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

Yeah they wouldn’t be IF the GPs were doing their job and not sending people to A&E to cover their asses, and/or IF GPs had facilities for a quick blood test (which totally exist in other much poorer countries) or an X ray so they wouldn’t need to send people to A&E for that, and IF there were more minor injuries or issues walk in centres

I always say similar to this. IMO, an independent prescribers qual should be MANDATORY for anybody doing nursing or midwifery. It’s absolutely insane that you can wait 2 hours to be triaged in a walk in centre for eg chest infections then have to wait hours more to see a prescriber. No wonder the NHS is so crap it’s whole system is beyond inefficient

Sometimes its hard to tell just by a glance. My DC had an accident earlier in the week, we thought it was fine, now suspect it may be a fracture. They look well and happy, but the only place to get an X-ray is A&E. So we will be cluttering the place up.

I agree. In my area the surgery is fully booked a month in advance and they release appointments for another week on a Monday morning. If you want an appointment at all it's best to be waiting as soon as the surgery doors open because they will prioritise the person in front of them over a ringing phone.

Sorry to hear your plight OP. Sounds awful. I absolutely dread any accident or ill health.
So little available.

I was in an and e with my daughter a few weeks ago. She probably looked fine but I’d had to give her an epipen a few hours before so we had to sit in the waiting room for six hours after she’d recovered from the reaction in case there were any issues from the adrenaline or a rebound reaction. You def don’t go there unless you have to, it’s so boring and also not a fun environment to bring a child. Had somebody a few years ago openly complaining on the phone that my daughter was in ‘with a bit of a temp’ - she’d been sent by the out of hours dr to rule out meningitis.

It must be impossible to weed out the piss-takers. Imagine - just one mistake.

However, last year I was bitten by a dog. Blood spurting out and I couldn’t stop it. I was welcomed in A&E practically on bended knee - the doctor who stitched me up said I was the first genuine case they’d seen that morning.

When I checked in there was a woman behind me who said she had a runny nose and hadn’t slept all night. When the receptionist said to take a seat but the wait was around four hours, the woman said, “Ok, I’ll go home and you can ring me when it’s my turn.” Hmmmmm.

Those people probably thought the same about you. Your medical diagnosis of other people as you walked by may not have been accurate

Don’t need A&E, but need something beyond GP and reasonably swiftly. Eg. Certain checks for certain chronic conditions. There should be better routes for these things but there aren’t.

I like that idea, @ScaryM0nster!

I'm imagining a nice big, airy waiting room with different doorways where triage nurses and doctors periodically appear to call patients through for, say, 'Auto-Immune / Inflammatory Disease Flare-Ups', 'I Suspect I've Got (Another) Blood Clot (Embolism)', 'My Mental Health Has Taken a Dive' (probably need to call that one something like 'the mindfulness suite'), and 'I've Got Something Stuck In a Bodily Orifice By Complete Accident'.

Then the main A&E can focus on 'I Think I've Had a Stroke', 'I'm Having a Heart Attack', 'I Can't Breathe', RTAs, burns, etc.

Don't forget the small percentage that believe that if the surgery is closed for the day your next port of call is A&E for things they shouldn't even be seeing a GP about ie, a cold or because an 10 year old child fell off a wall that was 3 bricks high, no obvious injuries and the child saying they had no pain and yes it does happen, just ask my Husbands ex. Some folk love the drama of going to hospital, they love being able to post sad face pic on SM from the waiting room, they thrive on the "oh Hun, so worried about you, " replies from their mates. Sad buggers.

Our A&E is in the same building as the minor treatment centre - seperate waiting areas, but inevitably the 2 merge .

Prior to this , I have been in A&E and heard people needing help with sunburn / ingrown toenails,

THink some people assume A&E stands for Anything and Everything

Agree with PP, when people can not get to GP, that is when A&E becomes bottlenecked. My GP surgery has limtied appoitments and if you miss them (8am wait) then you have to ring back the next day.

Weekends and bank holidays add extra stresses to the sytem!

50% of the waiting room will likely be the plus ones who have come with their relative/friend who needs to go to a&e.

Also when you have had an op or similar on discharge the ward advise if you have further problems you go back in via a&e.

I’ve been to A&E many times with SVT (on their advice), heart rate of 180+….you probably wouldn’t think I was ill to look at but I then am taken into resus and given meds to reset my heart.

At one point pre COVID I was in A&E at least once a week due to gallstones. I needed strong pain relief, iv antibiotics, a load of other meds and full panel blood work every single time as my liver wasn't coping with the stress and my blood work was showing levels 12x higher than they should be.
On the outside I looked a little uncomfortable and tired but a liver specialist had no idea how I was walking around and not in complete liver failure at 25. I needed A&e but didn't look like it, they eventually moved me over to a department where I needed to be seen every day by the specialist which wouldn't have happened soon enough through the gp

i would agree that a vast majority of people who sit for hours and hours in a&e do not really need to be there, but in all likely hood, they have called 111 and been told to go, because the standard response from 111 is to go to a&e.

the GP's do the same, if a patient rings and asks for an appointment today, and there are none they are told, if its an emergency, go to a&e.. and off they trott!

I broke a bone in my foot whilst on holiday. I had a cast put on. I was told there was no way I could self refer to my home hospital fracture clinic to have the cast removed. The only way to access the fracture clinic was to go to A&E at the hospital near home and explain. I had to wait to be accessed by them and then I was referred to the fracture clinic. I had to wait over 4 hours for basically a tiny bit of admin. The system is broken.

My son was seemingly fine and chatting away in A&E too when I took him there early that morning as advised via 111. Later that evening he had a cardiac arrest as he had septic shock and a week later, after barely surviving, he was diagnosed with cancer.

If only it was that simple and the sick people always looked sick.

But if you have been to A&E you know they take your name and address on arrival, they ask what the issue is. They send you to the waiting room. Then they call you for triage. And if you do not present with issues that grant A&E, then they tell you to go to the GP. If they think you should see a professional, have X-rays, bloods..., then the put you on the corresponding waiting list and send you to the waiting area in the meantime.
The waiting time for the first triage is not that long. So most people who are in there are there for a reason.
The real problem is that there are not enough resources to deal with patients. GPs do not provide appointments, have long waiting lists and impossible to get through phone systems, then things get worst and patients that do not look all that bad are in A&E. But.... there have been people dying and all in those waiting rooms. If they had obviously looked like they had a stroke, then I can imagine that they would have been taken in.
Also, there are always lots of relatives/ companions in A&E.
Me, on the other side, I have witnessed casualties presenting with blood, obviously broken bones, vomiting sickness, massive pain. Yet, they were in that waiting room for a while, which I think is unacceptable.

My A and E does a version of this.
My OH has leukaemia and back in March had a really nasty chest infection that turned out to be flu (we didn’t know this at the time.) GP saw him a few times and when he didn’t respond to antibiotics and seemed to be getting worse he advised straight to A&E for blood tests and chest X-ray.
He was triaged quite quickly and prioritised due to his condition so he was seen within about 2 hours by their on-site GP/ doctor. She wanted to send him home but after a fight with her (by me) he got the chest X-ray and bloods. This part took a further 7+ hours in total but he was found to have Flu and was finally admitted to a ward for 5 days. The 7 hour wait was grim but my point is that they had implemented exactly this process. For the most part it worked.

Im an ED nurse.

If you are just talking about walk in patients, we have GP attached to our ED. Of our ambulatory aptients, at triage we send over on average 30% of patients to the GP. Much higher if you include childrens ED, it is closer to 70% in childrens. But adults only its 30%. However some could see a GP but by our triage its not appropriate, id guess another 20% are in ED when there would be better alternatives. Minor injuries we redirect before they book in to the walk in centre, unless there is a legitimate reason why they cant attend, so i dont have even estimated stats there. Then theres patients who come in because they literally have no place else to go, regular attenders who are in because they want and sandwich a hot drink and few hours out of the rain. Do they need to be there, no, but whats the alternative for them? Im more than happy to give them a sandwich and a cup of tea, try to move them on when the department is full and we are running out of seats, but if we have plenty of spaces, they can sit for a couple of hours.

However, most patients in the dept are brought in by ambulance, and waiting for ward beds. So looking at the whole department, id estmate its along the lines 30% total could utilise other services.

However! Some brought in by ambulance probably could have avoided admission if they had access to primary care when needed, if an infection had been seen to quicker, it wouldnt have escalated till they needed IV antibiotics. If waiting lists for surgerys werent so long, etc etc.

Its a complex situation. A&E isnt viewed how it once was, its now viewed as an alternative to GP's, because people cant see GP's. But people attend with a "GP" problem, knowing the pressure on departments, and still get angry at the 8, 9, 10 hour wait to be seen. Its frustrating as staff, but i get it, i understand theres no alternatives.

Reasons I’ve been in A&E where it probably looked like we were there for no reason

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.

DS with a fairly small but deep cut in his elbow - needed it stuck together because it wouldn’t close as it was right on his elbow.

DD electrocuted herself at work, passed out, was seemingly fine, but they wanted to check her over.

DD - concussion, she ended up off work and uni for 3 weeks, but she was mobile and talking.

I’ve a back issue that has a list of, if this happens go straight to A & E - one of them happened so I did, but I’d have looked fine.

We were sent there every time by 111

That would be one way to cut wait times: if you aren't screaming in pain or bleeding from your eyeballs go home.

I doubt 70% of a&e patients would put themselves through it if they didn't need it.

Certainly at my a&e it's full of miserable ill looking people.

She has a point though, doesn't she.

I always take food, chargers, entertainment etc to a&e, you'd probably think me a time waster too, though I'm always at paediatric a&e. I hate it there.

My son is a frequent flier, mostly due to zero other out of hours services here. Our out of hours gp services are triaged at a&e! Madness! He had recurrent tonsillitis, would go from fine to refusing all fluids and floppy within 24 hours - there was nowhere else to go over weekends and holidays. After the first few times of trying to wait it out for a Monday gp I just started taking him to a&e as soon as I spotted it, or he ended up being admitted for iv meds and fluids.

As well as his tonsillectomy this year (which went badly and resulted in 2 further a&e trips, 1 ambulance and a 2 night stay..) he's also had hand surgery he waited on for 2 years. When we first went to a&e for that, he was fine, running around, playing. But he needed surgery after a freak accident and now can finally use his hand properly after 2 years. That trip we'd be viewed as time wasters too. It goes to show that you can't always judge it right by appearances - especially for children in my experience.

I've never noticed proper time wasters there. I've seen young kids with orbital cellulitis running around just fine using their single working eye, the obvious bone brakes, no poop for 10 days and so on. These all need urgent care.

Quite often 111 will refer people to A&E who might look ok but need to be seen quick and that’s the only option.

To offer another perspective

When my daughter was 18 months she banged her head on a toy. She vomitted and was pretty out of it. Took her to A&E and the first hour we waited there she was grinning at everyone, running around and seemed totally fine. Anyone who had seen her would have thought she didn’t need to be there. After an hour the vomiting came back full force and she had to be monitored overnight.

You walking past people is a small glimpse of that persons trip to A&E