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

They... SHOUTED at you? What was the story there?

Quite a while in the past, I think it was 2014 was the last time it was met.
https://www.kingsfund.org.uk/insight-and-analysis/long-reads/whats-going-on-with-ae-waiting-times

They've readjusted the goals now though - there's a realisation that we're never ever going to get back to standards as they were a decade ago so need to have more realistic targets. Initially it was supposed to be 98% in 4 hours, then it was 95%, currently we're aiming to try and get back upto 78% in 4 hours - hoping to achieve this by March next year.

I agree a lot of the people (not all unfortunately) who are allowed to wait excessively, 12-24 hours, and really affect the figures really should never have been there in the first place.

I had to go recently, for a minor injury, but no minor injuries unit here. It felt ridiculous, so I actually didn't go for 24 hours (and got shouted at for that when I got there), but I'm in good health and wasn't in a great deal of pain, but I felt dreadful by the time I left. It was hot, crowded, noisy, uncomfortable, I spent a lot of time standing or sitting on the floor, leaving seats for people who needed them more. No way to get a drink or anything to eat, without leaving the waiting room and risking missing your call.

It was horrible, but I'm young(ish) and fit and could cope. The idea of going through that when actually unwell....

The chairs need to be compact, easy to completely wipe down, robust (so no moving parts). There's massive amounts of vandalism that occurs - it pretty much rules cushions out - sterile cushions that can be wiped down are expensive, if they get torn and they will within days they'll need costly repairs/replacement.

Part of reception staff role is to monitoring the patients in the waiting room - i.e. notice if someone's collapsed, there's a fight etc - they need to be visible to the room and not tucked away. Privacy is difficult in hospitals - just think on the ward when you're being examined and often quite indepth discussion about your symptoms/history - there's just a thin curtain between you and lots of quite bored/waiting people who are mostly listening in. At least reception is often noisy enough that most people won't hear and generally it's quite minimal history being required - i'm here because i've got a headache, chest pain, a rash....

My experience with dh, he has prostate cancer and had an operation. Couple of weeks later in absolute agony after catheter removal. Couldn't walk, lips, ears turning blue I thought he was having a heart attack or stroke, called 999, no ambulances call 111 not a chance. He crawled to the car and I got him there. 9 hours waiting before we found out he was leaking urine into his body. They thought he had a urine infection. I screamed at anyone who would listen that the level of pain he was in was not a fecking urine infection. He had every pain killer thrown at him. His operation had failed and he was verging on kidney failure.

Second time he was waiting to go on the ward for an infection in his catheter and needed iv antibiotics. 10 hours. Old people waiting for the same thing 11 hours plus. I had to go to the corner shop to get pain relief for him, I got chocolate bars for the elderly people waiting there to keep them going. One elderly lady said it was the best tea she had ever had. Bless her.

It was absolute hell on earth. It was the middle of summer and I had to go and find somewhere to fill up the water jug so people could have water. Its basic care and it is not fit for purpose.

I had to wait for 12 hours in a&e last year while 19 weeks pregnant with dangerously high blood pressure. I ended up sitting in a corridor as the waiting area was so uncomfortable, overcrowded and smelly. Care was great after though.

It's to put off the time wasters and from homeless people sleeping on the chairs. Awful for the people who need it though

Don't get me started. When I was 16 weeks pregnant my bladder decided to stop working completely. I had to wait 9 hours in a&e. It was absolute agony. I started to bleed and thought I was losing the baby: still no rush for me to be seen. Worst time of my life. Luckily baby was ok. I think they have made improvements at the hospital now as they have an urgent treatment center but still scarred by my experience

The 4 hour target was nearly always met in the past. The people that went past were those who should not have been there in the first place.
In the past I never waited in A and E longer than an hour, and sometimes much less.

I just can't see it changing really, it's going to take a real paradigm shift to either meet the demand in a reasonable time frame/the 4 hour target that's never really been met i.e. working out how to provide enough staff and pay for - increased primary care capacity, education so people are more able to manage self limiting presentations, more social care to reduce bed blocking, separate mental health centres so people in crisis don't have to resort to A&E, larger/more hospitals to cater for the population increase....

Realistically how much of that is going to happen....

So what are the reasons for them being designed this way? Why can't there be an alternative to shouting through glass, banks etc have managed it? Why can't chairs be designed to sit in comfortably? Why can't the temperature be managed? I understand why when they're having to do the best they can in old buildings, but why are new ones just as bad?

I think they are like this to put off time wasters. Unfortunately,it impacts very badly on the ones who are not.

It’s called triage. The people coming in, hanging to life by a thread get priority.So if you wander in with earache or a sprained ankle - you’ll wait.
I have been to several in various countries - they’re all the same .The most terrifying one was in one of the supposed best hospitals in the USA … it many have been but the ER on a Saturday night was full of gunshot wounds and people handcuffed to trolleys escorted by police and people OFF their faces on god only knows what…

My A&E is much better.

you take a ticket as you enter and then sit down. Once your ticket number has been called you go into a private cubicle to tell them why you are there and be triaged.

The seats are still plastic and uncomfortable though.

Ours has recently got these areas called 'Safe to Sit' with more comfortable chairs, where they do e.g. blood tests etc and they have supervision and a coffee / tea pot and biscuits

Seems to be for after you have been triaged and separate from the other waiting room which is as mentioned here.

As others have highlighted, it is deliberately designed to be so uncomfortable, degrading and unpleasant, if you're able to walk you will leave. It's a form of triage using the environment. Only those who are truly desperately sick will remain. Anyone who isn't at death's door will take themselves off.

Agree completely.

I've been a few times in the last year for different reasons and with my son and it's just a hellish place, especially in London. All of the toilets were splattered with vomit and urine and I had to give a urine sample it was just disgusting. They don't even have water machines and I was too ill to walk to a shop, after about an hour someone got me a water. I was vomiting into my hands at one point and no-one even got me a bowl or tissue (I'd had an accidental overdose of medication and I was very ill). I think they make it so deliberately awful to put you off going.

I had this exact thought when we were sat in a and e. It also seemed odd there was nowhere to lie down. My son had a terrible concussion and had to lie on the floor as he couldn't sit and some other woman fainted off her chair.

I also agree that mixing injuries and illness is odd. We need injured, stomach, respiratory, rash and unknown!

I recently had the misfortune of having to go to A and E for suspected mini stroke in a city centre hospital on a Monday afternoon. I can't believe how bad it was. Far worse than people can imagine. There were no seats. People were lying on the floor. When I did get a seat it was unbearably uncomfortable.
I was triaged and sent to another waiting room as I 'would be seen quicker'. There were about 50 people waiting in there, with curtained cubicles around the outside. The man next to me said he had kidney failure and had been there for 6 hours. He finally left to go home in despair as he couldn't stand it.
People had no dignity in there. One man had something wrong with his bowel, and the whole waiting room could hear what was going on behind the screen. It was awful.
I asked a nurse if she enjoyed her job and she said it was very very difficult. I really take my hat off to people working in these conditions.
It took three days to find out what was going on with me.

It’s to put people off going, or in the hope that they are so uncomfortable they go home and just die there.

I guess the main issue is the waiting time. If you were to wait in that type environment for a maximum of an hour, say, it would not be as bad. The fact that others around you are suffering in often quite awful ways, for a long period of time. Just gives this feeling of doom.
That and they sometimes call someone's name who's so sick they've passed out, so they get ignored and even have died on the floor!?

There are no staff supervising the A and E room constantly, if some type of basic nursing care was offered there, it would be different, but they are in their rooms, and only come out to get the patient. Our receptionists aren't facing the main waiting area. You can't leave sick people alone to see which ones sink or swim!

I think there should be one person accompanying the patient, though. I disagree only the patient should be there. Often people are too sick, faint, unwell, or just have hearing/sight/dementia/cognitive/brain injury problems that means they can't communicate well, those people should not just be left in a waiting room without someone else to help them to the toilet, fetch food and drink or advocate if they suddenly deteriorate. That would be madness, to take someone out of a home where they have other people to check on them and make sure they are not deteriorating and then put them for many hours in a basically unsupervised environment whilst having an accident or emergency. Very dangerous.

This is also the sort of thing that makes people turn up with multiple relatives - so you can have one to help the person and another to e.g. stay and listen for announcements or go and sort the parking on the car or to go and locate some food once you've been stuck there for however many hours.