To wonder why A&E seems to be designed to be the worst possible place you could possibly be when ill?

Some of the kids who look bad really are not. Was in A and E and a young teenage boy was brought in by ambulance with suspected broken leg moaning in pain. X rayed, just bruised and walked out of there.

My daughter very obviously broke her arm a couple of years ago. Went to kids a&e, took 11 hours from beginning to end. Waiting room over capacity. When we arrived there was a really distressed mum with her daughter. Covered from top to bottom in chicken pox. She was sent over to opthalmology just was we were arriving.

6 hours later she was back with her daughter, and put in the packed waiting room, at the back of the queue. Daughter was in a wheelchair mum had no where to sit. Mum hadn't eaten anything since they arrived, and had given the daughter all her water. She looked ready to drop. I had to tell a dad to get up and give her a seat and go and get her the last crap sandwich from the vending machine.

In the meantime it was clearly being used as a GP surgery by a number of families. Kids who after a dose of Calpol were right as rain and running around. I don't know how the staff resisted telling them to go home. I nearly bloody did.

😂

The well educated doctor knows his surgery more than you.

Agree. I was in a few months ago. Sat in AGONY for 5 hours waiting to be seen by doctor (as triaged to see Dr due to severity of problem) and obviously in agony whilst others with a broken finger went before me. Fine, but offer me some decent pain relief if I need to wait, it's quite cruel. And I am a clinician myself so don't have delusions of grandeur of what to expect.
I actually think it's quite a traumatic experience, and I don't use that term lightly, needing to go to a+e without the environmental factors going on as well, especially something pain related.

And a big fat YES to the confidentiality side, it's appaling!!! Just having to basically give out your personal identifiable information to a room full of people plus whatever issue you've got going on, like wtf!!!!! Just goes against everything we're taught really.

@Nadeed she's still in, but looking much better thanks, and being very well looked after

I don't think that's fair either. If you're worried about something and can't get a GP appointment for 6 weeks, where else are you supposed to go? Coupled with months on end waiting for any kind of MH support, it can't be a surprise that people go to A&E.

It is not people socialising in A and E that is the issue. But that people are very poor at being able to judge when they need to go.

In the 90's my mum said her doctor told her he stopped the open surgery and it was appointment only as he was fed up with women with nothing to do with their lives were socialising in his surgery.
Maybe A&E have a similar issue?

Part of the issue is people go to A and E with very minor things. I see it on here all the time. Should I go to A and E with x symptom. Yes immediately, I knew someone who did not go to A and E and had x symptom and other concerning symptoms, and they died.
Loads of things posted on MN do not need A and E and nearly all the time the person posts some hours alter to say they or their DC have been checked and everything is fine.

@nonevernotever glad to hear they are treating you well and hope your mum recovers soon.

Just revisiting this thread because I'm back in a and e again with mum. It's been a long wait (currently at 11 hours) but in that time she was triaged after 20 minutes, has been given painkillers, was offered a baked potato with a choice of filling at about 6 pm along with every other patient waiting that wasn't nil by mouth, has been given advice about taking her normal medication and then we were all (not just patients) offered tea, coffee biscuits and sandwiches at 9pm. Bottled water from the fridge is freely available, the staff do their very best to find trolleys or comfy chairs for patients and stacking chairs for everyone else. And this was on a night when staff admitted it was the worst it had been for a while. Yes we still had to wait, but they had done what they could to make the wait more bearable.

Tbh it doesn’t sound like any design will help your problems.

Regarding why you weren’t allowed through a back route to X-ray. You don’t know why that area is controlled. It might be below, above or adjacent and MRI for example.

These places aren’t designed to piss you off. It’s hard enough to design one that works in the first place. Believe it or not that is usually the main objective.

I had a gallbladder attack a few months ago and spent 11 hours waiting in A&E in agony and vomiting constantly. I couldn't stand or sit so I had to kneel. They finally gave me 2 paracetamol, even though I told them I couldn't even keep water down. I immediately threw them up, but was then told I couldn't have any more pain relief for 4 hours!! Despite having thrown up 2 intact tablets. Eventually I was given IV painkillers and antisickness and was fine within 15 mins! After 15 hours of torture. I've since had it removed (privately as the waiting list in the NHS for an urgent referral was 2-3 years. And I am traumatised. I'm terrified of getting ill again and having to go to a&e again.

Basically, it’s designed with a ‘perfect flow’ in A&E in mind.

It doesn’t matter that it takes longer than 10 minutes to be seen by a triage nurse, or that you spend longer than 4 hours to be discharged. That’s not how it should be, so they aren’t going to design A&E around ‘bad practice’.

You can bring it up a million times, A&Es don’t operate like they ‘should’. It doesn’t matter, it wasn’t taken in to account with the funding granted. So they say the hospital staff do have isn’t taken in to account.

I shit you not. It’s fucking ridiculous.

@Peakpeakpeak Absolutely! It's wild that people keep trotting this out, "just make it a 24/7 service.... "

There's not the staff to really make it a fully 8/5 service, but sure let's just magic up a lot more GPs (+aux staff) to provide a 24/7 service. There's just not enough Drs coming into the job and this is why they're drafting in nurses/acps/pa's/paramedics to provide shortfall cover to maintain an 8hr 5 days service in most areas (ignoring the fact that clinicians in these roles will never have to knowledge and acumen of a GP) so when you pop in on the sunday morning to check out the random hand tingling that's been bothering you, you absolutely might have a nice reassuring consultation from the paramedic telling you the most common cause/that it's probably just a bit of carpal tunnel and give you some exercises, but likely they've not even considered causes like MS/Guillain-Barré Syndrome which a GP would.

The most obvious solution is to staff and have information for everyone about a) GP services 24/7 and not closed on weekends and unable to issue basic prescriptions

There are already not enough GPs for the limited Monday to Friday service. It would solve a lot of issues if we could have 24/7 GPs, but it's not an obvious solution because it isn't a possibility.

Yep, sometimes one isn't enough, especially when people are really vulnerable and struggling. Which of course is going to be a disproportionate number of people who are in A and E in the first place.

My grandad's got dementia, and managing him for many hours in an unfamiliar and stressful setting simply cannot be done by only one person. Regardless of whether any passing fuckwit understands and approves of this.

I’m not talking about the Consultants, their offices are in the ward areas, which is their convenient space, near to their patients. I’m talking about the senior managers, senior administrative staff, Chief Executive Officer etc., those people who just stay in their offices near the entrance to the hospital, people who would most likely not even be recognised by many of the ward staff, if they ever deigned to actually go into the ward areas.

I wouldn’t grudge a hard working Consultant a private parking space, but I do grudge these senior officials (many of whom have no hospital background, prior to becoming hospital managers) their private parking spaces and offices, as far away as possible from actual sick people.

Regarding the shorter internal routes, the lowly nurses/healthcare assistants aren’t allowed to use them. Their badges aren’t activated to allow access to these areas, they aren’t allowed to take shortcuts, they have to take the long way round.

”As you say we can get you a wheelchair and a volunteer to solve your problem.” Where all all these volunteers that can solve my problem? As I said in my post, there is often a queue waiting to be wheelchaired to where they need to be. There is normally a maximum of 3 volunteers to help everyone who needs it. They are a godsend, but there are not enough of them to anywhere near solve the problems. They don’t just wheelchair people to their clinic / X-ray, but also take visitors to the wards, so they can visit family / friends. They help outpatients use the self check-in computers and try to solve registration problems, trying to find out where someone is meant to go to. As for visiting in the evening, there are no volunteers to help after 5pm.

I have actually had to miss an appointment as I couldn’t get parked. I actually allowed myself 40 minutes to get parked, but there were no spaces apart from round the other side of the hospital, which is too far for me to walk from. I phoned reception they couldn’t help, I entered A&E and asked if it was possible to let me through the door which separated it from X-ray, but was told they couldn’t allow it, so I got to within 10 meters of where I had to be, but couldn’t get any further. I had to finally give up and leave, without being able to attend my appointment.

So, all in all, NO, you cannot solve my problem, but at least the senior executives can have their private parking spots and offices just inside the entrance, well away from the sick people.

I would definitely take DD to MIU in my parents' or PILs' towns rather than subject her to our one or our A&Es. MIUs can send you through for Xrays etc if needed. The experience is hugely variable by area/facility.

I totally agree. My dd was at a club when I got a call saying she needed hospital for hurting her arm. My first instinct is to wait for the morning. She had dislocated her elbow. The same when my son broke his leg. The first dread isn't " oh god its broken" it's "oh god I have sit my kid in a&e for 8 plus hours" with drunks and people puking everywhere.

We fid go straight to A&E both times but I really didn't want to. We also now go further out to a better A&E as that's the local nhs advice.