PRESSURE on the National Health Service means all sectors have to explore every possible way of maximising efficiency.

Resources - cash and human - are scarce so if hospitals believe they are having to deal with more people because GPs are seeing fewer patients out-of-hours health managers are bound to be concerned.

An increased number of people going to hospital accident and emergency departments in East Lancashire - and therefore pushing costs up - is being blamed on GPs refusing to work outside surgery hours.

Many doctors no longer have out-of-hours services and patients are told to ring NHS Direct for advice or a central number. But because they find this too confusing some people instead are heading for their nearest hospital even though their problems would not normally merit Accident and Emergency treatment.

But who can blame them?

It is up to those running our health services to provide appropriate treatment and to make it crystal clear to the sick and injured where and how those services can be accessed.

In the absence of other coherent information of course people will make a bee line for the one place where they know there are doctors and nurses - their nearest hospital.