There's Labours extra one million appointments without doing anything!

[KnittedCardi]

A total of 340,441 people sought emergency help with a sore throat in 2022-23, up 77 per cent from 191,900 the year before.
The number of people with coughs going to A&E rose by half, to 322,500. Those with earaches and nosebleeds were up by a fifth, to 233,00 and 56,500 respectively.
There was a 44 per cent rise in people whose chief complaint was a fever, a 30 per cent rise in nausea, and a 12 per cent rise in diarrhoea

How do we encourage people to be more self reliant - or even go to a pharmacy. You shouldn't even need to go to a GP with these sorts of issues, unless severe, let alone A&E.

Engaging our thinking brains for a second, is there even a tiny possibility that the steep rise in these A&E trips might be linked to difficulties in getting GP appointments for acute issues, and that by the time they subjected themselves to an A&E waiting room the conditions were severe or they felt they had no other options?

Or do you think national self-reliance just disappeared overnight?

@JassyRadlett none of those ailments are severe in that sense, or even need a GP most of the time. They are neither accidents nor emergencies. Yes, for some reason I think there has been a gradual, and latterly accelerating, decline in resilience/independence/ability to cope with minor illness or inconvenience.

Maybe if there were enough pharmacists and GP’ then people wouldn’t have to go to A and E?

Our local chemist is awful, it’s always packed. They’ve tried to move to bigger premises twice and get another pharmacist. NHS have blocked it all due to money. There’s 6000 people served by this chemist, a lot of them elderly with complex prescriptions.

The pharmacist always looks run ragged.

Because when I had a "sore throat" the gp was useless. I ended up in hospital with qinsy because noo e else would help. It shouldn't have come to that

@cardibach a nosebleed that won't stop is an emergency, Diarrhoeal disease is the second biggest killer of children under 5 worldwide. It is treatable, but only if the doctors are functioning.

Yes, you’re right. I should have said ‘most aren’t’ not ‘none are’.

The recorded message you get when you first ring our GP surgery literally directs callers to A&E now if they’re unable to get a GP appointment.

Can’t blame people for following advice like that.

i have had a UTI for over a year

I was at A&E last night with DD - we waited bang on 3 hours which given the state of the NHS I thought wasn't bad although it seemed a very long time at the time!!

However it was very noticeable that staff were coming out and calling names and no one was responding. We saw people just walking out. Some of them had come in long after us. A lot of them looked perfectly well.

Everyone knows that the waiting times are long in A&E - I simply don't understand why people who clearly don't need to be there are coming in, registering at the desk and then leaving. Someone has to process them, prioritise them, call them in.. ... seemingly not just once but at least 3 times.. they take up space in the waiting room... it makes no sense... it's hardly a nice evening out is it?

Your stats above though are interesting. I don't think they're entirely fair really. For example my friend once went to A&E with a nose bleed... and got admitted for a week because it was so bad. I fed her cats while she was gone and her kitchen looked like a warzone. There was blood on cupboard doors, all over the floor, loads in the sink, on the surfaces, the hob, the floor... and even on the cat!! It took me about 40 minutes to clean it all off. However in the stats it would jut be recorded as a nose bleed!

My mum went to A&E with a severely bad cough and very wheezy chest and it turned out to be pneumonia and honestly I've been close to going with earache when even co-codamol wasn't touching it although I didn't.

So it's difficult to say a person genuinely didn't need to be in A&E just because the categorisation on the face of it is minor. That said, it seems to me that a lot of people do misuse A&E

I wonder if hospitals would be helped by better funding for initial triage.
I went to a hospital abroad in the summer - you couldn't just walk in. There was a waiting area to be triaged before admittance.
Perhaps the rise in seeking emergency care for coughs and fever is linked to worry about COVID?
Time for some public information films about self care/pharmacies etc?

The majority of those people probably wouldn’t have gone to A&E if they had reasonable access to a GP.

We can’t blame people for using the only only service they have access to, even if they are using it inappropriately.

A sore throat that is actual an infection that requires treatment, or an earache so bad the person is crying in pain and has been doing nothing but holding their head for days. These things can be seen and quickly treated by a GP if there was a GP available. Even a nurse practitioner or supervised medical assistant could handle many of these conditions and refer on the complicated cases.

The problem isn’t people who get desperate enough to go to a&e. There will always be a few people who make that their first stop, but most people are sensible and the others don’t want the wait if nothing else. The problem is that conditions escalate because patients can’t be seen by the proper physicians.

Language matters.

"My mother has a cough and a sore throat . She has some aches and pains and feels a bit run down."

The reality:

"My mother has severe COPD and rheumatoid arthritis, sometimes she struggles for oxygen and can barely walk because she's so weak".

The idea that people are just using A&E like a one-stop shop for something the chemist can deal with is a total work of fiction and I suspect you've fallen victim to some nasty propaganda.

Remember, the way these ailments are described can be very misleading depending on the political agenda of the people selecting the statistics.

It depends on the underlying cause, surely, whether it needs medical attention? We can't tell from statistics the severity, the pain being caused by them, the impacts of them on the individual.

The idea that the correlation of this sudden increase has nothing to do with lack of GP appointments declining over the same period is a bit fanciful.

A sore throat presentation can be many things, some of which are fatal. Ditto a cough.

In the past we've been sent to A&E by medical practitioners for:
Sore throat (tonsilitis in toddler that had a frighteningly similar presentation to meningitis, we were rushed in through triage)
Ear infection (repeated, nothing more fun than a baby with a 40.5 degree fever)
Cough (GP rushed us to A&E as child needed steroids)

And that was in normal times. I can completely understand why someone with a painful, non-resolving and frightening condition who has tried and tried to get a GP appointment might feel they have no other option.

And I've seen a few too many people diagnosed with live-changing or terminal conditions after presenting at A&E with severe versions of these 'trivial' symptoms that either couldn't get them seen by a GP or were repeatedly fobbed off by a GP to really believed that their cancers and other diseases are really just because they're not quite resilient enough.

Our local A&E has this - it seems to have been introduced in the last few years but when we were sent there recently to rule out concussion we had a very speedy triage before being admitted to paediatric A&E.

They also have a minor injuries and emergency GP service on site, it seems to work well.

The wait at our local walk in is always about 10 hours. A and R with their 6 hour wait is shorter.

Is there an age breakdown for these?
It'd be a bit misleading to say 'people' if most were parents seeking treatment for infants... obviously you'd have a lower threshold for help seeking for infants or the vulnerable.

What’s the source of those stats OP?

I’d like to see the corresponding age groups to these visits.
Fever, diarrhoea, cough are all symptoms of common and relatively harmless causes in the fit, well adult population. In the very young, the frail and people living with chronic long term conditions they can be life threatening.

There's a poster in the waiting room of my Gp surgery saying that a cough that has lasted over 3 weeks could be the start of something serious and should be checked. I noticed that the NHS site says this too.

I know that there are idiots that call an ambulance for a broken nail but I'm not convinced that the majority are doing this. When my kids were babies GPs were happy to see them on the day and offer advice. Babies and children can get sick so quickly and the weekend is a long wait until you can book a gp appointment (especially if Monday is a bank holiday)

Meant to add I was once admitted to hospital for a week after attending A&E.

The symptom listed for attendance was "headache". It's true I did indeed have a dreadful headache . I also had had a seizure, had a temperature, confusion and a growing non fading rash among other symptoms.. but stats would seem show a trivial "headache" and people would wonder why Listsandbudgets didn't just pop a paracetomol and a glass of water and rest for an hour or two.

The “people” likely include infants, toddlers and the frail elderly where fevers, diarrhoea, coughs or sore throats can be life threatening. We lost hundreds of children to Strep A (starts as a sore throat) last year- is it any wonder that the work to increase awareness has worked?

Also last year’s 21-22 stats would include the tail end of the pandemic when people were avoiding A&Es due to covid and we had a spike in excess deaths as a result of people not seeking medical care.

www.theguardian.com/society/2023/oct/10/accident-and-emergency-visits-hiccups-earaches-nhs-strain

So, reading this, I’m going to admit I don’t really understand what is going on here.

I attended A and E yesterday, and was there all day (9.30am to 5.30pm) after being sent by my GP. Before I got anywhere near the triage team I had to go through a gatekeeper who took all my details and the details of my issue and logged it, prior to her sending me to the desk to formally book in to A and E. Surely that would be the point at which these people, upon saying they had a sore throat, should be directed back to either their GP, a pharmacist, a UTC or other walk in service? And form there, if there was concern it was more than a mere ‘sore throat’ (eg Quinsy at mentioned above), then that service could refer them back to A and E with details of their suspected condition (which is exactly what my GP did yesterday). How are these people actually getting in the door and in to the department in the first place? Or, is it the way this is being reported that isn’t 100% accurate. For example, I suppose it f someone was minded they could look at my record from yesterday and report that I attended A and E for ‘backache’, technically it could have come under that umbrella term. The reality is after seeing the GP he was concerned that Cauda Equina (a potential surgical/medical emergency) was a possibility. And, after testing various responses, so was the Consultant I saw, who sent me straight to A and E Obs and on to MRI. Thankfully I did not have Cauda, I had a badly herniated disc. But have I been recorded somewhere as having Suspected Cauda Equina or ‘Backache’ - because they are two very, very different prospects.

I’m not suggesting someone has an agenda, but I am questioning whether these ‘facts’ being presented raw, are entirely as they are being made out to be.

The Guardian article states it is

’Data analysed by the Press Association news agency’ given by NHS England.

Maybe people are increasingly relying on A&E because of the difficulty in getting GP appointments since the pandemic. Perhaps after all the fear mongering by the government regarding Covid many people worry that they could be more seriously ill than it turns out they actually are.
Maybe people presenting to A&E are immuno-compromised and the lack of GP access makes A&E the only viable option.
Remember many people don't actually know they only have a very sore throat/chest infection/stomach bug etc. until they have been diagnosed.

The route cause of this is not the public, and blaming us would be a mistake by any political party. It's underfunding of the NHS. Better access to primary care services would free up A&E to deal with actual accidents and emergencies.
To suggest that people don't 'waste doctors' time' could result in people dying, and would let any current or prospective government off the hook.

Remember, the way these ailments are described can be very misleading depending on the political agenda of the people selecting the statistics.

This.

Last time I remember the public berating of people it was dandruff and GP visits then I by chance heard a radio 4 medical program and GP on it was scathing about reporting she said it wasn't actually clear it was dandruff and in their experience it was the extreme cases only that got to GPs - one where it chronic wasn't ponding to anything and spreading to face and neck were as the reporting was suggesting people just needed to buy head and shoulders.