the gp surgery DOES NOT pay for extra visits to A and E, and to be honest, you would probably be waiting for hours to then be told to make an appointment with your gp and be even more discontented. If your wife needed any change in medication for example, the a and e department probably wouldn't offer her a prescription either (would say see your gp) or offer her a hospital prescription which would mean you waiting another few hours at the hospital pharmacy. The meaning of "A and E" is ACCIDENT and EMERGENCY. If you are saying your wifes ailment is an emergency then tell that to the gp surgery and they will give you a 48 working hour appointment as previously discussed. If it is not an emergency, what do you expect an emergency department to do? They are not GP's who work at a and e and a chronic condition such as arthritis would probably be out of their range of expertise, and much more within the range of a gp, meaning you may get the wrong advice. You have said that your gp surgery offer both "emergency" appointments and an appointment that could be booked a week in advance, so what is the problem?
Alternatively, each PCT area should by summer of this year have a "walk in" gp surgery whereby you can still be registered with another gp, but if it is more convenirent you can go there, and they are open 8am-8pm, 365 days of the year. A and E is a very bad use of resources for problems such as you describe, and i guaruntee you will will be even more dissatisfied when they tell you to go home and see your gp! I hope (god forbid) should you ever suffer a serious emergency, your treatment is delayed because someone wants to give their gp surgery a lesson by turning up and overwhelming A and E!!!