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 spoke to our site manager at work a few weeks ago, asked why we were on OPEL 4 which is declared when the trust has lost all ability to cope (used to be news worthy)….

• elderly people with old people issues, UTI, hip fractures, infected leg ulcers etc
• people that couldn’t get GP appts so just turned up at A&E (this has always happened but worse at present)
• bit of covid, not much, mainly discharged home (we have 20-25 covid inpatients on average at the moment versus 300 earlier in the year)
• then the usual stuff

But overwhelmingly was elderly people.
This is a major London hospital

The nhs isn’t perfect by a long shot, but it’s there and free at the point of care. I’d rather have what we have than a US style. it's free at the point of use here in Spain and we can actually get seen! From what I read on here the NHS is falling to pieces.

Packed if they feel it needs to be seen that day and they have no capacity to do so and there's no walk in centre then that's the only other option. Even if Gp's themselves know it's not appropriate.
Our surgery doesn't send to A&E. We have ANP's who triage and see on the day stuff as necessary. Such as your bite. Last week they were averaging near to 70 calls a day. One nurse. As I left on Friday at 5pm (after being there since 7.30) the one remaining GP taking over triage still had around 15 calls outstanding. One ANP has retired early, one off sick with Covid (again) and the other had already done a ten hour shift.
Utter chaos.

I had insect bite on ankle, I work at hospital and was scratching it. Pharmacist next to me said go book in (I work there) or you'll be an in patient needing IV antibiotics all weekend. A nurse practitioner saw it, said cellulitis and gave me antibiotics. I'm an allergic type person so just thought it was my usual sensitivities. If the area is red and swollen, draw around it and if continues to spread beyond the pen line or starts tracking, ie red lines running up from it, then you need A & E if you can't see anyone at your GPS. As you and I both found out doesn't necessarily need to be a Dr's appointment. You could try emailing a photo asking for prescription, if they have that facility at your GPs, they do at mine.

DD has just had a bite on her angle which got infected and she ended up with an oozing sore larger than a 50p. The practice nurse prescribed oral antibiotics and explained to DD (who hadn't thought to tell us about it until we noticed it) that because it was close to the bone it could have caused sepsis. Sure, you don't need to see a doctor for every insect bite, but the pharmacist has seen it and is also better qualified than the receptionist.

If the receptionist won't budge, try 111, and A&E as a last resort. Perhaps make sure that they know why you haven't gone to your GP.

OP, Ds had a strange rash come up on his face a few months back. I thought it was an allergy. The GP receptionist asked me to send a photograph and a doctor called us back immediately when they saw it. It turned out to be cellulitis requiring urgent antibiotics. I wouldn’t have even suspected it based on the descriptions and photographs of cellulitis online and he had no sign of a scratch or bite as a source either. In your case I would call them back, say you have been back to the pharmacist, who suspects infection/poss cellulitis and can someone at least review a photo, if that still doesn’t get you sorted, then go for 111 and finally, failing all else A&E.

To be honest, even when surgeries are trying their absolute best some patients don’t help. My GP surgery (who has done really badly throughout the pandemic and been investigated twice) is really trying to turn things around and has recently launched an extra clinic to try and cover the winter surge. They also announced face to face appointments as standard, unless we request otherwise. One week into the new face to face regime they have had to send out a message to patients, as a large percentage of those with booked face to face appointments failed to attend!

I was in A&E with my ds on Friday night. He has complex medical needs and although it was for an injury, rather than specific to his health needs, we ended up having an ambulance called, as he was triaged by a paramedic over the phone and they decided we couldn’t move him safely. Four and a half hours after the accident he had stabilised enough for us to attempt moving him ourselves, so we cancelled the ambulance and took him to A&E ourselves, which wasn’t easy, but I would rather free up an ambulance if possible.

I have to say it was probably the best, most efficient A&E trip we’ve ever had (and there have been a lot with him over the last few years). Four hours from arrival to discharge, checks on the door, well spaced quiet waiting room and the whole process steadily and efficiently moving through triage, to xray, to seeing the doctor and being treated. I was really impressed. While we were there my son was at risk of one of his conditions becoming an issue and they took charge straight away and dealt with it efficiently. Staff were all absolutely lovely as well.

First time I have ever been to A&E and not seen anyone kicking off or being rude to staff and everyone there seemed genuinely unwell and definitely needing to be there. I was the only person accompanying someone, as ds is 17 and vulnerable and I think that helped, as often when we’re in A&E whole families seem to attend with one patient and take up multiple seats. Ds is in a wheelchair, so he doesn’t take up a seat, so even with me attending too we only use one and even with two seats blocked off between seats there was always enough seats to go around.

I think this is also because our hospital has separate areas for minors and majors. Majors was rammed, ambulances lined up outside, four police cars as well, whereas minors was calm, well organised and as they turned away anyone without a genuine reason for being there the whole system worked.

It won’t have been a gnat. Probably a mosquito (maybe a tick but they you would have a bullseye swelling)

I know what you mean. I am very sensitive to insect bites and get a medium allergic reaction to mosquito bites where the bite areas swell into big itchy lumps and I feel the way you describe. Usually I would take a piritin or other allergy tablet and slather the bite with insect bite cream. If you have never had this reaction before defo ring 111 and ask for advice and to send picks. Could have been a spider as well I suppose.

I think it’s NU for them to be booked out including emergency appointments but unreasonable for the receptionist to be unnecessarily rude. Is there a minor injuries walk in centre near you? I’m surprised they wouldn’t send you there before A&E.

@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.

The line was engaged I.E people ahead of you in the queue making appointments.

all the emergency appts are gone

They were full!!!
What did you think or want would happen?
A) cancel someone else’s appt?
B) the receptionist is lying - why would she?
C) the Gp gives up their lunch break to see you? - unsafe and how many people does he/she do that for?

If they are full I can’t see what you thought could happen?
Now that’s not your fault but it’s not your GP fault either. It’s chronic, underfunding for 10 years. Try writing to government and not complaining on here instead.
C)

I'm sick of people with legitimate frustrations being told "ah well it's the government's fault". Quite possibly it is but random posters on here aren't the Conservative party and in the meantime they still need access to healthcare.

But there is also a lot of blaming the public for showing up at A &E.
So op is putting that side.

We aren't a nation of feckless A and E parasites.

we had a similar problem trying to get the doctors out to see my mum ( immobile) I made a complaint as basically they made it obvious they did not want to come out

in the end i got stroppy - they came out and gave her antibiotics and said if worse call 111 or 999 - said they thought it was infection

turned out we had to call ambulance ( could not get through on 111 ) and she had fractured femur .

Then she had to wait with everyone else for hours ( aged 87 ) for a scan . I just think if it had been done correctly in the first place she would have had better faster treatment .

I had a letter then a text to get my flu jab, both said to call after 10.30 to make the appointment, it was impossible to get through, I was on hold 45 minutes at one point before I gave up. I got in the car drove to the GP surgery and made the appointment in person, they weren’t happy but I suggested maybe if they answered the phones I wouldn’t have needed to come in. There were 4 receptionists sat chatting to each other while I was in there with the phones ringing, not one call was picked up in that time

@OakPine

DO you think the Royal Family have such a poor standard of care? Do you think Boris has such a poor standard of care? Do you think they get told to phone again in the morning?

GPs are doing themselves no favours. They need to up their game and do the job they are being paid their over inflated salaries for!

Hope you get the care you need xx

Don't be daft.

Do you honestly think any of those people are using the NHS? They are not, they have private healthcare at their beck and call whenever they need it.

LOL did you think the Queen sat in an NHS hospital ward last week, chatting with the other pensioners about their bunions? No, of course not she has her own accommodation at the King Edward VII private hospital.

Wise up!

gives the Queen medical advice? www.bbc.co.uk/news/uk-59015352

its not all the governments fault - its a combination of things - and obviously difficult times with Covid

and we all have to pay more if we want a better service - PLUS sort out the spending on NHS trusts - whose Managers earn more than the PM ( dont get me started on that )

@Tilltheebd99 I am also v v sensitive to insect / fly bites & always get a huge itchy lump at the site of the bite. If it's a mosquito bite it then turns into a massive black / yellow briuse over the course of the following days. It's itchy & sore & uncomfortable.
However on 3 occasions it has been more serious & turned into cellulitis. And there's no mistaking that - it's an infection of the cells of the skin & extremely painful & hot & swollen & red & sore. And can be deadly.

The receptionist was remiss in not taking this seriously. She could have asked for the OP to send in a photo & the gp could have taken a look between patients to ascertain if op needs antibiotics or not

As I said already the system doesn't appear to be working.

@Unsure33 it is the governments fault. We have a shortage of GPs and medics. This has been building for years. We spend less on healthcare per GDP than other developed countries. Social care and mental health care is a mess and this impacts on A and E and hospital beds.

@pucelleauxblanchesmains

I'm sick of people with legitimate frustrations being told "ah well it's the government's fault". Quite possibly it is but random posters on here aren't the Conservative party and in the meantime they still need access to healthcare.

Yes I see your point. But instead people blame GPs who cant cover for the shortage of GPs.

Why are there so few GPs?
Serious question - I'm not from uk & don't understand the shortage.

@NalPolishRemover It is not seen as a desirable choice for Drs in training. Long hours, lower pay than Consultants, and more verbal abuse from the public.

See similar thing happened to DS but pre-Covid. Sudden swelling on DS face but no injury to account for it. I tried to get hold of the GP. Tried numerous times but no one picking up the phone so decided to rock up to A&E who when I apologised for attending sighed heavily and said 'you'll never get a GP this time on Friday' shortly followed by 'it's a good thing you came in today it's cellulitis'. We all deserve better.

IMO medical students should be forced to undertake at least 3 years work as GPs before being allowed to specialise as consultants. That way they get to deal with people on the ground and gain a broad understanding of lots of conditions.

[quote julieca]@Pyewackect the issue is a lack of GPs. We either increase medical care staff, or we restrict access to medical care. Getting people to pay would restrict access to medical care. It would also increase pressure on A and E.
My dad had kidney injury last year. The symptoms are vague. It took a lot of persuasion to get him to the GP. He was immediately admitted to hospital for a week. He would never have gone to the GP if there was a charge.
And plenty of people to avoid paying would just go straight to A and E. If money is tight, an 8 hour wait at A and E is worth saving £50.[/quote]
I have a feeling if everything was privatised there would suddenly be a lot more GPs available.

hi
there are 1904 fewer full time equivalent GPs in the NHS than 5 years ago.

In August this year 25.g million GP appointments were delivered......2.2 million more than in August 2019