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.

@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?

I think a GP can probably squeeze in one more phone call rather than send the patient to A&E, frankly.

But mostly, of course they need resourcing better, it's about the system, not the GP or the receptionist.

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

The difficulty is it wouldn't have taken "seconds" for a GP to assess and treat you, whether by telephone, video or in person. And there are more people needing GP time than there are GPs available. So if all the appointments have been taken by other people, what happens next? Some patients will probably be added on as extras, for example somebody with a complicated medical background that the GP knows, or is housebound, but there is a limit to how many extra patients can be seen.

I agree it's very very frustrating and obviously places more strain on A&E. I don't know what the solution is.

Neither GPs nor A&E can see an unlimited number of patients safely.

I do find bigging up any worries and concerns to the receptionist really helps. They then want to delegate the issue. You think of the worst case scenario and say you're really worried about it.

@Spicychickentenders At my surgery they hold back emergency appointments. Receptionists are not medically trained to make these decisions. They should at least be asking a medically trained colleague if OP can wait or not. They are a Dr’s surgery not a hairdressers. They have a duty of care to make sure their patients have their medial needs met.

I've had this exact thing and it turned into nasty cellulitis. You need medication and if the GP won't see you today then you will need to go to an out of hours centre or A&E. I agree that it feels like you're clogging up A&E but you've tried the alternatives and they have refused to see you.

Hope you feel better soon

I’d try 111 or a local walk in if you have them. They’re not always well advertised

The GP should be able to fit in some kind of video consultation or via email for this - it doesnt actually need face to face just a visual look at the bite.

The fact that they havent is awful because you do need antibiotics! Call 111 and if that doesnt get anywhere go to A&E

YANBU it took me 2 weeks of phoning up every day for a gp appointment as I didn’t think I was unwell enough to go to A&E but I felt really ill.

Most days I couldn’t get through even though I rang constantly. The few times I did get through they’d say they had no appointments and to ring back the next day.

I ended up getting an ambulance and having a stay in hospital because I had kidney failure.
I was obviously seriously ill but it also cost a lot more money, time and effort. A quick blood test with a gp would have been a lot easier.

A couple weeks later I had similar symptoms but couldn’t get through to the gp so I went straight to A&E which could have been completely unnecessary but I knew it would be a couple weeks before I could see anyone.

Something seriously needs to be done. I’m not bashing gp’s at all but it’s not fair that the hospitals are under so much pressure when most of the things should be dealt with at a local practice.

I wonder why they don’t set up temporary practices in the local communities so people can go there instead.

@HopelesslydevotedtoGu

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

The difficulty is it wouldn't have taken "seconds" for a GP to assess and treat you, whether by telephone, video or in person. And there are more people needing GP time than there are GPs available. So if all the appointments have been taken by other people, what happens next? Some patients will probably be added on as extras, for example somebody with a complicated medical background that the GP knows, or is housebound, but there is a limit to how many extra patients can be seen.

I agree it's very very frustrating and obviously places more strain on A&E. I don't know what the solution is.

Neither GPs nor A&E can see an unlimited number of patients safely.

Wouldnt it? I've never been in a GP's surgery more than a minute or two.

OP can you ask to speak to the practice manager?

There is a shortage of GPs. I can get an appointment fairly easily as I live in a part of the country with a lower level of GP vacancies. If you live in an area with a high level of vacancies you will have issues.
The shortage of GPs has been building for some time. It has been largely ignored by government.

I don't know why people aren't signing up for online services for their doctor's surgery. You can book an appointment online without trying to ring all day.

I think a GP can probably squeeze in one more phone call rather than send the patient to A&E, frankly.

If there was just one person asking to be squeezed in I hope they would, but I suspect there are many many patients calling, and presumably the individual GP has a limit at some point.

Yes call 111, I've called before, made clear that I've been trying to get a GP appt and have been explicitly told they don't have any and my only other option is to go to A&E, they were able to get me a walk in centre appt.

If you have funds you can also access a GP online these days privately. I think around £75. Shouldn’t be the case that it’s needed but if you can afford it might keep you out of A & E

My gp surgery is still only doing phone appointments which seems bonkers

Ring 111. If you need a GP appointment you will be prioritised for a slot tomorrow. That's why there are never any urgent GP appointments - all taken by people that have, in desperation, rung 111.

@HalzTangz no all GP’s have this facility

*not

But it’s not going to be “just one more call” you are highly unlikely to be the only person trying to get seen.

They can’t magic appontments up out of thin air. The GP system is stretch to its limits sadly. It’s rubbish for patients and GPs alike but they can’t just make appointments from thin air

@HalzTangz

Many GP surgeries do not offer this at all. Every GP is an independent business running things the way they want to. Some are able to manage their demand, others are overwhelmed.

As others have said, call 111, they can arrange for you to speak with a nurse, direct you to appropriate out of hours, book you in at a&e if you need it etc.

@Moonopoly

OP can you ask to speak to the practice manager?

I tried to speak to the practice manager about a (to me) fairly obvious efficiency that could be made with their repeat prescription service. The way it works atm is bonkers and when DH was dying, actually one of the most stressful aspects was every dealing with this surgery. Anyway, I was genuinely trying to help with a suggestion that I thought would help both patients and staff but was told the practice manager "doesn't take calls"

Probably, I need to change practice...

I’d have asked the receptionist to put me through to the practice manager when they told me to call back tomorrow. You’ve sought medical advice so the GP needs to act on it.

I was poorly coming up to Christmas a few years ago. The receptionist said they’d no appointments so I rang 111. They rang the GP, an appointment was found and I was seen within the hour.

I have ended up 3 times in A&E after symptoms became an emergency as the problem was allowed to progress due to the inability of getting a GP appointment for weeks on end.

On other occasions I have resorted to deal with the problem myself, including removing a dental abscess twice myself because I couldn’t get a dentist.

So that’s the way that is this day, the moment you are sent to the GP you can expect sitting waiting on the line for a GP appointment for a couple if hours each morning for a few days/weeks just to be told all their appointments are taken and to call tomorrow, so you call 111 that sends you to the GP several times until the problem is severe enough to direct you to A&E.