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Original poster

How does this work ? (A&E question)

93 replies

JadeJewellery · 05/02/2026 17:16

Just want to start off by saying I’m NOT criticising the treatment I had nor am I criticising the staff. I’m just curious of how it works thats all!

It happened 2 months ago but just sort of wondering now since I’m feeling better and reflecting on it all. I’m in England if that makes a difference.

i was in a&e recently with what was potentially quite serious. I have multiple conditions, knew it was my heart and told them at reception. I was violently vomiting, could barely stand up, and I just had this feeling that I was going to die in the waiting area. My heart felt completely wrong and I knew something was very bad. It turned out I was correct- I was in 3rd degree block and my heart was barely in the 20s.

The treatment I had was brilliant, but it took so long to be seen for triage. I was in the waiting area for around an hour and a half and they were taking people in order of who arrived first rather than severity. There were multiple people going in for things which were definitely not life threatening eg a sore finger from 3 weeks ago (and it wasn’t that they were going in for minor injuries, it was all A&e) and even they themselves were saying to reception that I should be seen quicker because I was visibly so unwell in the waiting area but the staff kept saying I’ll be seen when I’m seen and i basically had to wait my turn

maybe im completely wrong, but i thought people were seen in order of severity rather than order they arrived? Or is that only the case after triage?

i know I sound a bit melodramatic about it all but I was just so frightened because I seriously thought I was about to die in the waiting area. I felt dreadful- they said the vomitting was because my blood pressure was falling so low and my body was struggling to keep going because I’d been in the block for so long. It was just frightening realising how many people were in front of me and I assumed (probably wrongly) that you’d be taken immediately if something was wrong with your heart?

but yeah not criticising staff they were brilliant! Just wondering about if that wait is normal that’s all

OP posts:
dizzydizzydizzy · 05/02/2026 18:51

I went my local A&E about 2 weeks ago. Triage took an hour. It used to be done within about 10 minutes. I was shocked to be honest, if uou're very seriously unwell you could deteriorate a lot in that time. A friend of mine recently had a massive DVT. He was 3 minutes drive away from a major London trauma centre. He got in a cab and went to A&E. If he had waited an hour for triage, he might have died.

At my local hospital, we have urgent care next to A&E, Anyone with a sore finger goes there.

HotdogMacaroniCheese · 05/02/2026 18:44

One hospital I worked in had a senior nurse on the door and would decide how quickly you needed triaging. That worked well.

DemonsandMosquitoes · 05/02/2026 18:39

Yeah similar. Sat waiting ages for triage with palpitations, and when I finally got seen I was in fast AF and rushed through to resus.

Allthesnowallthetime · 05/02/2026 18:38

I think staff do have some discretion in their decision making. When I took my daughter to A and E with breathing difficulties, they took one look at her and brought her straight in, bypassing triage. She was having her first asthma attack, with low oxygen saturations.

An hour and a half to triage sounds too long.

Newname71 · 05/02/2026 18:32

DuckWithOneWing · 05/02/2026 17:30

It was the same when my partner went into A&E last year. He had sepsis, and as soon as he was triaged he was taken straight through to resus and received amazing treatment. But we had to wait almost two hours to be triaged to get to that point.

I must have been lucky, or maybe our hospital do things differently. I reported to reception that I had tonsillitis but I was worried I had sepsis. I was triaged within 15 minutes, within another 20 minutes I’d had blood tests and was in a room on a drip.

I can’t fault the treatment I had. Several bags of fluid, IV steroids, IV paracetamol and several lots of IV antibiotics. I was really impressed.

looselegs · 05/02/2026 18:31

Waited in A&E with my 89 year old Mum for nearly 15 hours...
Suspected fractured coccyx and hip but she still had to sit on a hard chair for hours...
Triage was up to 3 hours and then 6 on top of that to see a doctor.

FortyFacedFuckers · 05/02/2026 18:29

Where I work, everyone is triaged first and then seen based on the severity of their condition. However, not everyone in the A&E waiting area is on the same “pathway.” Patients with minor injuries are often waiting for different staff, so someone with something like a sore finger may be taken in before you as they are in a completely separate “queue.” We also have patients who are referred in for specific things, such as an X-ray and they are again seen through a different “queue.”

TurraeaFloribunda · 05/02/2026 18:29

It works differently in different hospitals.

Our hospital has HCAs in A&E who do obs on arrival (temperature, blood pressure, heart rate etc) before triage and every hour while patients are waiting so anyone who needs to be seen urgently or is deteriorating can be prioritised. Another local hospital has a registrar (doctor) doing triage during busy periods.

Sorry you had such a bad experience.

Medstudent12 · 05/02/2026 18:19

I’m a doctor (medical not A&E so see patients like you once referred to medicine) and I think this is shocking. It is a ridiculous wait for triage and means those who are the sickest can’t be seen quickly enough. Plenty of people use A&E inappropriately but I think that’s partly a symptom of underfunded GP surgeries and a lack of investment in the nhs. And partly people not realising that the emergency department is for emergency’s like the OP had.

marshmallowwhip · 05/02/2026 18:15

If it happens again I would say “I’ve previously had heart block and I have a feeling of impending doom” which (previous ambulance dispatcher) would make me go “uh oh”

socksandshoos · 05/02/2026 18:14

A&Es vary on how they stream or triage on arrival but your hospital had a near miss in your case and I think you are being very reasonable under the circumstances

NHS is struggling so I mean this as a learning point for your A&E, please think about giving feedback of your experience to PALs so they can consider reviewing their triage system in busier periods - it will save lives.

TY78910 · 05/02/2026 18:10

Triage from what I’ve experienced is based on order in which you come in (the first point of contact doesn’t know what’s wrong with you) so that’s why triage. Then people get filtered in to different departments so some may not be seen by a doctor but advanced nurse practitioner etc and so more severe cases will be referred to particular departments etc

Kirbert2 · 05/02/2026 18:08

Womanofcustard · 05/02/2026 18:05

My husband was blue-lighted to hospital, he was taken straight in and dealt with straight away. NHS 111 called the ambulance. The ambulance took about 15 minutes to arrive. It was quite busy as well. I was (pleasantly) surprised.
OP, I think ambulance is the way to go, paramedics are brilliant.

When I called 111 for my son, they asked if it was possible for me to take him to A&E myself because the wait for an ambulance was 6 hours.

Womanofcustard · 05/02/2026 18:05

My husband was blue-lighted to hospital, he was taken straight in and dealt with straight away. NHS 111 called the ambulance. The ambulance took about 15 minutes to arrive. It was quite busy as well. I was (pleasantly) surprised.
OP, I think ambulance is the way to go, paramedics are brilliant.

Zanatdy · 05/02/2026 18:00

That sounds awful. I’ve been to A&E a couple of times with acute pancreatitis and I was seen almost immediately and never left the triage, they took me straight through to majors both times. Pretty sure all A&Es will triage on severity.

Original poster
JadeJewellery · 05/02/2026 18:00

Elisheva · 05/02/2026 17:58

If you think logically about it the only order they can triage people in is the order they arrived. If they saw people based on how sick they thought they were then that would cause chaos, plus they would miss serious illnesses where the person was misrepresenting their symptoms. And imagine what would happen once people worked out that they would be seen quicker if they said they were very ill!
The problem was not in the triage order but in the amount of time you had to wait to be seen. And that is a systemic problem.

Yeah good point tbh. I hadn’t thought of that. The little quiet older lady not wanting to make a fuss would be seen last and might actually be having a stroke. But would be last because she seemed ok. That sort of thing

OP posts:
Ophy83 · 05/02/2026 17:59

I think the only sure way to avoid triage is to come in on a blue light so if it happens again don't feel bad about calling an ambulance

Elisheva · 05/02/2026 17:58

If you think logically about it the only order they can triage people in is the order they arrived. If they saw people based on how sick they thought they were then that would cause chaos, plus they would miss serious illnesses where the person was misrepresenting their symptoms. And imagine what would happen once people worked out that they would be seen quicker if they said they were very ill!
The problem was not in the triage order but in the amount of time you had to wait to be seen. And that is a systemic problem.

Wingingit73 · 05/02/2026 17:58

After triage ir may be that the treatment you need requires a specialist from somewhere else in the hospital so they have to be called and waited for. Someone else's treatment could be really straightforward. Thats what i think anyway.

HotdogMacaroniCheese · 05/02/2026 17:57

Choconuttolata · 05/02/2026 17:55

If you call an ambulance and they do an ECG that shows third degree heart block the ambulance crew will pre-alert A&E prior to arrival and OP will be prioritised in Resus.

Show quote history

I’m a nurse and have worked in ED so I know how it works thanks.

My point is people think calling an ambulance means you skip triage and get seen first.

Original poster
JadeJewellery · 05/02/2026 17:56

Frazzledandfried · 05/02/2026 17:50

As PPs have said, people are triaged in order of arrival - the triage is what determines the severity of your condition and the urgency of being assessed. National target is to be triaged within 15 mins of arrival. Very hard to keep up with that though when new patients arriving in a consistent stream.

Makes sense! I think I’ve just watched too much greys anatomy where someone who looks unwell is seen immediately but of course that’s a tv programme and not real life haha! I mean, I obviously could wait, because I did, and although it wasn’t pleasant I survived to tell the tale so maybe actually I was safer to wait than I initially thought!

OP posts:
Choconuttolata · 05/02/2026 17:55

HotdogMacaroniCheese · 05/02/2026 17:50

If you are really bad then calling an ambulance to bring you in might be best.

Calling an ambulance doesn’t mean you skip the triage queue though. Unless you get taken straight into resus, in which case OP that might have been better. Although you can wait hours for an ambulance now.

If you call an ambulance and they do an ECG that shows third degree heart block the ambulance crew will pre-alert A&E prior to arrival and OP will be prioritised in Resus.

Original poster
JadeJewellery · 05/02/2026 17:53

ApiratesaysYarrr · 05/02/2026 17:49

Many A&E departments are incredibly busy- seeing 2 or 3 times the number of attendances that they were built for.

The issue with seeing people in order of severity is the point of triage. If triage was being delayed (and it sounds like it) it was incredibly busy. You won't have seen the rest of the A&E from the waiting room with patients in corridors, sitting in chairs who should be in beds (and that is after triage). When it gets that busy, everything slows down even more because there is no space to see anyone. I am not a A&E dr, but attend patients there as part of my job and there have been times where it has taken me 3 hours to find a space to see a patient, and that space is often the phlebotomy (blood taking) room, which of course shouldn't be used to see patients in, but if I don't see them there it may be another 2 hours before there is a free space. Then the phlebotomists can't get in there to take blood so have to do it in bedside location. I'm not telling you this as an excuse but as the reality of the front door of the hospital. My team often has 60 patients - that's 2 whole wards worth of patients - stuck in ED (A&E) waiting for a bed on a ward.

Unfortunately you can't rely on people telling you that they feel terrible as a marker of severity, there are lots of conditions that make people feel dreadful/faint/ that they can't stand up that aren't lifethreatening (conversely some people have lifethreatening/very serious things wrong and look reasonably OK).

I don't think you were being melodramatic, and in your case there was something seriously wrong, but yes, you shouldn't have waited that long for triage.

I used to suggest that patients complained, as sometimes patient complaints are a leverage to get things changed, but I think that the NHS (at least the front door bit is past that point), and it's really soul-destroying answering complaints about factors outside our control as the doctors and nurses on the front line.("why wasn't my mum moved to a ward/why did my grandad spend 2 days in a corridor"?).

Oh gosh I completely agree! Please do not think I’m complaining about the staff- they were great. And to be honest it’s not the end of the world I had to wait- I obviously could wait or else I wouldn’t be here.

I think it was just frightening because I knew something was really wrong, and it was upsetting for everyone (even the person with a sore finger who actually questioned why I had been left and wasn’t being seen by quicker) but I completely agree with you that some people might look bad and actually might be fine so fair enough if the staff thought this. Not the end of the world tbh and I was fine in the end, I just wasn’t sure if that was normal when waiting for triage or not x

OP posts:
HotdogMacaroniCheese · 05/02/2026 17:50

If you are really bad then calling an ambulance to bring you in might be best.

Calling an ambulance doesn’t mean you skip the triage queue though. Unless you get taken straight into resus, in which case OP that might have been better. Although you can wait hours for an ambulance now.

Frazzledandfried · 05/02/2026 17:50

As PPs have said, people are triaged in order of arrival - the triage is what determines the severity of your condition and the urgency of being assessed. National target is to be triaged within 15 mins of arrival. Very hard to keep up with that though when new patients arriving in a consistent stream.