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

That attitude isnt great either. A lot of admissions could be prevented if people (could) see a GP sooner and start oral antibiotics or treatments for their conditions.

it depends what you mean by “shouldn’t”. For example, you can’t call our GP on the day, they open the e-consult maybe once a week, appointments are often “we can see you in 4 weeks” at best…if you call 111 or go to a walk in centre (if you’re lucky enough to have one nearby) they often send you to A&E. A lot of the time it’s literally the only way to get seen by a medical professional.

I have never seen this, and I've been to A&E a few times for my own health issues and those of family members. Just because some patients don't look obviously ill, it doesn't mean they can wait until the following Monday to see a doctor. For example, one weekend, DD needed antibiotics for scarlet fever. It's an infection which can lead to life-threatening complications, such as rheumatic heart disease.

I can't imagine that spending hours in A&E would be anyone's idea of a fun day out. I've hated it every time.

It’s not for me to judge why people are at A&E! However, I’ve recently had to go twice with my elderly dad because it was a weekend and the GP insisted, even though we absolutely knew his problem could have been solved by a district nurse.
On one other occasion he had a temperature and needed antibiotics but because of his previous medical history, the GP wanted him to go to A&E. Spent 10 hours there on a corridor trolley and sure enough, got sent home with oral antibiotics.

I’m not complaining as we’re grateful to have healthcare but from what I can see, the lack of an army ‘on the ground’ of GPs and district nurses means that going to A&E is sometimes people’s only means of seeing a doctor.

I’ve now paid £15 a month for Bupa’s GP service so that we can easily get dad antibiotics if he needs them at a weekend.

Hmmm... I'm not entirely sure I agree OP. I mean, can you tell just by looking at someone as to how ill they really are or whether they had made the decision to go to A & E without going to their GP first?

A few weeks ago, I took my son to A&E (on the advice of our GP). He had a niggling pain in his leg with some redness, we were sat in the waiting room chatting away to each other and to an uninformed bystander, it could have been assumed that there was nothing wrong with him.

45 mins later he was being prepped for emergency surgery.

Yeah and then it takes a week to get X ray appointment and another week to get the results. Kind of doesn’t work with suspected broken bones.

my daughter needed a blood test to exclude lime disease after a tick bite gone red. GP gave me the form for a blood test at the hospital, sure. They only had availability in a week’s time 🤣
so off to A&E we had to go

why It’s not possible to have facilities for quick blood tests and x rays is beyond me, it isn’t difficult to do at all

Yeah this.
Also, a lot of people you would have seen would be accompanying someone else so it’s a pretty sweeping statement. I agree that the system is broken but you don’t have to be pissing out blood or vomiting on the floor to qualify for the A&E waiting area.

Completely agree, I'm of the age where I only see the gp/worry about something if it's fallen off, or I can get the duct tape to fix it, and thats with having life long issues (which I'm on meds for), last time I went to a&e/called ambulance was because I had a tmi, and that was only after a lot of people said, 'your not right'.
The level of 'I'm not feeling great so need to be seen now!' is ridiculous, additionally add in the problems of drug addicts (not their fault), street drinkers, general anti social behaviour causing minor scuffles, police get involved, person cries wolf, off to a&e.
In my wierd 'this is how we fix things' world, there would be 3 types of a&e, one for the police/prison service, one for the addicts, general difficult social problem people, and then the general one for everyone else.
Add to that, if you turn up at a&e for nonsense it's £10 - not huge but enough to make people double think.

Where I am, a and e effectively acts as the doctors.
My elderly mum has a doctors surgery where literally there are no doctors " we don't have any GPS on a Thursday or Friday." Call 111 and that is where you are sent. 1 waiting room. You are there for hours alongside all the traumatic injuries and illnesses.
It's just impossible. No one is there for a day out.

Like others have said you have no idea at all.

DD had some weird chest pain a few years ago, which had improved a bit by the time we got there (after been in agony for hours in the night). She'd improved so much that the triage nurse rolled her eyes hard at us. DD was sat chatting. People would have thought she was OK. Turned out her lungs were full of clots and she nearly died.

I'll tell you something....if she feels the slightest bit off with regards to her chest, breathing or her legs feeling funny we are straight to a&e now!!!! I don't care what anyone else thinks. It's the only place to get the blood tests and scans urgently.

I sent dh to a&e a couple of years ago with a weird rash/blisters which he'd seen the GP for multiple times and got nowhere, but on this morning I thought it looked worse/really not right. He was admitted as a medical emergency, kept in for weeks, treated as a burns victim and was seriously ill with a rare condition. He wasn't in pain, was sat chatting, his skin issues were not visible to anyone in the waiting room.

It shouldn't be called a & e. It should be called accident, emergency and cases that just can't get a GP appointment. "A, E & Sorry, no Gp"

There is quite a lot of evidence to support this point. During periods of junior doctor strikes, consultants have provided cover and waiting times have gone down significantly. Some A&Es have adopted the model of consultant led triage. What would be even better for a lot of patients would be consultant geriatrician led triage. Too many older people come in via A&E and leave hospital in a worse state than if they’d been stopped at the door in the first place. You need experienced clinicians to make that call though.

Totally agree I was sitting close to reception waiting to be called in to be with my very elderly mother who was brought in by ambulance one time and I could hear the reasons people came to A and E some of them were not needed to be seen urgently , a few examples, one man came in looked fine said I hurt my toe last week it’s still hurting , another I’ve had this cough for a few weeks asked if they had seen a GP both said no , when they were told it would be hours before they were seen they said fine and took a seat and sat on their phones drinking coffee in an incredibly busy casualty dept
Honestly a trip to a GP would have been better and there were more examples I felt like someone medical should have came out and said nope go home see your GP.

I was in A&E not long ago with my DD1. We were chatting and looked fine. A second look would have shown you both legs wrapped in clingfilm due to burns from boiling water. She could chat because she had morphine for the pain. People cope kn all kinds of ways whilst waiting.

Study after study after study has shown that A and E gets clogged up because the primary care system doesn't provide what people actually need. When you do provide what people need, attendance goes way down and millions of pounds are saved.

It is utterly utterly pointless for GPs to see each patient for 10 minutes. They might as well not bother. Once GPs can see patients for as long as they need and all the services the patient might need are close by and easy to access - social care, social services, OT, physio, housing support etc, - then people's problems get solved and they go away. The objection always raised to this idea is that it's expensive. It is not. It is far far far cheaper than the current broken system in which people come back for appointment after appointment, falling through the cracks, getting worse, needing more care etc. Solve the problem comprehensively and quickly, people are happy and they get on with their lives. They get jobs, they do more exercise, they are generally healthier. It is totally logical. However, if I see one more study 'discovering' this I will scream and pull all my hair out.

I will also add that in 2020 people were told that an illness that had almost no chance of killing them warranted shutting down the whole country and cutting the economy off that the knees. You can't incite that level of pointless fear in a whole population and then expect that population to have a sensible approach to their health.

You have no idea of peoples situations or how they hide their pain. I went to a&e as a teen as I kept getting recurring ear infections and I was in agonising pain- I had a chronic illness and could hide my pain well. Well when I finally got seen, I had a mastoid infection where the infection was septic and they said if I wasn’t treated within those few hours I would have had a brain infection and likely of died. But if you saw me in the waiting room, I was playing mobile games with my mum and looking ‘normal’ but I was nearing death in all honesty.

I’ve been with my own son in a&e where 111 called an ambulance and the ambulance sent us there, if you’ve ever known kids they are up and active and can go downhill very quickly.

I’ve also broke my hand but I was there laughing and joking with the nurses/doctors and keeping up the spirit because I tried to get on with things and had a high pain threshold - but you’re saying I shouldn’t have got my broken hand fixed because I didn’t deserve to be there??!?

everyone has a right to get their health checked, gp’s and 111 can send patients to a&e to rule things out. Patients can keep their spirits up by appearing normal, like do you expect people to be gloomy and put on an act just to look the ‘part’

GP can give you a form to get an x-ray though. Then you just tip up at X-ray for the imaging. Lots of imaging centers around now.

I think lots of GPs are running a really bad service. So much can be triaged by them via Econsult. We haven't seen GP for years, but have had all sorts of tests, after a quick chat on the phone. None required going through A&E.

My 93 year old mum recently spent 48 hours in a&e, 12 of those was in the corridor, she had fractured her hip, no beds available. I remember a young lad being there with his mum, he looked fine but his mum later told me that he was admitted with sepsis.

Of course some people would be better treated in a different setting - but we don't have those settings.
I think having urgent care units would make sense. Somewhere you could get quick turn around tests and treatment that does not warrant a&e but is too pressing to wait for a GP.
I regularly have to go to a&e for blood tests as the community / GP testing turnaround is 6 days and that is too long for me (medically, not being demanding).
I could be in and out of an urgent care type place in 20 mins!

The last time I went to A&E it was Christmas Eve and I had developed extreme bruising two days after chemotherapy. Instruction was to go to A&E asap, they would send an emergency ambulance if I had no transport. I might have developed sepsis.

Intravenous ABs later, I was sent home.

I was isolated while waiting, but would have looked perfectly normal with my clothes on.

The easy ones aren’t the problem. Yes it’s not ideal re overcrowding but you can get through minors quickly. The problem is the very sick people who need a bed but can’t get one. You don’t have 80 year olds on a hospital trolley in a corridor for 36 hours because a few people have turned up with a splinter. They are there because hospitals are full and there isn’t the right flow.

Obviously it’s not ideal to turn up at A&E if you could be seen elsewhere but those people are not at risk and don’t really take much time to deal with. It’s an absolutely false narrative fo be blaming the public for being in the wrong place when long waiting times are systematic failures to invest in bed capacity.

I think people have taken it upon themselves to decide that whatever their complaint, no matter how minor, that their doctor’s surgery should see them TODAY - in one day - without fail.

There are those of us who are old enough to remember that this was indeed the level of service that the NHS provided.

It is also the level of service provided in countries such as Germany, Austria and in Scandinavia - countries that have far more doctors and medical staff per capita than the UK has. Austria has twice as many doctors per capita than the UK has. Countries that invest up to 30% more per person each year on healthcare than the UK does.

When the German and Austrian healthcare services were re-established after the devastation of WW2, the underlying principle was that the level of healthcare that previously had only been available to those who could pay would be available to everyone. This is still the case, and any politician, right wing or left wing, who dares to tinker with this is quickly shown the door.

The NHS was also founded with similar guiding thoughts - all tied up with the idea that every family, rich or poor, had suffered during the war and that post war, the country would be "a land fit for heros" (which was actually also the promise after WW1) and that the NHS would be the envy of the world. The Conservatives opposed this and have spent over 70 years trying to undermine this, culminating in 14 years of Cameron, Lansley, Hunt and Hancock doing their best to destroy the NHS.

At ours for example children’s A&E waiting room is the access point for everything. Took both of mine at separate occasions last year - first DD badly sprained her ankle, second DS fell over and needed 12 stitches in his knee. Both needed x rays and then DD a boot - DS ended up being stitched in minor injuries.

both looked fine in A&E - DS in particular I think becuase adrenaline had kicked in (he walked 10 mins with blood pouring down his knee) and shock kicked in later when he got home.

Do you not think that this entire post is ‘entitled’ ? You think you’re entitled to judge whether someone’s attendance at A&E is valid ? Just because they're not visibly writhing in pain ?

Toddler with a crayon up her nose, I mean, I suppose she was fine as in it wasn’t bothering her, but it still needed removed.

I love your laid back approach to this! 😀