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.

I didn't say it was the GP's (or the receptionist's) fault. I said this is the reason A&E is overwhelmed.

I hear you. I need a ecg for suspected heart failure bit suspect a partner cancelled it when my bloods came back ok. I cant tell you how tempting it would be to go to A&E when I get chest pains. But I'm not it's my heart or the muscles inbetweeners my ribs.

If your dieing = A&E
Not quite about to die? = dont waste gp time. My sympathy for my gp practice during covid is gone.

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.

It is. I’ve been told at least three times by the GP to take my son to A&E because “we can’t deal with children like him” (learning disabled, needs a bit of patience and calm to be checked over). This has been for things which should have been dealt with by a GP, but what can you do if they refuse to do it?
Have you tried 111? They will probably tell you to go to A&E or to an out of hours GP appointment this evening.

My GP won't see foot things. Apparently we need a podiatrist for foot things, not a GP.
Ditto optician for eyes and dentist for mouth/teeth.
Pushing ailments into the private sector with paid-for consultations and treatments... But without an established mutual health/medical insurance scheme like other countries have.
Plus I wouldn't know where to start to consult a podiatrist and would they be interested in an infected bite/early diabetic infections/gout etc????

@IncessantNameChanger

I hear you. I need a ecg for suspected heart failure bit suspect a partner cancelled it when my bloods came back ok. I cant tell you how tempting it would be to go to A&E when I get chest pains. But I'm not it's my heart or the muscles inbetweeners my ribs.

If your dieing = A&E
Not quite about to die? = dont waste gp time. My sympathy for my gp practice during covid is gone.

You are perfectly entitled to go to A&E with chest pains. No one there would frown upon it, it’s always taken very seriously.

111 would be a much more appropriate next step, rather than A&E. They can arrange antibiotics to be sent to a local pharmacy, and you don’t need to set foot in A&E for something that isn’t an emergency

@FatCatThinCat

This has always been a problem. My DD burnt her arm quite badly and A&E said it needed to be properly cleaned and redressed with burns dressings every day for several weeks and to contact our GP's practise to arrange this with the nurse. GP's refused to do it, said the only appointment with the nurse was 3 weeks away and I could either take it or leave it. So I had to take DD back to A&E every day for 3 weeks for it to be done there instead. That was 20 years ago.

No that is a different issue. The hospital receive the funding to do this. A GP wont do it unless the hospital pass on the funding.

@Derbee

111 would be a much more appropriate next step, rather than A&E. They can arrange antibiotics to be sent to a local pharmacy, and you don’t need to set foot in A&E for something that isn’t an emergency

If that's the case wouldn't you expect the GP surgery to tell you that? How are we supposed to just know this stuff?

YADNBU. My dh wasted A&E's time recently for a whole day after being instructed there after an online GP consult. If she had seen him face to face, she definitely wouldn't have sent him there. He had to sit in a room with an elderly lady who was dying (and did die) too, because he had recently returned from abroad.

Spider bite ? There are some very nasty ones at this time of year.

@NC145632

My GP won't see foot things. Apparently we need a podiatrist for foot things, not a GP. Ditto optician for eyes and dentist for mouth/teeth. Pushing ailments into the private sector with paid-for consultations and treatments... But without an established mutual health/medical insurance scheme like other countries have. Plus I wouldn't know where to start to consult a podiatrist and would they be interested in an infected bite/early diabetic infections/gout etc????

There are a list of podiatry things the government no longer provide NHS funding for. There are still some podiatry funded things such as care for diabetic patients. This is the governments fault, not your Dr.

I took my son to the pharmacist the other day because of a nasty rash. She told me he should see a GP fairly urgently. Obv no appointments available so I called 111. They did the initial assessment and said a clinician would call back. They called three times over the day apologising for the delay and doing a quick further assessment. Then they called again at 4am and left a voicemail saying that as I hadn’t answered they were closing the case. I thought they were meant to call three times before closing it?? So 111 isn’t always the answer either!

@EishetChayil my BIL went to A&E yesterday with severe heart pains, not able to speak or move without pain, and was there 18 hours. They couldn’t even admit him, and had to do tests on him in the corridor.
Sounds like A&E is totally overrun atm

You aren't kidding OP. My dad is currently seriously ill in hospital after not being able to get a GP's appointment and being turned away from the walk in centre when we tried there. When we finally did get a GP to see him,my dad,an elderly,unwell 83 year old was made to sit and wait outside in the rain on a bench,as the chest infection that the walk in centre said that he didn't have,had aggravated his COPD and given him a cough. Therefore he wasn't allowed to wait inside. He ended up being sent straight to hospital once the Dr had seen him.
A friend who is a consultant in children's A&E days that 8 hour waits to be seen are common and she doesn't blame anyone as it is the only place people can get treatment at the moment.

Twice I've had to use 111 when something wasn't urgent enough for A&E but couldn't wait for a GP appointment. When by daughter had an insect bite that got infected we were away from home, so phoned 111, who agreed she needed urgent antibiotics and fixed a walk-in appointment at the nearest A&E. We went straight in, got it assessed, got the drugs and went back. I hope you get it looked at soon!

It does depend where you live. there are much better services in more affluent areas because quite reasonably that is where the medical practitioners prefer olive for better quality of life. when we lived in West London there was no problem getting a gp appointment and there was a choice practices as well as walk in services and multiple hospitals and consultant services, in West Wales we have an overworked chronically understaffed gp practice with unfillable vacancies as who would want to move and work as a salaried gp in an area where there is deprivation and ill health problems to go with it and be under pressure from lack of funding and support. Even though it's got a National Park, it just doesn't attract doctors to fill the vacancies like well resourced affluent areas do.

YANBU. Medical centres and surgeries don’t have the means to support the capacity of patients they have so they have to resort to the farce that is receptionists triaging when you phone, same day appointments or no appointments and to then send patients elsewhere. I live in a town where three new estates have popped up in the last 5 years but we still only have the one med centre that is the same size and employs the same amount of gps. It’s not rocket science to know that it just won’t work. But I guess the money to expand or build a new one isn’t there. All I hear about it places closing - birthing centres, minor injury units etc. I don’t hear about any new places. New surgeries and new hospitals is what we need when the population is still growing.

we can’t deal with children like him” (learning disabled, needs a bit of patience and calm to be checked over).

I stick with our lovely but frustratingly small GP surgery because of my learning disabled and medically complex DS as the staff all know him and are lovely. The downside is that it is practically impossible to get through on the phone.

@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.

No we pay far less GDP for our health system than other developed countries. Our population has grown, so have treatments such as for premature babies and cancer. The funding has not kept pace. You want a private service instead? It will cost a lot more just to maintain what we currently have. And the issue is a lack of GPs. It is like HGV drivers. If you don't have enough actual staff, then there will continue to be issues. And look what happened to eye services in Nottingham when it was privatised. It went from a world leading service to struggling to manage basic eye issues. And it costs taxpayers a fortune. It is a scandal. But someone is making a lot of money.

This is exactly why a&es are overwhelmed, no fault of the patient most of the time there is just a complete lack of funding for GPs. Id advise a walk in centre first or an urgent treatment centre if you have one near you. Failing that a lot of a&es actually have a GP service within the department nowadays so you could ask to be streamed to them. In addition lots of a&es have same day emergency care units which you would also meet criteria for with it likely being cellulitis as a result of the bite.

I would complain about that comment. You have tried to sort out self care and been advised by a pharmacist to see a GP. I know someone who due to a pre existing issue would need to be seen immediately with a bite on one of her arms.

I think a lot of GP surgeries are over whelmed but that does not excuse inappropriate and unhelpful comments. I had some blood tests, apparently I should have looked on line for the results but no-one told me, and previous blood test the GP rang me with the results. When I rang the surgery the receptionist kept saying we encourage people to check the system etc and must have said that 10 times, despite me telling him I wasn’t told I had to and had previously been called by the GP with results. I did end up complaining to the practice manager as I have no issue with looking for my results on line, but I need to know that is the expectation before I can do it.

@Rosesareyellow exactly. They keep building more houses and estates but still the same number of GPs and close walk in centres. Then blame the GPs for not enough appointments. I mean it isn't rocket science what the issues are.

If you have tried every option to see a GP, spoken to a pharmacist, and yet still not got an appointment to see someone then sorry but the only option is A&E. if A&E is overwhelmed that’s because it needs more resources, more funding and more staff and that is not my problem I’m afraid.

Maybe ohone 111 op and tell them the story see if they can get you antibiotics.
It might save a long wait at A and E.