My understanding is similar to what you say: first stop is at the local hospital to “stabilise” and then a transfer to the bigger hospital to do anything more than that. I assume local A&Es have an emergency neurosurgery capability but not a wider neurosurgery practice.
What I’d encourage you is that discovery of an AVM doesn’t immediately mean it’s going to bleed. It’s a very frightening time and I was just as rocked by the discovery of my AVM.
I first discovered mine in about Sep 2015 because I could hear the whoosh, whoosh of the blood sneaking from artery into a vein that passes my ear, so the rough squirting of the blood each pulse I could hear. I asked my doctor if I had a lot of wax in my ears (because you hear a lot more internal things when your ears are blocked) and he said “no”. So I parked any concerns until I felt it was getting louder. By April 2016, I decided it was definitely louder and started googling things. I discovered the possibility of an AVM or DAVF and made an appointment with my GP. She referred me to ENT, I think because I could hear the noise in both ears rather than just one, so she made a referral for tinnitus.
I got to see the ENT in August 2016. He confirmed AVM and referred me for an MRI and then to neurosurgery at Nottingham (I’m in a similar situation to you where my nearest hospitals are in Leicester but don’t have a neurosurgery practice). It then took until April 2017 to have an operation to fix my DAVF.
So that’s at least a year from “something’s wrong” to getting it put right. So please don’t go round worrying that he or she is bound to have a bleed this week or next because it’s just too worrying a way to lead your life. The one thing I did was to buy a medical wristband and put my NHS number, condition and emergency contact details on so that if I was found inspecting the carpet really close up or making even less sense than usual, someone might get me an ambulance and the medical crews would have some extra clues as to what might be going on. That helped me settle a bit while I waited all that time.
Hope something here helps,