This is why A&E is overwhelmed

[PackedintheUK]

And it's nothing to do with over anxious patients seeking "unnecessary" medical care.

I have a very sore very swollen ankle as a result of an insect bite. I've asked advice at the pharmacy and been told it looks nasty, see your GP, you probably need antibiotics.

So I've tried. I've been calling GP surgery all morning and finally got through to have receptionist incredulously say "you want to see a doctor for a gnat bite?" and then be told the next appointment is 16 Nov.

Me: but pharmacist said I need seeing urgently.
Receptionist: All the emergency appointments are gone for today. You'll have to call back tomorrow.
Me: but I've been calling all morning, won't the same thing happen tomorrow?
Receptionist: Well I can't do anything about that, if you're that worried go to A&E

So,I'm not sure that I am "that" worried, but I have been told by someone better qualified than me that I should be seen. We lost a colleague to sepis this year, a fit young woman and it happened incredibly quickly, plus I have a friend currently in hospital on intravenous antibiotics from a very similar looking bite he got at the same park.

I also don't actually feel that well.My body aches and feels heavy and I'm a bit queasy, which could be coincidence or my imagination.

Probably/hopefully it is nothing that won't heal itself in a few days but it feels irresponsible not to take the advice I've been given. Also to go to A&E

So A&E for something that could (probably) have been dealt with in a matter of seconds in a GP (telephone/video?) appointment?

There's no walk in or minor injuries here.

Yes, A&E is overwhelmed, and that is a bad thing. But when primary care is overwhelmed, GPs should just squeeze another one in?
It’s complex and all interconnected and not the fault of any of the staff working in these departments. One thing is for certain though, if you squeeze another patient in and make a mistake it will all come down to you.

Perhaps a hybrid system would be preferable?
In Ireland all maternity care us free as are GP visits from infancy to 6yrs.
Most pensioners have medical cards which gives then free care.
People under an economic threshold also qualify for a medical card - approx 30% of the population.
If you need a referral you can go public involving a waiting list or you can pay cash to go private or if you have health insurance you can use that to go private or semi private
I've never waited longer than a day for a gp appointment for non urgent & have always been seen on the day if it's urgent

It works pretty well overall

I have been able to send photos through to my practice before. I had a spot on my nose that suddenly swelled up! Practice nurse saw it, immediately prescribed antibs and said to go to A&E if it suddenly worsened due to it being a skin infection on face. Send a photo if you can, go to A&E if you feel worse.

The NHS has been underfunded....and had excessive expectations of it for at least the last 30 years.

Our population is elderly, increasingly so.
Medicl possibilities are ever increasing and treatments more complex, more successful but more expensive.

Big pharma holds all the cards for some expenses

Our country don't want to pay enough in tax for health and social care OR ration what's covered/available.

My maths can't come up with a solution other than STOP blaming the GPs......they are under huge pressure,
don't blame the hospitals.....they are virtually all in OPEL 4 ...the highest level of emergency
BLAME SUCCESSIVE GOVERNMENTS who happily champion the NHS as a vote winner but abandon it when there is need for serious strategic long term planning and funding.

@Staffy1 There would be more GPs available if everything was privatised for those who can pay.
I used to use a surgery that offered care to homeless people across the city. They used a lot of appointments and GP and nurse time. Privatise the service and overnight those patients disappear.
But lots more would go to A and E. Attendance at A and E would soar.
Poverty is going through the roof in this country. There are a limited number of people who can pay £50 a time for GP appointments.

@NalPolishRemover

Perhaps a hybrid system would be preferable? In Ireland all maternity care us free as are GP visits from infancy to 6yrs. Most pensioners have medical cards which gives then free care. People under an economic threshold also qualify for a medical card - approx 30% of the population. If you need a referral you can go public involving a waiting list or you can pay cash to go private or if you have health insurance you can use that to go private or semi private I've never waited longer than a day for a gp appointment for non urgent & have always been seen on the day if it's urgent

It works pretty well overall

Yes i worry this will happen. I would give up work and sign on. Wouldnt be worth my while as a disabled person to work. Or I would reduce my hours. Basically it would mean everyone managing but not on loads of money would be shit upon. Medical care is expensive. You get cancer for example and you are fucked.

@Julieca I understand your worry but that's not how it actually works in Ireland. My father has has complex medical issues over the past 15 years & including cancer twice & other rarer conditions & has had world class treatments- all free.
Here, people with disabilities would be entitled to a medical card ensuring free care

@NalPolishRemover I am not officially disabled under PIP. I doubt I would be covered although I have to have appointments regularly. These used to happen at the hospital and now are at GPs. I would be fucked financially.
It is already hard being ill enough that you can't work full time, but not ill enough to get financial support as a result.
Healthy people who go once a year would be fine. I have regular check ups and admissions to the hospital. I pay a fortune for travel insurance, health insurance would financially cripple me. No insurer wants people with ongoing health problems that are just going to get worse.
And it would lead to me dying younger. I know because this is what happened to my American relatives with the same inherited illness.
I don't expect anyone to give a fuck though.

Nail ' 'The GP could have taken a quick look between patients'......
Times this by twelve (average extra 'quick' requests per day if accommodated) including the documentation of findings on the patient's record and arranging of prescription, maybe three minutes per patient each at a push. Almost 40 minutes extra work. That's more than the lunch break in the whole working day.
'Just' squeeze in this, 'just' a quick glance at that, obviously not a HCP.

I would just deliberately take a NMW job as I would be better off having health care costs covered by the government than earning more.
I would also take my teenagers to A and E rather than the GP every single time.

Totally agree OP.

When you are better, I recommend Dispatches on Channel 4 with Matthew Syed looking at the problems in the NHS including the overuse of A&E due to the lack of funding of primary care (GPs).
We used to have a walk in health centre in our city. Great for the weekends and for non urgent stuff. But it was closed and the building is now student accommodation.

Yes our walk in centre was closed as well. They were brilliant for things like the OP has that do not need the expertise of A and E, but do need treated.

@BrilloPaddy

Local health access centre? Or Minor Injuries unit? and I'd phone 111 and explain what you've said here, that a pharmacist said you need it looking at and your surgery won't help.

A & E isn't the place until you've tried all other possibilities.

The OP has already stated that there is no walk in type place or minor injuries in her area. Not all areas do have them.

In many regions you have pharmacy, Gp (surgery or out of hours at discretion of the call handler) or A&E. otherwise it is 111 who will often send you to A and E anyway.

@cptartapp I see your point. Coukd a GP not keep one appointment free to be spent looking at urgent things each day?
I am.(clearly) not a Health care practitioner but it's evident from all the posts on mumsnet each day that the NHS is not really working.
But then it also seems that people may prefer it than considering alternative systems so what can be done...?
@julieca as I said you mat well be eligible for free care under the Irish system. I obviously don't have access to your personal situation. Perhaps you live in an area where you don't have to wait several weeks for the appointments you & your dc need? As you seem happy enough with the system & that's great if so

I was only responding to the OP who was left in a potentially v serious situation due to extreme lack of availability of appointments where she lives

@NalPolishRemover I can always get a GP appointment on the day if I need it. But my GP knows if I say I need to be seen that day I really do and am at risk of ending up in hospital otherwise.

I was in a similar situation with an infected insect bite and couple of weeks ago. My ankle swelled up and a large area around the bit was bright pink and it was spreading. I phoned the surgery and said I needed medical advice. Was told the nurse practitioner would phone me back which she did and prescribed antibiotics. If you aren't feeling well, you do need treatment sooner rather than later. It's shocking that some surgeries are being so unhelpful. Definitely 111 or minor injuries unit.

We still have a walk-on that closes at 7. If you get there after about 4pm you see a triage nurse and are told to come back in the morning or signposted on if considered sick enough. It’s useless for working people and is definitely how my small issue became a bigger issue.

[quote NalPolishRemover]@cptartapp I see your point. Coukd a GP not keep one appointment free to be spent looking at urgent things each day?
I am.(clearly) not a Health care practitioner but it's evident from all the posts on mumsnet each day that the NHS is not really working.
But then it also seems that people may prefer it than considering alternative systems so what can be done...?
@julieca as I said you mat well be eligible for free care under the Irish system. I obviously don't have access to your personal situation. Perhaps you live in an area where you don't have to wait several weeks for the appointments you & your dc need? As you seem happy enough with the system & that's great if so

I was only responding to the OP who was left in a potentially v serious situation due to extreme lack of availability of appointments where she lives[/quote]
I have 6
And a duty doctor whose whole day is dedicated to ‘urgent’

[quote NalPolishRemover]@cptartapp I see your point. Coukd a GP not keep one appointment free to be spent looking at urgent things each day?
I am.(clearly) not a Health care practitioner but it's evident from all the posts on mumsnet each day that the NHS is not really working.
But then it also seems that people may prefer it than considering alternative systems so what can be done...?
@julieca as I said you mat well be eligible for free care under the Irish system. I obviously don't have access to your personal situation. Perhaps you live in an area where you don't have to wait several weeks for the appointments you & your dc need? As you seem happy enough with the system & that's great if so

I was only responding to the OP who was left in a potentially v serious situation due to extreme lack of availability of appointments where she lives[/quote]

With respect, keeping one appointment free is going to do nothing to solve this problem. You clearly have no idea of the scale of the demand for services that GPs are dealing with.

@PaddingstonsHat - are you still in a situation where people may have to wait 3weeks+ to get an urgent appointment? That's really shocking if so

@julieca I'm so glad you can get the appointments/ care you need as soon as you need it. That's all any of us want at the end of the day. Do you think that's down to there being less demand / population where you're based or how is is possible for your GP to manage same day appointments?

The problem is 1904 FEWER GPs than 5 years ago

If every GP has approximately 2500 people on their list that's 4,760,000 people without adequate access to GP services

in reality it's more and not evenly distributed.

@julieca it wasn’t an A&E emergency. DD needed to be assessed by a GP. Instead of getting a GP appointment, our GP surgery said we had to go to the A&E as they were out of appointments. I tried to call 111 and they advised to see a GP. They tried to call the surgery but even they couldn’t manage to get the surgery to squeeze her in.

I think the A&E should be for emergency appointments only. Not for appointments where a GP should be seen but the GPs cannot fit them in.

This exact thing happened to me earlier this year. I was bitten. Sent a photo on the e consult thing and got prescribed antibiotics after a telephone call. Exactly what was required and no unnecessary face to face assessment required.

@ChequerBoard I really don't as I don't live there & have never used the NHS system.
What can be done to make it easier for urgent cases to get attention faster so?
These are genuine questions & in no way goady. I have direct experience of the benefit of fast intervention and it seems so very worrying to me that people are finding it so hard to get seen

I haven't RTWT but I thought pharmacists can prescribe antibiotics for insect bites?