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.

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.

And blame those who voted for the shower of shite currently running the country.

I think the “healthy” people going private because they don’t know what else to do is exactly what they are hoping for. While it will probably relieve a small amount of pressure - the nhs will then become a critical care only service or will only provide for a small group of people who cannot afford anything else and it will be of a lower standard.

ivykaty most practice nurses do not prescribe. I don't, not neither of my colleagues. My ANP colleagues yes. Different role. My clinics are full for the next month anyway. The whole month. I'm due to retire in less than five years, as are both my PN colleagues. The ageing PN workforce is another time bomb.
Nail our GP's already have several free appointments each day for urgents. They're filled within the first half an hour usually. One slot would be a mere drop in the ocean.
berlin where are the staff coming from to work in these extra walk in centres? We've had three staff with over 100 years experience all retire early last month. One pt replaced with no more on the horizon.

@LakieLady

*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.*

And blame those who voted for the shower of shite currently running the country.

True: next election, what will we all look for? What/who will we vote for? Don't just complain here.....complain to the politicians....use your vote and educate those around you to use theirs.

That's a shame for you but I'm not sure why it's my fault?

@ChequerBoard I never said it was.

The NHS has been running on almost empty for decades. Population has increased, ageing population has increased, medical technology has advanced so that more conditions can be treated, more drugs are expected to be prescribed with associated monitoring (cholesterol etc) - but the funding hasn't kept up. It's been chugging along due to the dedication of staff, who are prepared to work just that little bit harder year on year, to keep it going.

Then along came Covid, which has decimated the service. And now the NHS simply can't cope with the demand.

You can complain to the practice manager all you want, but all that achieves is to take up the time of the manager and the GPs, so that they are even more busy discussing and replying to your complaint.

If anyone actually wants to do something constructive, that might go some way to balancing supply and demand, I would suggest lobbying your MP as a starting point. I would also suggest ensuring you are as healthy as you can be - quit smoking, lose weight, take exercise, eat healthily, drive carefully - if everyone did that, then demand would lessen considerably.

But mainly the NHS needs more money.

I totally sympathise but I'd like to say sometimes it can work well.

Two months ago I filled in the form on 111. It said I needed to be seen by a doctor within the day and did I want a call back. I clicked yes and received it within two hours. Less than two hours later I was at the OOH doctors clinic based in hospital. I was then sent across the way to A&E and kept in hospital for a week. Ten days ago I was unwell again and rang 111. They said I needed to be seen within six hours and was given an appointment two hours later. Sat in the normal A & E and was triaged within the hour. She then spoke to another doctor and then offered me to be seen by the out of hours doctor as would be quicker than the A & E doctors. I did then get sent to them as needed further checks but it was all very smooth and apart from the top doctor everyone was lovely.

Today I rang about something else. Was in a queue of more than 30. Held on for about 50 minutes. Offered phone appointment 70 minutes later. Had it forty minutes after that. GP said he'd refer me. 2-3 hours later I had my appointment for next week.

It's a difficult time for everyone but it does seem like some surgeries aren't running as they should and I really feel for everyone whom is struggling.

The PP who would fight for her child, lovely, but you are important too. Please get help.

I wonder why the GP surgeries can't be 24 hours. Literally as they are 8-6.30pm but 24 hours. It can't just be because they isn't enough doctors. Would work better than 111 sending everyone to A & E between 6.30pm and 7am.

@SunshineCake1

I wonder why the GP surgeries can't be 24 hours. Literally as they are 8-6.30pm but 24 hours. It can't just be because they isn't enough doctors. Would work better than 111 sending everyone to A & E between 6.30pm and 7am.

there aren't enough GPs

@SunshineCake1

I wonder why the GP surgeries can't be 24 hours. Literally as they are 8-6.30pm but 24 hours. It can't just be because they isn't enough doctors. Would work better than 111 sending everyone to A & E between 6.30pm and 7am.

I’m a human being, not a machine. The whole thread we have been saying that there aren’t enough GPs, that we are stretched, that we don’t see our families and are burning out. How can this be a solution?

Sunshinecake1 yes or even just an out of hours emergency GP service. There used to be one locally and you rang an out of hours number, was assessed, and given an appointment to attend within a couple of hours. There was a hospital across the road as well. Excellent service especially when you consider there is no GP service from 6.00 pm Friday evening until 8.00 am Monday morning. It was needed. Our area used to have six major hospitals, all specialising and excellent, now there is one and the population has increased dramatically.

If it's one of those vile they are evil and I come up in a massive whelt every year.

Can you get hold of some Phenergan 25Mg, from the Pharmacy

1 of those will calm it down and I'm not aware of any contraindications - you can use them for children so they've very benign. That may just get it under control.

I love (NOT!) the suggestion of other care units - we don't have them in our area & 111 can take hours (all night) & than be told to go to - A & E!

Btw Phenergan is an antihistamine. Your body has probably gone into overdrive and maxed out on histamine so it just stabilises your levels.

Well,quite.

Here we don’t have OOH or minor injuries, only GP or a&e. Dh once came home feeling unwell at 6pm and had tracking up his leg from flea bites. I sent him straight off to a&e where it was taken seriously, was so bad they discussed admitting him but decided they had no beds. As a midwife I’d been expecting he’d need IV antibiotics but they decided to go with oral which luckily did the job.

So yes, don’t mess about with flea bites/gnat bites and it does seem a crazy system when there’s no gP appts left or it’s the weekend or evening and the only alternative is a&e.

And while on the face of it it seems sensible to book emergency appts for the following day if they can’t be fitted in that day they could then easily end up booking all the emergency slots for the following day and possibly the next day. 🤷‍♀️ Maybe they’re hoping if it’s bad people will go to a&e and then it’s not their problem?

OP if you’re feeling unwell get seen tonight, OOH if possible but a&e if no alternative.

Sorry my post should have said

vile horse flies

@SunshineCake1

I wonder why the GP surgeries can't be 24 hours. Literally as they are 8-6.30pm but 24 hours. It can't just be because they isn't enough doctors. Would work better than 111 sending everyone to A & E between 6.30pm and 7am.

Yes, makes complete sense. And seeing as there literally aren’t enough GPs, the current ones should stop taking the piss at 60 hour weeks, and start actually pulling their weight by working an absolute MINIMUM of 140 hours. And take a pay cut.

you may have been bitten by a horse fly & need antibiotics
The receptionist is NOT qualified to say this or give an opinion & you should raise a complaint

I know it’s been mentioned already but I went to boots to show them a bite I was concerned about and the pharmacist drew around the bite and said she couldn’t treat it. She suggested I rang 111 to arrange antibiotics because I wouldn’t get in at the doctors for days and it could have become cellulitis or sepsis but then within 40 mins I was at home with antibiotics. The pharmacist told me to keep the pen on and go to a&e if it spread further.

@BungleandGeorge

If all the appointments were booked I’m not sure what you wanted to happen? Should the GP have to stay there all night to see all the ‘extras’? Either it’s an emergency (a&e) or you could wait another day?

I don't think I said I wanted anything "to happen" except people to stop blaming parents for A&E being overrun.

Although, as you ask, would it really be so terrible to book me one of tomorrow's emergency appointments while I was on the phone and save their telephone system a call tomorrow?

1, We could require all doctors to work full time and not take any other jobs.

1. We could try to reduce the UK population. We have 18m more people than when I was born. If we could lose 18m we might start to have a bit more space.

@NOTANUM

I agree entirely with you, OP.

The NHS primary care system is broken. My DD got sent to A&E when she could have been seen by a GP but they're not doing face-to-face meetings. I then got told off in A&E for not seeing the doctor first. You just can't win.

The NHS is beyond broken. We need to stop considering it some sacred cow we can't criticise and work out how to fix it. It clearly isn't a money thing as we pump money into it compared to countries with much better systems. It needs full-scale reform but sadly it's politically toxic so no-one will touch it.

This is absolutely right.

@Xenia

1, We could require all doctors to work full time and not take any other jobs.

1. We could try to reduce the UK population. We have 18m more people than when I was born. If we could lose 18m we might start to have a bit more space.

Surely a part time doctor is better than a doctor who leaves completely as they can’t fit in full time work with possibly other caring responsibilities or small kids?

@Spicychickentenders

I understand your frustration, but I don't understand what you expect be done, if all the appointments are gone for today? The GP surely does not operate an unlimited service? If the appointments are gone, the they are gone.

Some GPs have chosen to strictly implement a book on the day service, as otherwise the appointments are booked months in advance.

I just wonder what you think should happen, if there are no more available appointments. Surely you understand that they will run out at some point during the day?

Ok, so after reading this post OP is probably wondering what to do next?😕

There are huge demands from very competent 18 year olds to read medicine. If we could weed out at age 18 those who will be wanting part time work we could then just hire the full timers and take them into university on the basis and with a contractual obligation to work full time in the UK NHS .