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

Not even sure you can get that much cash out from a cash point
mist have a limit around €500

And don't forget the brightest strip lights in the world!!

@MikeRafone you may be right. Sorry.

My local ER/A&E is actually pretty good (US). Free valet parking so you don’t have to worry about parking. Clean, comfortable quiet waiting room, and for fun I just checked 48 min wait time. I think that’s pretty average except for the overnight when it can go up to a couple of hours.

It’s the level 1 so all bad injuries are taken there.

Last time I brought my DH in for a suspected kidney stone he was in an exam room before I had a chance to hand the keys off to the valet and get through security.

That’s true. Mine did bloods and an ECG as part of the triage. Doc when I eventually saw him just added a chest X-ray and a referral to Covid medicines clinic. No complaints about the care, just how uncomfortable the waiting room was.

I read it was €260

is that incorrect? €2000 for an ambulance ride?

They also order scans immediately if you go in with something suspected to be broken, so again, by the time the doctor sees you they have more information. It's not a perfect system, and if you turn out sicker than they expect, they can order more things as they go along, but it makes complete sense to get the most information early on for a pre-diagnosis and then refine it, rather than wait a very long time to see the main consultant, who then orders tests.

That cost is based on a thread yesterday where a woman posted about her husband being taken to hospital in France by ambulance. That is what he was charged. And the ambulance went via a cashpoint so he could pay.

Another good thing our A and E does is to do the screening blood tests and measure BP/temperature while you are in the waiting room, and any further tests are added on the top by the doctor, this means that when the doctor sees you they have a lot more information than in the past when bloods were only ordered once you saw the doctor after, say, eight hours. They do this via a nurse who works alongside the triage person. It's very efficient.

Yes completely agree OP. My most recent experience is nowhere near as bad as so many people's experiences on here but I had to sit for 4 hrs on a hard plastic chair with nothing to elevate / support / prop up my leg even though my injury was snapped ACL and torn knee cartilage, and also with no painkillers.

It was only for 4 hrs because I gave up and went home at that point (so no idea how long it otherwise would have been) because the triage nurse was so unpleasant (which I think was v much an exception, almost as the only exception in terms of hospital staff I've otherwise encountered being kind and compassionate but in this instance it seems I had gone to the wrong place - my bad (had had the accident abroad, been seen in hospital in France - also horrific, not given any painkillers just told to get some from pharmacy when opened the next day, fly home and see a doctor at home - it was weekend and had been picked up by parents so didn't think would be able to see their GP so went to A&E thinking that was the 'correct' way to get in the system back home)).

I was seen, treated and out of a French hospital in about 90 minutes once, after a fall. Didn’t cost anywhere near 2000 euros.

Not that this is actually what this thread is about.

That wouldn't work at our local A& E @Bellamari. Parking is limited to 20 mins.

I think those saying that it's like that to put off the unnecessary visits are barking up the wrong tree, it's precisely the sicker people who struggle on the small upright chairs, those who aren't that unwell do just fine.

Same for saying that in the past everyone was very ill and came in on trollies, this is not true, A and E has always treated accidents and many accidents don't require trollies, they are broken or sprained wrists, ankles, kids who fell off beds and need a quick scan, those facilities aren't available at the GPs at all, so there's no option to go elsewhere. In fact, it would be neglectful not to take someone in with a suspected broken bone, even if most times it turns out fine.

A and E does best when it has quick triage, like ours does, so that it can correctly allocate people to what they need, so GP if antibiotics (again not always predictable in advance), cubicles but not trollies if minor break/sprain, and trollies for those who are more severely ill or just older and can't sit for long time periods.

Our city does not have one minor injuries unit which does not help matters, but other than that it's quite good now, apart from the chairs and the harsh lighting (if you have an eye problem, a migraine/potential stroke or a brain problem that harsh lighting is very unpleasant).

I have to admit this wasn’t my experience last time I used A&E.
I went with severe bleeding during a miscarriage and I could not have been treated better.
I didn’t even sit on a waiting room chair before being taken into a cubicle, made a cup of tea (for me and my husband) seen really quickly.

A and E design was fine when A and E worked properly. You were checked in quickly, and if it was something even semi serious you waited for 20-30 minutes to be taken through to the cubicles. The only people who used to wait a long time should not have been there.

Eg. People could be given a number and sit and wait to be called to check in rather than standing in line.
I don’t see why you can’t go and wait in your car if you have one, and receive a quick phone call when it’s your turn. It would clear the waiting room and people would be more comfortable and actually able to lie down a bit.

Lets all move aboard then and sit outside for a few days before we get seen to. If we get seen to or pay private.£300 it cost to get picked up by ambulance to be taken to a & e in France then 2000 for treatment count your blessings you live in the UK !!

I read once that they've got the management of A&E the wrong way around. Instead of having the nurse do triage then you wait for the doctor, you should have the most senior doctor on duty do the triage. They can then send half the people home straight away, or with medical advice. The rest go back to the waiting room and wait for more tests/care.

It was. I’m large chested and didn’t have a bra on. Too ill to care much, but it felt very undignified. I was also anxious I could be infecting vulnerable people.

I would be great to have LOADS and LOADS of money to build a new hospital from scratch.
Our is a Victorian building that needed replacing many many years ago but has been patched up on a shoestring budget.
Receptionists sadly need physical protection nowadays with screens. Chairs need to be as cheap as possible, same as everything else.
Private hospitals are probably very lovely (obviously don’t have A&E though, but you get the point).

I tthink some of the quick changes made during covid haven't been rolled back, plus no-one does a 'time & motion' study of the patient's journey through A&E. It's also about space & infection control.
Interestingly the Design Council did some work with hospitals in the past to improve A&Es - don't know whether the improvements are still in place.
Improving patient experience
Reducing violence in A&E
Overview of NHS design projects (edited to sort out links)

I was in A & E last week. Horrendous environment.

They now have self service check in/triage screens. So many questions on this screen, very clunky to use and when you are feeling poorly, not what you want to be doing. Lots of people were frustrated with it, many needed assistance because they were not tech savvy. You have to stand for 5 mins whilst going through all the questions and many struggled.

That's not even including the uncomfortable chairs, little cardboard hats with sick and urine under the chairs (I counted four), some unpleasant acoustics which made it much louder and the harsh lighting.

I find it bizarre that they don’t have the facility for sick people to lie down while waiting.

I slipped down icy steps and broke my tailbone. Couldn’t sit on it so I went to hospital lying down on the back seat of a taxi.

I was unable to sit so I lay on the floor. They told me off - said I had to either sit on a plastic chair or stand up. I said I can’t sit at all and I can’t possibly stand for 5 hours! They shrugged and said you’re not allowed to lie on the floor so you have to either stand, sit or go home.

So I stood until I fainted. They got me up and said the same again - if you can’t sit then you have to stand, if you can’t stand (because I just bloody fainted) you have to go home.

So I got sent home with a broken tailbone and no treatment or medication, because I was physically incapable of sitting or standing for hours on end, and they wouldn’t let me lie down.

On a later visit to the same hospital I told the staff a woman was passed out in the toilets. It turned out she was perfectly fine, she was
just lying on the toilet floor where they couldn’t see her and tell her to get up, because they wouldn’t let her lie on the waiting room floor.

The kids A&E at the same hospital has no plastic chairs, just long vinyl covered benches. They’re still washable and hygienic but much better because patients can lie on them if necessary. I don’t understand why they don’t have the same in the adult waiting room?