How do families manage urgent medical care without nearby childcare?

[MixedBananas]

Me and DH and 2 DC under the age of 5 and live remotely in Wales, very small town. All my family are in England SW over 3.5/4hrs away. DH has no family in the UK no close relatives but has resided in said town for over 20years. His Distant relatives live in London & Sheffield.
When we have urgent medical issues we have to drag the kids with us to apts. We have no one we trust to look after the kids and sometimes we postpone attending A&E due to lack of childcare. E.g I had a bad car accident and refused an ambulance as I wasn't able to bring the kids with me and their Dad was 1 hour away at work. I later went to A&E with the kids in tow as DH drove me and I had a small fracture.

How do others cope with it? If we lived down the road from a Foundation Trust no worries but we are 45mins drive over 30miles away from local A&E. All our local hospitals have downgraded to minor injuries only and working hours.
When I was younger this was never an issue. Our local town hospital was a major A&E with Drs. If anything they couldn't handle they would transfer you by Ambulance so never affected my parents. We were al born at said hospital it was convenient and nwver disrupted ofhers lives.

How to others cope who have no family the village doesn't exist? I am struggling. We can not afford to move closer to family. Rent is 4 / 5 X the amount SW England.

Wow, nice generalisation there. Some questions for you to reflect on....
Are you saying villages per se are cliquey, whether in Wales or elsewhere?
Do you think Wales is entirely compromised of villages? You're ignorant if so.
Are you saying Wales as a whole is unwelcoming? Again, so ignorant.
You cannot generalise in this way. I've lived in places that others make similar generalisations about i.e. London. Didn't find it unfriendly at all but maybe as I wasn't living in a pretentious part of London...

I would move. Life is too short to live somewhere you can’t make good friends.

We don't have a village in that there's not really anyone I'd disturb at 3am to give my children to... I have a few local friends but they have their own kids and nobody that I'd disturb at that time!

We'd just carry on as we usually do. If one of us needed A&E, they'd go alone or we'd all go. Thankfully it's not often been an issue. I've needed an ambulance once and they allowed my son to come when I explained there was no alternative. We don't have family anywhere.

You just attend medical appointments alone and the other parent stays with the kids. You say your dh drove you all to a&e? He should've stayed home with the dc. He could've dropped you off there or you could've got a taxi. Were all your dc in the a&e waiting room for hours?

I've only twice in over 60 years had to go to a&e (once aged 9, once aged 40). DH had some health issues but we had friends who helped out.
I'm sorry it's been difficult for you to make friends, I would hate that.

If you’re in a situation where you have no friends or family, you need to save a bit so that you can afford a taxi to get to the hospital if you can’t drive yourself. One of you will have to stay with the kids in an emergency.

Exactly this!

Your husband is your village. If you need to go somewhere he stays with the kids and vice versa. Get a taxi or uber there and back.

Are your kids in nursery or school?

I have almost no village aside from a grandparent we very occasionally ask to babysit and nursery for 3 days a week for 3 year old DS (was 15 hours a week previously and didn't attend before 2 years old).

I have been to several medical appointments alone over the last couple of years. I had to have an operation last year. Got an uber to the hospital while DH stayed with DS, he collected me later on with DS in the car. We can handle appointments on our own even though we'd prefer some support.