A&E crisis

[mumsthewordi]

i am shocked to see the images from the wards, particularly impact on most vulnerable. Is this just the reality of a health crisis under any government, or do we think Labour have something to answer for?

My post is not about my ability to source my own vaccine. My post was that in covid times there was a mass drive to get people vaccinated, more centres set up, online booking system run by the NHS. That is all gone now and yet the services within the NHS have got worse. Yes, you can self medicate and rest etc etc. I am purely saying that if hospitals want to reduce the numbers of people unwell with flu, it would be a good idea to boost the numbers of people vaccinated, it goes hand in hand.

I am wondering why GPs don’t open at weekends and evenings? Or why they don’t rotate lunches/work shifts? Maybe other GPs do but mine doesn’t.

I think a lot of people end up going to A&E as they can’t get an appointment. It would hopefully take the pressure off.

This is an exceptionally bad flu season this year and the NHS is always skating along the edge of collapsing.
The 2 facts together mean the whole system is stretched beyond capacity unfortunately.

Quite simply because there aren't enough of them. Increasing the number of gps (there are plenty trained and available, just not the money to pay them) would be the quickest way of starting to repair the crisis in the NHS. Would take pressure off a&e too.

They’re isn’t enough of them. We have a growing population and the conservative goverment decided they would train fewer new GPs than before. We are also losing GPs to countries who pay more.

An aging, more ill population plus long waiting list means some waiting say a knee operation will need appointment due to pain, perhaps they now have an issue with their hip due to walking in a way to compensate, maybe they’ve developed depression. We need more GP appointments for the same number of people.

Exactly. Someone I had the misfortune of talking to the other day mentioned that neither her or her 4 children were registered at the GP. If anything is wrong they just go to A&E.. ffs.. 🤦‍♀️

A&E crisis
128 replies
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mumsthewordi · Today 06:40
i am shocked to see the images from the wards, particularly impact on most vulnerable. Is this just the reality of a health crisis under any government, or do we think Labour have something to answer for?

Don't be ridiculous. The appalling state of A&E is nothing to do with the current government.

My husband is having life-saving surgery at the end of January. We have been in and out of hospital 4 times since late October, once by Ambulance.

The first time he had to wait nearly 30 hours for a bed (with sepsis, double pneumonia, dangerously low potassium and acute kidney injury, and though it was unknown at the time a nephrotic gall bladder (gangrenous). The second time, he waited for 54 hours in a hard, plastic chair, in a corridor with IV lines for antibiotics. As an aside, he has crippling arthritis in his spine and was unable to walk for some time thereafter. He was subsequently an in patient for 2.5 weeks, when the gall bladder issue was identified and a first surgery carried out. whilst on the ward and whilst he was delirious with sepsis, someone failed to put the side of the bed up after observation. He fell out of bed, severely damaged his knee (something called “false gout”) and is still using a walking frame.
The third time, he was treated with IV antibiotics in a side room with several other people, only overnight that time and finally again 2 days before Christmas and again only overnight, thank god. We were told during triage on that occasion that the wait for a bed was 60 hours. Blackpool Victoria Hospital.

Once he got through the system, his doctors and surgeon were fantastic and we are immensely grateful.

BUT, those long waits, for him and others, were nothing less than physical torture.

I lay the blame for the gobsmackingly awful state that A&E and the ambulance services are in squarely at the feet of the previous conservative governments that spent years running them into the ground.

Exactly. GPs are working flat out. Where are all these magical new GPs going to come from?

There are currently lots of GPs that can't secure jobs because there isn't the funding. Perhaps GP surgeries could recieve adequate funding under the NHS contract?

Last year we spent one of the May Bank holiday's in our local A&E when DH had chest pains. We got home around 11pm and had been there all day. A kind lady gave us some pizza she did not want. Apart from that just crisps and chocolate and hot drinks from the machine. I would not want to do that again.

To pay ALL their staff a decent salary, not just the GPs and nurses!

Because they want a life?
Because there are not enough?
Because the package offered isn’t attractive enough to tempt them?

A nurse in A&E told me once that some patients are there because you don’t pay prescription charges if you need.

Stick a GP next to each A&E where you get a prescription in the usual way.

GPs don't open evenings and weekends because they aren't contracted to. GPs are not NHS, they are small businesses with a contract to the NHS. They can only work within the contract or they won't get paid. GPs in Wales have not received their funding or contract for April 2024 yet and we're almost at April 2025! They are in dire straits.

And that's just to provide appointments. Where does the money come from to pay staff, electricity, gas, stationery, medical equipment etc? Same place as any other small business. The NI increase that's coming in in April will cost approx £32k extra a year, hospitals will get help from the government to pay this, GPs won't.

How can they provide the service they want to without funding? GPs really are doing all they can but it's no wonder so many are closing.

Short term action is almost impossible. To improve matters we need a way to be able to send people home to relieve bed shortages-so social care problem. We also need more gps and more hospital staff. None of this can appear magically. It takes time. All they can do to help quickly is the tweaking they have mentioned like encouraging people to use the app and 111 and pharmacy rather than A&E.

I feel there's been a fundamental shift towards fewer more centralised hospitals which also have fewer beds when we have an increasingly ageing population. Not everything in a hospital can be solved by high tech treatments.

Labour are going to need time, money and investment in people-remove the ring fencing of money for physician associates and give more gps jobs. Walk in centres attached to A&E would definitely help. I attended one once at a London hospital, triaged at a reception, diverted to the walk in (which is what I'd gone for) and was seen by a gp. But of course most hospitals aren't built with this provision in mind.

So that & all the other suggestions requires money... look at the outrage when Reeves raised taxes on Business & changed CGT rates?

Would be even worse had she reversed the Tories cuts to NI for employees.

Bottom line we all want extra spending but no one wants to pay for it.

Some people say tax the super, we'd then get howls of protest of "capital flight"

But one area is benefits... who wants to cut them?

Precisely

Benefits have already been cut to the bone and it’s a false economy as cutting welfare payments usually leads to spending more on healthcare. Which probably leads us to another reason the system is in crisis. Tory austerity policies leading to an unhealthier population.

Oh yes but the cry is Dont raise taxes, cut benefits!

As you say, its a false economy but thats where we at right now... at an impasse... where no one is willing to raise taxes or cut benefits/number of claimants.

We certainly cannot borrow more, so how do we fund the Health Service we all want? & please dont shout Insurance.... thats just another tax, which employers and employees will not want to pay.

Increasing the population, whilst keeping pay low & austerity is some sort of perfect storm.

This is purely down to the Tories. Years and years of negligence to get it to this state.

It's hardly news surely?

Blame the Tory voting brexiteers for staffing issues and general running down of the NHS.

Why are so many Labour voters so forgiving. I'm one that wants them to be held accountable on their pledges

Plenty of gps struggling to find work right now. The shortage of gps isn't because they don't exist, it's because the NHS won't contract them.

@mumsthewordi I will want them held accountable too. But everything is so run down, buildings, staff, equipment, goodwill with other countries etc. they must feel like they are pushing a boulder uphill. I can't really see any major changes yet but I'm willing to give them 12-18 months before I try to judge whether they are going in the right direction.
Have to say their ability to explain what they are doing and why it matters and how it fits in their grand plan is pretty poor. But if communication is their only fault I can live with it. I just can't judge yet.

Austerity fucked with the health & social care services and that it will take time to correct those mistakes. It is a fairly obvious point that a failure to invest in infrastructure, estates and equipment will limit productivity.
£11 billion alone is needed to bring buildings and equipment up to date.

Isolating your question to problems within A&E without acknowledging the impact of austerity on the NHS and social care as a whole seems very odd. It works as a whole - if you reduce beds, don't invest in scanners, dont have sufficient numbers of staff, have crumbling building and closed wards, not enough ambulances etc then of course you will see problems across the whole system.

From 2023

'A difficult position to be in, especially as nearly two-thirds of NHS trusts in England submitting bids to the programme were rejected. The programme also focuses on new hospitals which are only the tip of the iceberg when it comes to the need for capital investment in the health and care system outside of this. For example, despite rising demand and the ambition to shift care out of hospitals, lack of capital investment in primary and community care means that 22% of primary care premises predate the NHS and these services often don’t have the technology, data and connectivity they need to better co-ordinate patients’ care.
Compounding this situation now are the financial challenges facing the NHS, which have placed it in the unenviable position (again) of having to cannibalise capital budgets to keep services running day to day, further reducing investment in buildings and technology. And the long-anticipated NHS-wide capital review, due to set an overall strategic direction for NHS capital, has been kicked into the long grass again with a revised publication date of summer 2024 (despite originally being planned for winter 2022–23).'

www.kingsfund.org.uk/insight-and-analysis/blogs/nhs-estate-continues-deteriorate