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

PS DD2’s OH also did 2 placements in A & E during his training, and did lots of locuming there, to earn extra money.

I don’t claim to be a diagnostician. However DD2’s OH, who is also there with us at weekends and evenings, is a doctor who has done a psychiatric rotation. DD2 had an ED, when she was younger.

If the MH team in A & E have decided to admit a patient; but there are no beds, they send them to the UTC for mental health, which has temporary beds. I have spent days there with DD2, while she’s waiting for a bed. There’s a TV lounge, kitchen, toilets and settees in the entrance hall. DD2 says there are some small rooms out of sight, where people sleep on reclining chairs and bathrooms. Patients get 3 meals a day, plus snacks and families can help themselves to food and drinks in the kitchen. There’s more women than men, waiting for admission usually.

I imagine, if people are waiting there for 5 days, as they may have to, they get hungry?

I think we should remember too the huge waiting lists for the little there is under CMHT, CAMHS and ED services. The situation is dire. Many parents are battling with nothing. If people don’t want mentally ill young people cluttering up A&E waiting rooms provide better services will be necessary.

I too have been in A&E many times with my dd for MH and ED assessments. Neither are necessarily easy to spot. Many of us without EDs don’t feel the need to eat whilst waiting in A&E and staff are not handing out food. Ours has a single ££££ vending machine EDs can vary in patients. There is A typical Anorexia My daughter has a friend who has never been skinny and has had numerous admissions for Anorexia. My daughter has the more conventional type and been admitted numerous times when not at her skinniest. You’d never be able to tell when she has tried to take her own life either. She masks it all very well.

Thankfully A&E isn’t run by arm chair diagnosticians and often liaise with the ED services she is under.

Oh cool, you’ve decided pain isn’t an emergency now? I’ve been getting kidney stones for 20 years. Thought I knew the drill—until a 9mm stone caused a total blockage and I ended up with sepsis but sure, let’s shame people for going to the ER because you think it’s not serious unless someone’s literally coding -- never mind mind that kidney stone pain can be indistinguishable from appendicitis or ovarian torsion or, you know, other things that can kill you. Your take isn’t just bad—it’s dangerous. Maybe sit the hell down before someone follows your advice and doesn’t get to walk back out.

My adult daughter has epilepsy. If she has a seizure in public she will be taken to A& E, even though she will have recovered by the time she gets there. They will keep her in for observation. She will look fine.

i spend time, sitting around in the mental health bay in ambulatory majors, waiting with DD2 for a mental health assessment. Imo, it’s easy to spot the girls with ED - they are obviously skinny, but wearing baggy clothes. There’s usually plenty of food given out and they seem to have rules around eating. Still DD2 does, due to OCD - she’ll only eat packaged food, and even then with a knife and fork. If someone offered her biscuits in a tin, she’d refuse them. They have to be individually wrapped!

Exactly, thank you. It started out as a stomach bug, but that caused emetophobia, so he was at the point of only eating a few foods and not every day, to avoid throwing up. He was originally diagnosed with ARFID, now they’re saying it’s OSFED. Hes 17 now and preparing and cooking all his own foods at set times, because having control helps.

I have not said that, I hope you read case notes better than this. I said pain alone wasn't an emergency - as has been evidenced by OP, not being an emergency.

People are free to do whatever they want, I'm not the one on my high horse about them not being worthy enough.

I went to minor injuries with infected finger, no nurse available at gp all week, was getting very painful

I live in an area with next to no immigration adding to existing residents and provision is dire.

I’ll go back to my original comment of where I said you are trying to say that people in excruciating pain should not attend A&E if they know the cause??
yes I called you out on that, pure nonsense!

Net migration was 431000 in 2024. That 413000 on top of existing residents. Every year. Of course it will have an effect, because we haven’t fixed the lack of funding and yet our already strained systems must cater for additional people each year. I’m sure many will be net contributors to the economy, but certainly not immediately, and in the meantime, will add an extra burden on already strained infrastructures. It’s important to acknowledge that an already underfunded system cannot manage additional bodies. There are positives to immigration but we have to strengthen the foundations of our systems first, to ensure that all who come and settle, are adequately provided for. We just don’t have that right now.

This is the line the politicians want you to swallow. The NHS has been chronically underfunded for years. Nothing to do with immigration.

That's the problem with immigration, the country is over run and people can't get doctors appointments so what can they do?

Its not immigration, the problem is systematic underfunding of services for decades.

After a bout of noro I had diarrhea which turned bloody. Called 111 and was told to go to A&E. After an experience a few years ago where I collapsed in pain, was taken to A&E, treated like a timewaster while they completely missed the fact my gallbladder needed to be removed and left me in a really awful position, there was no way I was prepared to do that. I told the 111 person that I could not get myself there (true, I was too weak and shaky). And got a call from a clinician, had a very productive chat which lead to a robust management plan agreed with my GP. There are people in A&E who do not need to be there. But there are lots of systems telling people to go when other options would be better.

Last week I was away from home in a rural bit of the country. Started with symptoms of cystitis late at night. Reluctant to leave until morning as I have had this before and it rapidly became REALLY bad. Had I been at home in our big city I could have gone to the 24 hour pharmacy and got over-the-counter antibiotics, but because of where we were, A&E was the ONLY option. I was very reluctant to take an A&E slot, but the staff were lovely and agreed it was my only choice due to lack of any other out of hours provision.

They have streams. So, one stream for a person, who broke their ankle in a straight forward fall, and another stream for someone, who broke their ankle, due to a medical reason for their fall.

Patients might complain, the hospital is not monitoring the streams adequately.

if that’s in reply to me. God no. of course not.

and actually I’ve realised the end of my post is missing

we don’t have enough Gps. We don’t have enough appointments that work with commutes or working life. We don’t have enough walk in clinics. At my doctors you can only get same day appointments. And when they run out they run out. So you could take the day off to try and see a doctor, be unsuccessful at 8.30 and have to do the same the next day. That could be for the usual minor stuff you see a GP for (like repeat pill prescription etc) or the more major (minor) stuff like lump your worried about or painful boil. Now the lump you’ll try again (if work allows), the painful boil your going to end up needing more urgent care so off you go to A&E.

You think people deliberately avoid the gp so they can have the pleasure of sitting in A&E for 12+ hours?

When I was growing up we had two levels of a &e. So possible breakages in the big hospital and a cottage local hospital for everything else.
theyve been closed. You could get doctors appointments and home visits. You probably worked near your home (so near your doctors) so if you had to nip out for an appointment you could. You could ring up and get a doctors appointment for a weeks time so great for stuff like pill repeats. You could also get emergency that day.

now you try for an appointment at 8.30 which you may or may not get for that day. How does that fit with commutes and work?

Start at the entry point of making GPs accessible and work for modern life and youll

They can't win. Treat emergencies first and leave wounds til later? Slated. Treat wounds first and someone else has to wait? Slated.

Similarly, a gp wanted an urgent ultrasound scan for severe pain in the area of my ovaries. He phoned only to be told they had no walk in out patient appointments for a few weeks, but they said they could “admit” me via a&e and wait on the ward! Not only did it take a couple of hours going through a&e being triaged etc, even though they knew on the system I was only passing through, finally on the ward I was formally admitted, given a bed, a doctor came to do a full admission file of medical history, various tests and examinations, etc and there was a general impression that I’d be there a few days - just waiting for a 5 minute ultrasound scan! I even got to choose my evening meal and breakfast the next morning! Luckily none of that was needed as almost as soon as all the paperwork was done, a nurse came to tell me they were ready for me in the ultrasound room and asked if I needed a porter to wheel me down! No, consider I’d driven myself there and walked across the hospital! Quick scan, nothing found, I thought I’d just be able to walk out l8ke normal, but no, had to go back onto the ward to wait for the discharge paperwork. They like to make work!

I once had a gash over my eye and had to endure 5 hrs at A&E. Once triaged and dying imminently was ruled out, I just sat and quietly bled all over the floor in A&E. At least I got 3 seats to myself.
since then I now pay to go to the private minor injuries unit. It’s not cheap, but definitely not as humiliating.