To think 70% of people shouldn’t be in A&E

It may be very different in different areas of the country so perhaps if there are areas with short waits then people may go without being desperate. In our area I think people who should go often dont or not in a timely manner due to the waits and this causes further issues for the NHS

Yes and no. Last time I was there, there was a teenage girl who’d been referred there by 111 for a uti.

Give over. It’s not medication, it’s something to itch their scratch. They certainly shouldn’t be lumped in with people of genuine need, who wants to share a room with that? When I left they were hanging around outside in packs, with cans of beer. Intimidating and very scary - especially in the middle of the night in the pitch black when I need to walk back to my car.

People need to be absolutely desperate for help to sit in a packed waiting room for over 12 hours often on the floor surrounded by some very distressing sights.

I imagine to an outsider I also looked fine when I was sitting on a chair in A and E having been sent there with suspected Cauda Equina. And my husband certainly looked fine when he had sudden sight loss in one eye and the GP sent him straight there in case of stroke.
However, that doesn’t mean there aren’t people there who don’t need the A and E care. But I don’t understand why all depts can’t do what my local hospital does. You get pre-triaged in a room before you even get in to the A and E. And if you’re there with a sore throat or twisted ankle (for example) you get sent to the walk in centre (on site) or told to go to the minor injuries clinic or wait for a GP as appropriate. The people on the desks (there’s usually two) are either nurses or other hcps (so not just receptionists). You only leave that room and go in to the A and E department if they consider you a genuine A and E case. Randomly after years of not darkening their doors, me and DH have been there four times in the last couple of years. The two above times and once when I had an accident and the GP was concerned I had fractured my eye socket and another time when I needed oxygen and monitoring after an asthma attack. Even with this system though, it’s like a war zone in there. And that is because of the insane amount of new house builds in this area over the last few years without a single GP, UTC, MIU or hospital being considered let alone provided.

It'll be in the news soon.

I agree. We had to recently go to A&E as my wife was having chest pains and breathlessness. On the surface of it she probably looked absolutely fine (and was initially dismissed by the triage nurse) when in fact she was having a prolonged allergic reaction coupled with a chest infection. I absolutely refuse to put my and my family’s health and lives at risk just in case. We pay for a health service and we have a right to access it at all points.

Half the people may be accompanying the sick person and indeed not be ill themselves. The last time I was in A&E with my partner the quietest person in the waiting area keeled off his chair and died on the floor so you just can't tell!!

Well lucky you for having a gp that you can actually get an appointment with!!!

I think A&E is a last resort for those that have been trying to get appointments.

What do you mean by a “drop in centre”? Do you mean a minor injuries unit? If so, we don’t have one where I live and in any case, my understanding is that they are not staffed by doctors so only useful for things like cuts, etc.

Last few encounters with A&E my family have had, we all looked “okay”.

1. parent fell badly while holding baby and both landed on hard surface, 111 advised baby needed checking over at A&E, baby was fine thank god

2. infected bite which had suddenly spread through the whole limb overnight and it had tripled in size, it was the weekend no doctors provision and would have been ridiculous to wait two days to ring the GP as blood poisoning is no joke

3. patient had been fobbed off by GP for months and eventually presented at A&E with agonising pain and vomiting, she turned out to be dying of cancer

The bite could have been treated at minor injuries, it clearly just needed antibiotics. The vomiting/pain should have been picked up by the frankly terrible GP. The accident - well it’s A&E I guess that was the right place to go to check a baby for concussion? Ironically that was the healthiest patient but could have been very different.

Asked the OP for permission?

My dad was chatting to me in the waiting room when I took him to A&E. He died a few days later in the hospital.

I think you're generally correct though. Most people could at least go to the drop in centers. We have a couple of them that are for fairly urgent but not life-threatening stuff.

Do you have any data on how many of these “repeat offenders” there actually are and the extent to which they clog up the system? I would be surprised if they make even the smallest dent to be honest.

Imagine assuming you can diagnose and identify medical conditions with no training just by looking at them.

There are conditions that people are not dying from but waiting medical intervention for two months can still be very detrimental.

I was recently in a&e in the early hours after an accident. There were several "frequent fliers" as the nurses called them, literally a dozen or so homeless people, who apparently go to a&e frequently to try and get a prescription for something, or just to hang out somewhere warm/dry.

Popping in and out for vape/smoke, chatting and laughing. Plus a multitude of people giving nurses pure abuse for no reason which is disgraceful.

I dont think everyone needs to look like they have been in a car accident to qualify for a&e, but I do think people wasting time should be dealt with somehow.

People won't like this, but if you had to pay for treatment, waiting times would rapidly decline. The Swiss model works well.

One of the things my GP practice does well is triage. None of the receptionists do unqualified triage by numbers, if there isn’t a convenient appointment or you are a possible urgent the triage doctor rings back. They say it saves the practice and patients great many unnecessary trips to the surgery and reaches the “quiet but need seeing” for exactly this reason. Everyone wins.

The origin of formal triage in most A&Es was to meet targets not patient benefit. It enabled hospitals to say that all patients had been seen within X hours even if they had waited far longer to actually be treated or dispatched home. Its ironic that the more patient centred approach could also have been more cost effective.

I was in A&E with DH looking completely well last week, following a TIA. I was told that if I could drive DH to A&E it would be faster than an ambulance. 999 told A&E reception to expect us, and on arrival he was immediately triaged, sent back to A&E waiting room looking very healthy, then given a bed in the A&E ward, still looking very healthy, but actually classified as being in "hypertensive crisis." (MAP 151) Monitored all day, CT scan, ECG, medications, follow up appointment at Stroke Clinic.

Kids were worried sick so I sent them a photo of their Dad in A&E looking very well and grinning and giving a "thumbs-up." I can imagine what you'd have been thinking, OP, if you'd seen him posing for that photo!

A&E is the correct place to go following a TIA, even if it does put you in the category of people who look perfectly fine and are chatting away. Given that his blood pressure was sky-high, and he'd had a "warning" TIA, if he'd been sent home and told to see his GP, I'd probably be a widow by now.

😂

She genuinely was unbothered by it, and I don’t actually know how long it was up there as I found it because I wiped her nose and it was blue 😐 it was way up there and she’d not had access to crayons for days that I could remember.

But like, once you know there’s something there you can’t just leave it and I definitely couldn’t get it out, they actually weren’t sure they were going to be able to, they were planning on putting her under a GA and flushing it at one point

But she was completely fine, no breathing issues no infection or inflammation, just having a nice day out at the hospital 🤦‍♀️

I think 111 does over-send to A&E. And I think the lack of access to other parts of the NHS does mean that people are there who shouldn’t be. The last time I was at A&E, DD had concussion. She looked fine. Other people who might look fine might be a suspected blood clot, chest pains, even a broken wrist can pass the “casual witness” test I would think

What puzzles me is that it's incredibly difficult to get an appointment at my GP surgery, yet there are big signs in the waiting room saying they 'welcome new patients' with instructions on registering. They can't cope with the patients they already have!

Plus sometimes they are the ones who actually get it wrong.

My son who had septic shock caused by a bowel obstruction deteriorated so quickly in the end because a senior surgeon ignored nurses concerns and insisted that he wasn't a surgical case, he also decided that the sepsis protocol didn't apply to my son because he was certain it was just a tummy bug.

Did you let this fart rip in A and E?