Health Anxiety clogging up A&E

[Influencerofcrap]

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

We’re all arguing about an article that doesn’t have any stats except for a 12 million increase in demands for GP appointments vs 2018. No explanation about what constitutes a demand - is it from different people? Or does it include the same people calling back several times and being turned away? Could it be linked to an ageing population? Could it be due to a growing backlog of people who need to be seen? Could it be linked to people not getting proper treatment (I was given the wrong prescription for my condition 10 times by 5 different GPs before taking myself to A&E)

Oh no wait, it’s got to be around health anxieties.

I call bullshit.

Frequently posts appear on mumsnet asking should I go to A&E? If you even have to ask it's a no. Usually it's a boil or something, many people then state you need antibiotics asap else this, that t'other will happen, always worse case scenario. A&E is for car crashes, industrial, agricultural and serious sporting injuries etc, It's for heart attacks, strokes and blood spurting. It's for broken bones and bones sticking through skin. Accidental electrocution, secondary drowning. The clue is in the Department Name.

Maybe the problem is due to all of the below:
a) 111, it seems they always send you to A and E to cover themselves.
b) Dr Google is enough to frighten anyone
c) the lack of GP appointments, especially if its a friday and you have to wait all weekend.
d) the high expectations that we have of the NHS and medicine today thta they can cure us of everything..

I dont know what the answer is but I have been to A and E twice this year for hypertensive BP, and I just had to wait there for 4 hours until the numbers came down to less crazy values. Did I really need to be there?

Just to follow up my last post responding a comment bashing NHS managers (oh how original). I'm a fairly senior manager in an NHS Mental Health Trust, and one of the key parts of my role used to be writing bids, tenders, and investment proposals for additional funding. When I started this role in 2017 I'd say that made up approximately 80%+ of my work. It's now probably less than 5%, and the amounts being bid for are a paltry £100k here and there instead of the millions it used to be. In fact we are being asked instead to identify savings every year of up to 7% of our total funding.

Conversely, our referrals have gone up over 300% since then. So for anyone who feels that NHS MH support is lacking, can you please explain to me how we are meant to provide the same service (or better service) to over 3 times as many people with less money year on year... I'll wait for your great ideas!

As for posters who advocate 111 doing triage, this is basically the system that’s in place in my parents’ local hospital in France. A&E doors are closed and only open if the local phone triage system says you can come.

When my mum started feeling unwell with an almighty backache, we called. We were dismissed by a person reading questions off a cheat sheet. My mum died in absolutely atrocious pain at home with my now traumatised father by her side. She was screaming the place down. We suspect an aortic dissection.

So no, a backache can’t always wait. And no to A&E only seeing patients triaged via the phone. It doesn’t work.

Totally this. Oh for the days when your mum or granny told you "stop whinging, there's nothing wrong with you!".
The vast majority of minor ailments get better with time - symptoms can be helped with over the counter products.
The number of intelligent people I meet who go to the GP about utter trivia is shocking. An averagely healthy person shouldn't need to see their GP for years at a time, ie not unless there is something actually wrong.

@Roseyposey11 it seems my last comment to you didn't post.

According to you I'm wrong for doing what both my consultant and GP have said I should do.

But according to others on this thread I'm wrong for going to A&E because I've sat and waited it out before and ended up very unwell.

I'm also wrong for not going to a pharmacy first, even though they tell me they can't help due to my history.

So where am I meant to go?

This is deluded and a perfect example of how misunderstood general practice is and how damaging comments like this are.
ALL Gp’s have to see patients in person where necessary.
Most are actually doing far MORE appointments than pre-covid, to the point of being unsafe.

The problems are mostly due to a mix of there being less GPs, more GPs working PT, population increase in some areas, increased medical complexity due to an aging population and increased medical complexity with waiting list delays etc.
GPs also carry out the bulk of the work in the NHS but funding does not reflect this.
The GPs I know all work far beyond their hours every single day, care deeply and still go home worrying.
You are dangerously wrong

The posts here are so similar to teaching and education. Having a constant go at teachers instead of the underfunding. I think that these roles that are public facing are super stressful, with too high expectations and gaslit all the time.

The result is lots of educators and medics leaving in greater numbers than ever before, this can only get worse.😒

But A&E are not set up to diagnose cancer. It’s often an incidental finding after a patient has had symptoms for a number of weeks. Yes, they may have failed to get an appointment with their GP and out of desperation resorted to A&E, but A&Es are set up for acute medicine.

My DSis died last year of pancreatic cancer, a notoriously difficult cancer to detect early. Her only presenting symptom was sciatica which was being investigated by GP. It deteriorated rapidly over a weekend and she was sent to A&E by the out of hours GP. She was diagnosed with an abdominal mass after a CT scan. They were looking for spinal damage. She died 8 weeks later.
Her late diagnosis was not due to her GPs oversight or to her not seeking help earlier. She was still running almost daily six weeks before diagnosis. Dry few people with sciatica will have pancreatic cancer, it’s not a diagnostic symptom.

Cancer happens, it often grows/develops rapidly. With the worried well they may be cancer free at the beginning of the year but terminal by the end of the year. They may not present with symptoms connected with cancer so it is pointless coming up with anecdotal evidence that illness is missed.

Shit happens, as a cancer survivor I can tell you that it comes out of the blue, it’s often symptom free, particularly in the early stages. There are excellent screening services for a handful of the most common cancers, but early diagnosis depends on whether you use them. You would be surprised how low attendance is for screening, it’s primarily due to fear.

In the future we will see routine full body scan screening which will hopefully catch cancer at a much earlier stage, but only if patients attend. Many won’t, for lots of reasons. The worried well are just as likely to ignore serious symptoms as they are to over egg the simple symptoms.

I was always taught to listen carefully as the patient enters the room, ignore the middle waffle and wait for the massive red flag as they leave. They will always leave it until the end, as they are half way out of the door before they tell you why they are really there. We all fear what we don’t want to hear. Somehow we expect doctors to spot the problem while they are examining us. If they don’t find anything without prompting we can kid ourselves it isn’t there. Bring on the scanners so that we can spot the problem without patient input.

I was being very serious about “hysteria” - so many women are dismissed by male doctors when they have genuine serious illnesses.

Re lack of appointments, I was in our GPs last week for a regular injection, and there was a list displayed of missed appointments.. GPs, Nurses and Physios. I wish I’d written the numbers down, there were probably around 40-50 over a month. All those appointments going to waste!

In 2023 I was diagnosed as pre diabetic. I was offered a place on a course of sessions where participants were given helpful information and advice. We could weigh in too. At the end of the course, those who had completed it were all out of the danger zone. Sadly, almost half had dropped out. Another waste of resources IMO.

There's none around here where I am. I know as I had a deep cut and couldn't stop bleeding, UCC would have come handy, but that wasn't an option. I ended up going to private urgent care centre. But not everyone can do that.

17 months ago, i was constantly at A and E, for about a month on and Off. There was definitely a lot of people who went who treated it as a day out. A lot of folk shouldn’t have been there .Plus don’t get me started on every member of a family being there.

Yes and when you have symptoms that need urgent treatment, the advice is to go to a&e. Obviously.

Great advice! While we’re at it, people with depression should just cheer up, and women with postpartum psychosis should just look after their bloody kids!

You go to your GP and not A&E.

My ex neighbours had a little girl who fell off a wall, she walked around and went to school for 2 days and the school sent her home on the 2nd saying she needed to get her arm looked at. The following day her 2 car owning parents decided she needed to go to hospital (hurrah) but they tried to call an ambulance????

@RockOrAHardplace and when your GP won't see you and you get worse?

@Flower35214 absolutely. So you'd be able to call 111 & they could send you to A&E...

But (although I am female), I do tend to find that men have a much more sensible attitude to health. They don't fuss and they don't assume that every little symptom is sepsis or cancer. And they are usually correct.

(Pregnancy aside - I realise that those issues often do need attention).

Margaret McCartney is a smart woman.

111 told my relative to tuck up in bed with a hot water bottle as she had a “standard sickness bug”. 2 hours later she had a heart attack so big it tore her heart muscle and killed her instantly.

Another relative had a massive stroke which left her in a coma and with life long severe disabilities. They don’t offer clot busting drugs on a Sunday at our local hospital. This drug would have broken the clot up and likely minimised the damage. Our lives have never been the same.

My child refused all food and water for 14 months. They were EBF and this was deemed adequate despite their age. I was exhausted. “We realise you must be anxious but the wait is approximately 58 weeks to see a paediatrician even in urgent cases”.

I went to the pharmacy for a minor ailment, they wouldn’t speak to me because of breastfeeding.

The local pharmacy won’t help my child due to their age; the GP won’t help due to it being a pharmacy issue.

My smear test has been cancelled 7 times by my GP surgery. I’m now terrified I’m going to be one of those statistics who had a late smear test and ended up terribly ill due to something not being picked up early enough. (I now know about a mobile screening service, but they are not advertised locally and I did not know).

I wonder how many more people have experienced missed symptoms, refusal of service, dismissal of serious illnesses.

There’s no wonder we are anxious and people visit A&E terribly anxious about something seemingly minor.

I’m sorry but from reading your comments, you are absolutely part of the problem.
You went to the Doctors to stave off a sinus infection means you didn’t actually have one when you booked the appointment which means, at most, you had a cold?
There are hundreds of over the counter medicines for sinus issues. I have seen people literally stand outside the GP doors waiting for them to open to make sure they get an appointment. If you are that poorly that you need to see a Doctor, there should be no excuse why you couldn’t do that.

But the point of this is there are people literally dying in ambulances queuing up to get into A&E because of stupid, self-centred people taking up space and time in A&E for a fucking sinus infection or similar.

I have had my Grandad die in an ambulance in a 7 hour queue to A&E.
My Nan went to A&E having had a mini stroke on Christmas Day, she sat there in that chair for 17 hours waiting to be seen until she had a full on stroke.
And my 1 year old nephew waited 16 hours to be seen and consequently died in hospital that night of Meningococcal Septicaemia because they hadn’t treated him with antibiotics in time.

And you’re genuinely saying “should I just sit at home and worry about my blocked fucking nose” YES!

And before you rattle on about chronic illnesses, I have severe chronic asthma and have never wandered into ACCIDENT AND EMERGENCY for it.

When I was in A & E recently, I had no idea why other people were there. Why would I?

I have health anxiety and find it does the opposite for me, I tend to avoid going to the doctors as much as I can.

I'm in a situation now though where my symptoms could be significant - lower right abdominal pain going on for more than three weeks and stomach issues. Referrals are taking a long time and doctors have suggested I might just have to go to A&E to get the scans I need. I convince myself not to go because I'm concerned it might not be an emergency and I know how people view those with health anxiety. I'm slowly getting worse and my life is on hold, my symptoms are very real and there is definitely something going on. But the anxiety makes it hard to know when I need to take the right course of action to get the right help.

Many of us are very self aware about our health anxiety and take a much longer time to decipher a health situation and get help for it. Many of us have been on waiting lists for therapy for years.

We also have to recognise that there are many people who have significant symptoms which may not be deemed an emergency - but they need to be diagnosed and treated quickly to avoid getting to that point. There doesn't seem to be a workable system for the people who sit in that grey area.