A&e regular attender

Me too. It was an awful scheme. I met the guy who ran it.. Paul Jennings. Totally out of touch with the people who were in distress. Made it all about him (he had been 136d in the past.. but his was "valid"). Total knob.

you can’t go directly to a ward unless you go via a&e, if you call the respiratory ward they will just say to go to A&E and if needed they will admit you. and sometimes I dont even need to be admitted , just need to be stabilised and then I’m good to go home

Of course you can. Ways to go directly to a ward (had these with DD)

Your GP rings a department and says they are sending you
Your hospital know you have something that can kick off, and you are given a form which allows you to present at a particular department (often for a time period eg a week)

You are under a particular consultant who runs a clinic which you are told you can attend if its at a time thats open
You have a specialist nursing team and are given specific contact details for them (DD has had this for cardiac).

Its quite unusual to have a well managed chronic condition that means you end up at a&e a lot. Usually its indicative that something isn't being managed appropriately.

Unfortunately not everywhere has these in my area we have nothing

@Carrotmccarrotface
Most people in a mental health crisis find A&E to be a very distressing place with all the lights, noise and people. Alternative pathways such as crisis response, safe havens etc....are often much more appropriate.

The patient is not left to wait longer. As many previous posters mentioned, marking someone as frequent attendant usually triggers a review to identify why they are attending and how they can be better supported through other avenues, including primary care. It's not a punitive practice. I just don't necessarily agree with it being kept on notes indefinitely. I think notes should be updated based on more recent time-frames as it helps no one to still see a warning when their last attendance was 15 years ago.

I got told off for going to the urgent care walk-in just one time ever! It was the first time I'd ever been. History - I'd had a cough/cold about a year before and went to GP. GP diagnosed pneumonia and told me off for just leaving it so long and not coming sooner. Said that if I get a cough like this again, I need to see someone. A year later I had a cough/ cold that felt exactly the same so went to the walk-in. It wasn't pneumonia this time and I got told off for attending with just a cough.

My elderly mother goes through phases of being a frequent flyer. We managed three visits in A fortnight recently, but there's never been any suggestion that it was inappropriate. It's got to the stage where we not only recognise some of the staff, but also some of the other regulars. The most that has happened in her case is referring her on to the age team so that they can check she has everything she needs at home.

I was what you would call a frequent flyer years back im doing a lot better these days but that is completely down to my gp who has been so supportive and has given me so much of his time and help to get out of the situation I was in. I'm one of the lucky ones and that's 100% down to him if he hadn't helped me the way he did I would of carried on as I was and probably be dead now

The problems with overuse of A&E fall into different categories and the reasons are complex. The last time I was at minor injuries with my DH there were:

• A young woman being detained by police officers for “kicking off” outside. She appeared to have been brought in with some care workers of some description.
• A woman who confessed she was only there because she had not been able to get a GP appointment and ultimately gave up waiting and went home.
• A man who told me he was there for an infected cyst (an issue for the GP/pharmacy)

Among these characters you likely have:

• people who are bored and enjoy the drama of attending and telling people about it/checking in on fb
• people who have health anxiety and think a problem is much more serious than it is
• people who are experiencing acute MH crisis and need urgent intervention
• those people who are at a genuine loss of what medical treatment is most appropriate for them and to be fair it can be confusing as what is available is not consistent across areas.

Any of the first three are a cause for concern imo and need support to unpick the reasons for their frequent inappropriate attendance. Someone who attends regularly with an actual medial problem is not a cause for concern in this way but I would expect they would be concerned the condition is not being adequately managed at home.

Omg im so glad they stopped sim I didn't even realise iv been out the mh/hospital loop for a long time now that's great news it was absolutely disgusting that, that was even allowed to happen

This.

I used to be a frequent flyer to A&E for mental health. Believe me, I never took myself there... was always taken by police or paramedics that had convinced me to go. I was considered a high user of 999 services, and was under Serenity Integrated Mentoring (now stopped, as it was actually harmful to patients... it was basically criminalising being in crisis - have a Google for StopSIM if you want to read more about it).

One A&E nurse was very kind and said that most people who come to A&E get sorted there and then, or moved to a ward where they have some more treatment/surgery etc.... with MH, it can be upsetting and frustrating to see someone in mental distress as they simply can not fix it there and then. It is always a long journey with therapy and lots of working on one's self. (unless it is something that a proper medication regime can fix).

In the main, for me, A&E was terrible for MH. I was on an assessment unit, and all 4 beds were mental health related. I could clearly hear the nurses saying "ooh, a few sections are going to be handed out", and basically gossiping about how the patients were presenting.

You say you know how things work but you said ‘Why dont you go direct to that department’
So im telling you thats not how it works

A condition can be well managed and controlled ‘in clinic’ and health care providers doing everything they can but that does not mean you will never need A&E for that particular condition and to be honest its just daft to think that all conditions can be sorted in clinic

If your multiple health conditions can be treated in clinic and there is never a need for A&E then great for you

But i have multiple conditions where i am very well looked after in Clinic (They couldnt do more) but i sometimes need to go to A&E in between those times
Its got nothing to do with the consultant or the clinic not looking after me well enough
its a symptom of a condition that sometime needs emergency treatment
Which by the sounds of it is the same as the OP

I would imagine you might have an alert on your electronic records to rapidly show staff that you have a known condition that flares up - and if it is a high risk scenario like brittle asthma or severe epilepsy there may be a specific 'rescue' plan from your specialist - speeding up urgent care.
Depending on how the electronic records are arranged the alerts may look different for a 'frequent attender' for mental health or social reasons, or substance misuse. Likely to be a specific icon for someone with a history of violence to staff.
What icons they use and how niche they get will depend on the computer program the trust uses. I often struggle to work out what on earth all the icons mean to be honest (but I don't work in ED!)

If you have a serious condition of course you should be there. That being said, your doctor is failing you with long term treatment if you need to keep going with the same condition, they should have you referred to someone who can get it stable

@JessicaPeach , one of my DC was the same, she was finally diagnosed as having asthma and given low dose steroid inhalers... and 10 years later, has never needed an A&E admission for respiratory issues since.
I was told they "don't like" diagnosing asthma in under 6's, but ultimately did for DC due to number & frequency of admission to hospital with viral wheeze.
Might be worth asking for a referral to follow up.

I have multiple health conditions I know how things work.

Of course in an emergency you go to A&E, say you have a chronic heart condition but then suffer a sudden heart attack out of nowhere then you of course go to A&E.

If you have a chronic condition and are having a heart attack every month ending up in A&E then the question is why? and what is not being managed properly. That's something you go to the specific department for to prevent it before it gets to emergency.

Even if you have an emergency you are suppose to be discharged to the correct team to STOP it happening again.

A lot of A&E time is wasted by people with legitimate long term medical issues who do in fact need help but who do not manage their condition in day to day life until the emergency point or because of a failure in the collapsing NHS system where they are not being treated correctly (Ive been there too, COVID was a bloody awful time for getting help and I ended up in A&E due to it many time over the lockdown period).

If anyone finds themselves a frequent flier in A&E because of a on going condition they should be pulling up their specialist though. They deserve to have proper preventative treatment not walk a knife edge of just surviving.

If its a case that they actively refuse any help or do not keep up the treatment program then they are either a nuisance or more likely should likely be refereed for evaluation to assess their capability to care for themselves (physically or mentally).

No idea why you have chosen to incorrectly read and react to my post this way. I have mental health issues.

Yep this is what happens and when people are talking about stigma around mh they are mainly talking about the way they are treated by medical staff. Iv been almost killed multiple times by nhs staff due to comments in my medical records.

I find your comment very concerning. As anyone who has had or witnessed a full on anxiety attack knows, it can be incredibly frightening. Confusing the symptoms with more serious illness is very common. But what happens on the times it is a genuine major health event and the patient is left longer than they should be due to previous visits.

I don't think anyone was suggesting that, just that there may be suitable alternatives available. It will differ by area but some near me are crisis teams, evening mental health drop in cafes, and a mental health emergency centre as well as eg: GP, samaritans and shout, and talking therapies before crisis point. A and E will of course be appropriate for some mental health issues but in some cases it is definitely not the best environment for people in mental distress.

My daughter has Asthma and it’s one condition than have medical staff worried. I bet you are straight in when you have been triaged and you are in resus. i assure you you have to be pretty ill to be in resus so you obviously need to be there.

Direct to what department?
It really is not that simple

I have multiple consultants in multiple areas,
Do you think i could just turn up at that clinic and say ‘Hi’
Even if it was during clinic hours, it doesnt work like that at all , clinics often cant give you the treatment that you need (especially in an emergency)

When im in A&E sometimes one of my consultants is called but you cant just go to that department (even if it was open)

I don’t understand that. I had to attend A&E twice, years apart, for an excruciating reaction to an infusion I’d had. First time I was given Oramorph, which helped a bit. Second time I was told that they could not prescribe any painkillers- nothing at all. I was in so much pain I couldn’t sit or lie down and had to keep moving, even talking to the Dr in A&E I was walking up and down the room, I slept standing up, hanging over the footboard of my bed. This was - of course it was- on a Friday and I had 60 hours of misery and despair until I could get a GP appointment on the Monday

I have a cousin who is a paramedic. Her take, I'm sure, would be it won't be "blacklisting" unless you are actually calling an ambulance or self reporting at A+E when your condition doesn't warrant immediate treatment, or you could get to A+E easily yourself.

What they should be doing, is trying to work out whether there is anything else that could be done to prevent flare ups being so regular or so severe that they need A+E often. I don't think it will be about "blacklisting", it will be about tracking and working out whether their A&E attendance could be reduced with better involvement of other services.