a holistic view of society.
Stephen Frost, Manchester
I have MS and I had a severe relapse in January last year which resulted in me being unable to stand. I was admitted to hospital via A&E twice in a month.
The first time they managed to stabilise my condition and send me home after a week. I had previously not needed a care plan as my MS is normally stable and I have a twice-yearly session with a nurse.
The second time their attitude completely changed. They were quite hostile towards me and left me in no doubt that they didn't want me there because, as one nurse put it, "it doesn't do our ratings any good". I was told I was blocking a bed which could be used for somebody who would need surgery.
I had a third relapse later in the year but I used the 111 service instead. I was seen by my GP and I managed the relapse at home with help from family and friends. I stayed at home and recovered with strong painkillers. If the 111 service is working as intended it will probably help. However, when I phoned it seemed quite chaotic.
My experience in hospital has put me off having recommended surgery on disc problems, which were found when I visited hospital in January. I'm having second thoughts about going back in and I'm seeing a surgeon at the end of this month. I suspect the hospital's attitude towards me might be different as having surgery is "good for the ratings".
Sarah Allen, Wiltshire
I am most likely in the figure of people who have visited A&E more than 10 times in the past year, if not 15 times, first in London, then in Salisbury Hospital. The reason for this is because I suffer from intense stomach pains.
I have been to my GP and numerous specialists who have failed to give me a reason for the pain. When I was 17 I was diagnosed with endometriosis. Now every time I go to A&E I am told it is simply an endometriosis flare-up. I am given morphine and sent home.
It's not that the A&E staff are irritated - they keep saying, "It's this problem" as if saying so fixes the problem. It doesn't.
On my last visit I was diagnosed with gallstones after 18 months of repeated visits to A&E. The diagnosis was made over two months ago and only this week am I going to an appointment with a specialist.
Even when the NHS is attempting to diagnose the issue, the patient has an extremely long wait between each specialist consultation and has no choice but to continue to seek help at A&E.
111, the walk-in centre and my GP always tell me to go to A&E if the issue flares up. If you are not giving people a way to deal with the medical problems away from A&E and you're making little effort to diagnose people's problems, then imposing a huge waiting list, I find it difficult to sympathise with the issue of repeat visits.
Trish Roscoe, Southampton
I have visited Southampton General A&E several times a year with my elderly parents, every three months or so. My dad died last year aged 89 and my mum is 86.
They have had good attention from the GP, practice nurses, community matron and outpatients. However, growing frailty and complex diagnoses result in fairly regular 999 calls.
The ambulance crews are always wonderful and have tried to keep them at home. However, if they've had a fall they are usually unable to stand any more and they are often admitted.
On New Year's Day, my mum broke her leg. We waited an hour for the ambulance and for at least another hour in A&E, simply due to volume.
During the hours at A&E I can see that there are usually a few very vulnerable people who are drunk and/or mentally ill and who come back regularly.
Having been a social worker for over 30 years, I'm aware of the family breakdowns and service rationing which goes on, which may be the reason these people are desperate and seek a warm sympathetic reception at A&E. Common sense would suggest that individual follow-up of repeat visitors would yield results. But it is no-one's job to follow up.
Southampton A&E are brilliant, particularly in an emergency. However, the 111 service has added confusion and the out-of-hours alternatives have become very fuzzy.
Written by Richard Irvine-Brown and Jonathan Griffin.