Health Anxiety clogging up A&E

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Im really pleased that finally someone within the NHS has come out and said this.

Having been treated myself in A&E, in the corridor (outside triage) due to lack of cubicles, I was genuinely shocked at the amount of patients that attended who shouldn’t have been there. I’m not talking about those that were genuinely ill and couldn’t see the GP and had no other choice but the ones that were clearly anxious about their health and symptoms that didn’t warrant an A&E visit. They were all sent on their way but it still was time that was taken away from those patients that genuinely needed help. I wonder what the answer is to this, because something has to change.

Health anxiety not emergencies clogging-up A&E

I’m a GP and I don’t know why I read threads like this because it becomes even more clear that so many people think GPs are a combination of work shy, barely educated and spend most of our time studying up ways to make the service more difficult to access. Yes loads of people have health anxiety - therapy can help but the waits for this are so long. I see loads of patients who don’t have a mental illness but they do have problems with their mental wellbeing. I listen and empathise but I would argue that this is not a GP problem to fix. The same way loneliness isn’t, the same way your relationship with your partner being rubbish is not a medical condition, etc etc. Lots of people don’t have friends or any real support networks. We are now 14 years after the austerity budget and the societal effects are everywhere. But the feeling is this is somehow the GPs fault. Patients ask for home visits because they can’t afford the taxi fare to the surgery. But if you say no you are uncaring,lazy etc etc. I hate it. Im a good GP - I care about the patients and I work hard to try and get them the care they need. But I leaving General Practice in a few months because life is so miserable and the public hate you so you start to think what’s the point. Hopefully life will be more satisfying on the other side.

@ThisNavySquid Thats terrible and I hope you are doing well now? At the risk of being overly personal. What on earth symptoms were the GP and A&E dismissing as health anxiety?! I know anything GI related always gets marked down as IBS/Anxiety.
Truly sorry you had this and glad you saw a Dr that finally listened! It’s awful how some drs are so egotistical and gatekeepers to testing etc.

I needed to use A&E in France recently. If you are not taken there by an ambulance/emergency services, but want to go in for any reason, the hospital I used didn't let you in before you called one of the emergency numbers and were triaged on the phone.

So you can't just walk in. You phone something similar to NHS Direct - a free number in any case - and once you have been spoken to and THEY decide your case warrants A&E - you go to the hospital, ring the bell and give your case number. They know you are coming already, and why, and that sifts out the time wasters.

I am not sure this would work in the UK with the ridiculous lack of GPs and other local health provision, but it is apparently working quite effectively in France.

There were also some urgent treatment centres with xray machines etc but the injury I had had happened out of hours.

If you think that was a stupid question you’ve already preached the system and it wasn’t a stupid question

Similar story here, and I don’t look like someone with multiple medical conditions

Well it’s the lack of appts and medical gaslighting a lot of Drs do that is the big issue I’d say. It’s of course not all Drs, but it is a lot. A lot won’t even see patients in person still and haven’t gone back to pre covid in person appts.

I know rather a lot about it actually. I also know rather a lot about how the NHS functions.
If you have repeat serious sinus infections, you need to have been referred in a timely manner to an ENT team. If the waiting list is long, then contact the consultants secretary. Repeatedly harassing your GP, even on the advice of your consultant, when it is not always medically necessary, is not going to achieve anything. It is not your GP’s fault that OH feel that way. It also takes up appointments for people who go really do need to be seen.
Repeated use of antibiotics also has serious health impacts and even more seriously, adds to the already terrifying problem of antibiotic resistance that we are facing.

The lack of urgent cares/out of hours is also a big issue.

People have literally been told to seek a doctor for a head ache because it MIGHT be a symptom of brain cancer, and then theres bewilderment when people actually do go and see the doctor for head ache like the campaign wanted.

Interestingly on this, and I wonder if there are more people finding themselves in my position, I didn't go to the GP or push for tests for my headaches for a long time, because I was afraid of wasting time or being told I was just anxious. I was having classic brain tumour symptoms but we had to go through migraines, cluster headaches and, of course, anxiety on the way to diagnosis.

Eight months after the symptoms started I finally had a CT which confirmed a brain tumour. Not cancerous, thankfully, but damaging and symptomatic.

I think if they run with a "it's not cancer, it's anxiety!" angle now in health promotion, they run the risk of missing life changing and life limiting diagnoses. I don't know what the solution is, it seems like there are no winners either way.

A therapist.

Sorry to be pedantic but delaying endometriosis diagnosis doesn't cause infertility.

@Roseyposey11 so despite both the consultant and GP agreeing that this course of action is the correct one - managing at home and seeking medical help via my GP if my symptoms worsen, I'm in the wrong for following that?

I should allow myself to get so unwell I have a 40° fever and end up in A&E? Oh no, wait that one is wrong as well.

I should go see a pharmacist, who then tell me I need to see my GP due to my past history?

Or should I just stay home and hope I don't die?

Absolutely this (as a nurse myself)

I think my ENT surgeon, who carried out my FESS surgery knows more than you

His advice about how to manage ongoing chronic conditions is what I follow.

FESS doesnt fix everything, quite often, for many of us sufferers.

A renewed ENT referral is what I now need, guess what, cant get a GP appointment to discuss this

A huge issue is patient don’t have resilience so it’s exactly that - they aren’t mentally unwell., They don’t have a mental health condition but they can’t cope with lifeevents and stress . so they refer to talking therapies and end up on a waiting list because there’s really nowhere else for people to go

My area are developing spaces and systems that are exactly for this. They support with building resilience and really common problems that people struggle to cope with, but clients don’t want that - they want one-to-one therapy despite not having mental health problems.

That is not the answer people working on their anxiety is

I know of someone young who didn't want to bother A&E with their stomach ache and died in the night. Another who didn't, and by the time they were seen had terminal cancer. If you have a health concern how can you judge if it's serious or not?

I've had health anxieties before, rung 111 and been advised to go to the hospital only for the doctors there to say it wasn't necessary. Sometimes I think 111 can give terrible advice.

Impossible to get a GP appointment around here. Thousands of houses are being built and no GP surgery.

Sure loads of people are ridiculous going to A&E for a common cold but there's a lot wrong with the system making it worse.

They love threads like this!

get to have the peasants fighting and arguing and blaming each other. Excellent deflection. Scapegoats: the misdiagnosed fobbed off people who later turn out to be truly sick and people suffering from mental health issues (just look at suicides every year and state of nhs mental health) (and even if they do have health anxiety, they need help and support in other ways, not blame and attacks)

it’s amazing how they find a million ways to blame everyone, pensioners, young people, immigrants, women, disabled, etc but never, ever those who are truly to blame

instead of calling “ them” out and holding them responsible

good sheep we are

Btw OP

invisible disabilities and illnesses exist. Not all disabilities are visible. Millions of people live with invisible disabities. You can’t tell if someone is sick or not just because they don’t look it to you.

People need an easy channel to access medical help if needed. Given A&Es is the only one accessible in this country no surprise they are so crowded.
The current system is inadequate, that's the issue.

Just to clarify as it actually takes 6 years of university study to train as an ANP. 3 years to become a nurse, you then generally will need at least 5 years hands on experience and then the ANP course is a 3 year masters course. They are highly qualified.

Advanced nurse practitioners do the assessing, prescribing, referring and sick notes. Nurses do the dressings, hcas do the bloods. GPs know a little hit about a lot of things, their role is entirely overrated imo and one that an ANP can do perfectly well.

Exactly this!

when it comes to NHSE trying to “educate” the public, they just default yo “oooh might be cancer” rather than trying to explain to people there are many many many reasons why you stomach/back/legs hurt or why your headaches, it’s like “no! Cancer!”

I work as a nurse in a GP surgery which has excellent access (as in every patient is seen or spoken to within 48 hours for their issue) and so much of what I see is such minor pointless stuff but people cannot put up with a moment of discomfort. ‘A tiny bit of stomach cramping’ which has resolved- need immediate review of coil fitted 2 years ago and 2 scan have confirmed is correctly sited. 3 hour history of tiny bit of redness on hand- not painful or itchy. Wants investigation into why a certain brand of red wine (no others every just this one bottle) gives them a headache straight away.

Urgent Treatment Centres! I cannot be the only person where there are 3 in a 25 mile radius.