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

This is exactly what we need.

I agree there needs to be a rethink on GP care. In my practice there are 20 GPs. Well, that’s impressive, you might think. But they all work one half day each!! The admin for that must be huge, apart from the palaver of, say, trying to reach a particular one. I was prescribed a new drug by consultant, but it had to be issued by GP and the wait for her to sign it was at least a week.

Some areas have a lack of options. The option in my area being: wait 3 weeks for a doctors appointment, pharmacies that are only open until 5 pm, or A&E.
Both Primary Care and the local Walk In Centre were shut down years ago here.

I went to the walk in centre/minor injuries a couple of years ago with what turned out to be a Bartholin's cyst. I'd never had one before so didn't know what it was and couldn't get a GP appointment. I was triaged and told I had to go to A&E as I needed blood tests and they couldn't do them at the walk in centre. I got to A&E, explained what was wrong and got asked why I thought I needed A&E! I explained what had happed and the nurse said the walk in centre was always sending people across when it was unnecessary. I was then sent to ambulatory care and saw a doctor and was sent on my way with antibiotics.

There doesn't seem to be any joined up thinking. My GP surgery is a lot better now and it's much easier to get an appointment thankfully but the walk in centre is still useless so I get why people would give it a miss and go to A&E.

For comparison, I now live in Europe, where there is also a national healthcare service, paid for through employee and employer contributions deducted at source - so basically a compulsory tax exactly like income tax paid in the UK, and charged at a rate only a little higher than in the UK.

My GP surgery has the usual GP services found in the UK, but there is also an x-ray facility, ultrasound, and a small lab for blood and urine tests. It also opens early in the morning, on a couple of evenings and at weekends, so it is the first port of call for anyone with minor illness, minor injuries and for regular tests. There's no need to go to A&E with a cut hand - the GP can look at it, x-ray it if necessary and a nurse can stitch it up (and look at it a week later when it's healed). Small injuries like a broken wrist can also be x-rayed and plastered. Anyone requiring more extensive treatment is sent on to A&E at the district hospital.

I've had to go to this A&E department on a few occasions, either for myself or for neighbours. I've never waited more than 30 minutes - on more than one occasion there has been no wait at all.

Generally because the most experienced doctor is busy trying to stop the actually really sick patients from dying.

Can they?
Others have said their GPs don't refer to x-ray. I have no idea whether ours does.
Anyway, you are triaged in 15-20 mins, referred to minor injuries and then to x-ray if needed, so out of the A&E queue quickly.

It’s strange that people expect to be able to access healthcare that they pay for in one of the wealthiest countries in the world isn’t it? The entitlement(!)

That's what happened with my son too except he had septic shock and went downhill all of a sudden after looking seemingly fine after some anti sickness medicine. His organs were shutting down and initially, he only went in because he was dehydrated due to what we thought was a tummy bug but he actually had a bowel obstruction.

Children especially can go downhill so quickly despite looking fine. Sepsis is terrifying too, there's a reason why it is called the silent killer.

The problem isn’t the people. It’s the NHS.

We don’t have enough GPs or the ones we have don’t have the ability to do anything or don’t want the responsibility, waits to see consultants are disgusting so people become even more ill when their issues could have been found and treated had they been seen sooner , mental heath care is non existent so people become suicidal and are told “go to A and E”.

There was a post the other day from a parent whose child had a weird patch on their tongue. GP prescribed treatment but told her if it didn’t work “go to A and E. WTF she was baffled.

It’s the snowball effect of not having proper primary care. I’ve said it before and I’ll say it again. We need a system like the French AND we would then need to actually hire more consultant, GPs and Nental heal th professionals but no one has the balls to enact it.

Ah we must be spoilt here as we have a fab one that does and has its own xray and ultrasound and phlebotomy team.

Last time I went to A&E I was fine. But there just wasn't any other way to get a referral in time. I had gone to a private clinic or a check up and labs (wasn't planning to use public healthcare services). The lab results came and the private lab is not as extensive and they can only see if the result is positive or negative. So the doctor called and said I need more accurate results and told me to go to an A&E cause getting a GP and then getting a referral to specialist, then getting referral to a lab and then getting results would take too long.

If employee needs a doctors note and you can't get a GP and they won't sign it over the phone, A&E you go.

There aren’t any minor injuries centres that accept kids nearby and it required specialist blood tests so the GP told us to go to A&E

Drug addicts collecting methadone are genuine people in need of their medication.

The way the NHS is structured means that A&E is often the only option. Also, the whole point of a health care system in a developed country is that people should be able to get urgent medical assistance when they need it.

e.g. if you get chest pains and feel breathless one evening, what are you supposed to do?

or you bang your head and have a large bleeding cut?

or you suddenly notice a weird rash near a small infection site (this actually happened to me - extremely lucky I did google it and go to A&E - I had to be put on an antibiotic IV immediately)

Oh, I agree, what I'm proposing is if you change the way certain people are addressed by primary health care, by having a separate route for the repeat offenders (sorry, cant think of a better expression, not meaning offence), then it frees up the normal route for everyone else.
There isn't a magic wand to wave, but I certainly think that adding different routes to access primary care would free up the bottle neck, which at the moment is GP access

I had a pulmonary embolism when I was 22, had a bit of chest pain but felt fine. Was sat happily gabbing away in A&E.
Because of this history, whenever I cough up any blood and get a bad chest infection, the GP usually sends me to A&E to have a D Dimer which is a blood test that the GP can not do and can only be done at the hospital. Again, I usually just have a bit of a cold, should I put on a sick voice and a sad face to save being judged?

You are generally correct, but a lot of people in the waiting room may actually have been relatives not patients. Most of my time spent in ED waiting areas has been whilst a relative was being seen.

I don't know how you can tell whether someone should be in A&E from looking at them sitting in a waiting room. I've been to A&E precisely 3 times in my life (all for my DH). We chatted while waiting. Two times he had a pulmonary embolism and the third time was when he'd cracked his head open (you could see his skull) and needed stitches but we'd cleaned his head up at home and he was wearing a cap so he looked perfectly fine. Until he took the cap off 🤕
We wouldn't even have gone to A&E for the stitches if there were any walk in centres available.

What qualifies you to make this judgement - are you a doctor? Have you assessed them all?

Just because you think people don't "look" sick, doesn't mean they aren't.

My ex was in A&E a couple of weeks ago with headache and double vision, seemed otherwise fine and then while there had a massive stroke. You really can't triage people with your eyes!

Also loads of people are in A&E because the GP or 111 has told them to go there.

My partner went to A&E recently with excruciating headaches that the GP kept dismissing as anxiety. He was straight to a CT scanner and was told he did the right thing in attending. He probably looked ‘fine’ but what else can you do when you’re constantly dismissed?!

Minor injuries might have been better

I think you’re being slightly judgemental you have zero idea why people are in there. Not every emergency is a screaming one. For example, I was with a friend in A and E a few weeks ago- she was having an ectopic pregnancy. We were sat talking etc but she had emergency surgery 6 hours later.

Actually virtual queuing might be a good idea