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.

Whenever I've contacted my GP about abscesses and UTIs I've been dealt with quickly. Both are infections that can turn nasty if left untreated and the treatment is SO simple and really would take literally seconds to issue a prescription for ABs.

Contact them again OP and long term, change your GP this one is no good.

You could be developing cellulitis and need seeing.

I went to A&E with similar symptoms after a horsefly bite on my ankle last summer. Suddenly got worse late on a Friday evening, spreading red area, etc. Our minor injures/drop in had just closed for the night and I knew it couldn’t wait for GP on Monday (had known a colleague get really nasty cellulitis in similar circs), so I just went. Luckily this was before lockdown had been properly lifted (was maybe June time?) so not the usual Friday night carnage to contend with. But nobody shouted at me for coming in. Gave me some ABs and told me to come back if I had any sepsis type symptoms. You’re probably going to need ABs at some point and the quicker the better, so just get it done. It’s shit that A&E is overloaded (have also spent 6 hours there recently waiting with a fracture) but you don’t want to lose a leg just to be polite.

OP I'm really annoyed on your behalf about that receptionist's retort. Insect bites, if they become infected, can have really nasty consequences. Our GP surgery is really good with insect bites and will prescribe antibiotics without even seeing it.

Call 111.

This is a few years ago, and I don't know how many years this was going on, but the number of trainee doctor places was seriously limited by the BMA themselves so I am sure we are now seeing the impact.

@silveryslade

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.

And if everyone does this the same thing happens.

All the emergency appointments are filled with people who are fine.

The amount of people who seem to be on their death bed, and when you review them have only had a sniffle since the morning. Hope the appointments weren't booked with the above kind of patients and you missed out op.

I had a similar experience twice lately. My daughter was sick so the gp sent her to a and e because they have have quicker access to the lab from there.

We were 12 hours waiting for a simple antibiotic. We should not have been there at all but had no other option as the gp sent us there.
There is no middle ground and the last place on earth anyone wants to go to is a and e.

There must be a better system.

I was thinking about this lately and the apgar score. Someone just invented that and I think it was a woman, it was a system of measurement. I think they should introduce a measurable system for clearing patients out of a and e. The a and e I was in was totally disorganised and everyone was just wasting time and totally pissed off.
It’s just not working at all but if it’s any consolation the emergency rooms appear to be the same in Ireland too. Other European countries don’t seem to have this issue?

I hope you feel better soon.

Sorry, haven't read the full thread, but does your surgery not have a video consultation service through an app like Livi?

You shouldn't have to, but if you're desperate you could pay about £30 for a private appointment (which can lead to a prescription) though Livi or PushDoctor etc

Ring 111. Explain what has happened so far. They will probably send you to A&E.

I know someone who scratched their leg on a thorn bush. It swelled up and she developed cellulitis. Got it sorted but it was very unpleasant and took ages to heal.

'111, should be able to make you an appointment at a walk in/minor injuries/OOH rather than waiting forever and a day in A&E'

This. It astounds me how many people think it's a choice between trying to persuade a GP receptionist to let you in or hours in A&E.

Also most practices have advanced nurse practitioners, you don't need a Dr to prescribe antibiotics.

I wouldn't have said it was an insect bite I'd have said I had signs of an acute infection and had a high temp (even if you don’t). Gp receptionists need things spelling out a bit ime, I do wonder if they have even the most basic of health care training to understand what they are dealing with.

Everyone who shows up at A&E gets triaged when they arrive.

Not saying you are wrong for most patients but that is not how it works currently at our local hospital.
Our local hospital was in the news recently as it went on red alert, or whatever it is called.

The system there is, for those who ring 111, you give details and then on arrival, after seeing a first nurse, a ENT doctor or whichever sort is needed, has already been alerted, and then you wait for that doctor to be ready to see and treat you.

@Plantstrees

This is a few years ago, and I don't know how many years this was going on, but the number of trainee doctor places was seriously limited by the BMA themselves so I am sure we are now seeing the impact.

They've allowed new medical schools to open at a few Universities now. They've done it in the NE England to try and recruit more GPs there... but obviously it'll take a few years before they're fully trained and operational!

Packed you really think you're the only one asking to be 'squeezed in'. You could be one of a dozen requesting the same.
As a practice nurse I often 'squeeze in' extra patients who come late, walk in, attend inappropriately etc, to my own detriment. If the GP 'squeezed in' everyone who wanted to be seen they could be sat there until midnight!
It's crap all round but unless you work in primary care atm you really have no idea how horrendous it is.

[quote julieca]@ChequerBoard nobody should have to use private health insurance. This is a failure of the government.

OP it does sound like the receptionist has judged your issue to be very trivial and not needing a GP time. She thinks you are a time-waster. Ring and speak to the practice manager.[/quote]

It's a choice.

Personally my socialist principles go out the window when my own children's health is being compromised.

If you want to let your child get pneumonia and be hospitalised because you'd rather wait for a NHS GP appointment than use a private service that's provided free of charge by your employer then you crack on.

Ime with dh they are funnelling everything through a+e. His cardiologists secretary said well his scan must be normal or we’d have contacted you but go to a and e if you’re worried.

So we did, heart scan very much not normal and he was admitted.

@cptartapp

Packed you really think you're the only one asking to be 'squeezed in'. You could be one of a dozen requesting the same. As a practice nurse I often 'squeeze in' extra patients who come late, walk in, attend inappropriately etc, to my own detriment. If the GP 'squeezed in' everyone who wanted to be seen they could be sat there until midnight! It's crap all round but unless you work in primary care atm you really have no idea how horrendous it is.

No, but I'd like to think they aren't sending dozens of people a day to A&E

Sepsis is a risk but also cellulitis, where the tissue becomes infected, and can be really nasty.

Agree with suggestion of emailing a photo but if you get no response then A&E.

This sounds like a prime example of the risks/flaws of receptionist triage.

It astounds me how many people think it's a choice between trying to persuade a GP receptionist to let you in or hours in A&E.

Umm, even the staff at the GP?

@LadyCleathStuart

Tell me about it, DH had very obvious gallbladder pain for months. Nurse practitioner kept prescribing medication for IBS despite DH repeatedly saying where the pain was and how he had a strong family history of gallbladder problems. He asked to be referred for a scan and was told that if the pain was 'that bad' he should go to A&E.

In the end that was what he had to do and it was them that finally prescribed painkillers and got him referred for a scan.

He didn't need to do that, if he had been able to see or speak to an actual doctor at the GP surgery, and if they had listened to the actual symptoms described he could have had the tablets and been referred without taking up resourcss ar A&E.

Its a farce sometimes.

For years I had stomach pain. About 20 months where I could barely walk. I couldn’t stand straight. My local A and E kept refusing to see me. Telling me it was gallbladder pain. And no dr would see me as it wasn’t an emergency.

So I got taken to another hospital. Who were incredulous that it hadn’t even been looked at. They kept me in and it was finally found to be a rare type of liver and kidney problem!

Had I of stayed home for another few months. I wouldn’t be here.

how many people do you think a GP should sew in a day ? 20 ? 40 ? 80 ? is there any limit ? should they just work until everyone who wants it has been seen ?

how long should each person have ? 5 mins ? 10 / 20 what?

Because THERE ARE not enough GP'S TO MEET DEMAND. And however mush you offer to pay them most will not work any more because they are exhausted, burned out and cant take any more ....

Stop blaming GP's, stop blaming your surgery. start blaming the people who have underfunded and cut GP services for years , the same people who are threatening and bullying GP's now ...

@Mixingvax

Did you not think to call 111 and go to a minor injuries unit instead of A&E what is the receptionist supposed to do magic an appointment out of thin air? I understand it’s crap and yes you should be able to see your GP but there is too many patients per go and not enough appointments gp are working 12 hour days and it’s still not enough if isn’t their fault!

If that was the appropriate action I'd have expected the receptionist to suggest it.

There isn't a minor injuries here (as I said in OP)

Have we not already established that there are many areas without a minor injuries unit?

As an A&E nurse I sympathise.
The patients really are trying. At least 60% of the attendees that I think could probably of been dealt with in primary care have tried, they really have. They’ve been sent to A&E by 111 or their GP. Or they’ve called and are unable to get an appointment. They then sit and wait for hours upon hours, it’s such a rubbish patient experience.
111 can be really helpful as long as you don’t trigger the questions that will send you an ambulance/to A&E.
My own GP can be helpful though if I call them out. “This is a primary care problem, you are commissioned to deal with, this is not an A&E problem, could I speak to the practice manager” sometimes you have to advocate hard!