Background Crowding in the Emergency Department (ED) continues to be a challenge across the country. Recent focus has been on the increasingly complex elderly patients. However, data from the Royal Infirmary of Edinburgh (RIE) shows that over the last 10 years, attendances in young adults have doubled, whereas those in over-65s have increased by just 16%. Studies show that patients aged 18–40 are least likely to attend their GP; perhaps they see the ED as a convenient one-stop shop for 24-hour access to care. Until now, literature exploring their motivations to attend the ED has been sparse, often limited to establishing characteristics of a frequent user.

Method and results This project investigated the reasons for attendance to the ED in young adults aged 18–40 and their opinions of the emergency services at the RIE. A survey was conducted for three weeks where 131 patients were recruited at check-in, the waiting room and within department cubicles.

Questions were based around recurrent themes of previous literature, which discussed the ideas of the ED being a convenient system to acquire medical attention at any time of day. Patients were asked about their reasons for attendance and to rate on a Likert scale a series of statements about the ED.

Conclusions Our findings show that patients aged 18–40 in fact, did not consider the ED more convenient in terms of time or location than their GP, nor did they think the ED provides better care.

However once they considered their problem as urgent they did not perceive primary care as being able to accommodate this urgency. Patients therefore present to the ED as the only other option. Understanding this perspective provides potential targets for intervention, allowing patients to be seen by the right person, in the right setting, the first time.