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

@Influencerofcrap I agree to an extent but worth saying every time I've called 111 they've sent me to A&E even though I've felt fine (usually fainting related). I seem totally ok & I'm there with my knitting feeling fine. I sense people are thinking I shouldn't be there but I always try my GP, who say ring 111, who tell me to ring GP, who tell me nothing so ring 111, who send me to urgent care, who send me to A&E, who send me to Same Day Emergency Care.

I end up being triaged about 1,00000 times. It's ridiculous & such a waste of time. & I'm sitting in urgent care/ A&E looking and feeling fine and everyone is judging me for being there. We need a 1 stop triage service I think.

Not sure bout this. Dd had to go to the local walk I. Clinic recently due to a broken bone and sports injury. I didn’t feel it serious for -
A&E as it wasn’t life threatening, just a small broke bone. Lady in front of me in the queue had a 10 year old with a rash. Her description to the receptionist was that the 10 year olds older brother had a similar rash last week. Their GP had said it was nothing to worry about and the rash had disappeared. Now it had appeared on the other child she felt it more serious and wanted it checked out. Ridiculous. She should have been charged for wasting time.

But you must know of GPs who are not doing the right thing. The GPs around our area all have different appointment systems eg
One GP surgery
You must ring and ask for a telephone appointment as first step to a fast-track appt. A GP will call you within 24 hours and will decide if you need to be seen. If you do, you will be seen by a GP within 24 hours.
Or
You can book a general appointment by phone with which ever GP is available - usually within 2 weeks
Or
You can book a general appointment by phone with a named GP with at least a 3 week or more wait (was 6 weeks in July) .

Another GP surgery
You must ring for an urgent appointment. You will asked very personal questions by the receptionist who will make notes. A physician's assistant will then telephone you- might prescribe something over the phone or ask to see you within 24 hours. They might then prescribe treatment or may decide you need to see a GP- you will then be offered an appointment with a GP within 24 hours.

Or
Same first step as above but you will not be offered an appointment with a GP but will be asked to call back at 8am the next day and hope you get one of the daily urgent appointments. If you don't, you repeat that call every day until you do. (Took 5 days for MIL)

Another GP surgery
Ring for an urgent appointment. You will be seen by a Physician's Assistant- this was me before Christmas. Physician's assistant belittled my symptoms and wanted me to go home and 'see what happens over the next couple of months'. I insisted on seeing a GP who referred me immediately to gynae under 2 week wait - possibility of cancer of the womb. 5 weeks later after a series of tests/procedures that initially were worrying it was confirmed as not cancerous. The Physician's assistant could not even pronounce the words properly. On the phone to GP when I insisted on seeing one, he said 'Mrs LuluBlakey is worried about possible uteric cancer'

It's just awful. People have no idea who they are seeing - MIL had to ask who the person was treating her chest infection she had waited a week to get an appointment for- she had been told, by a Physician's assistant she needed an urgent appointment with a GP and to keep ringing at 8am - took 5 days to get an appointment (not counting the weekend in the middle). She arrived to a woman she had never met before or heard of. Turned out she was a nurse who could prescribe. If she hadn't asked, noone would have told her. The woman introduced herself as 'Caroline'. So MIL has - been grilled about her symptoms by a receptionist, had had a telephone appointment with a Physician's assistant, a face to face with a Physician's assistant- who had listened to her chest and then said she needed to see a GP and told her to ring for an urgent GP appointment- which she did every morning at 8am and it took 5 working days to be allocated one, which when she arrived was not with a GP but a nurse and she was only told because she asked 'Caroline' what her job was.

My very elderly aunt is in hospital. Dr's look like all the other staff, everyone is 'Phil', 'Jane', Sol', 'Manja'. No job titles ever evident. Today I spoke to someone who was wearing red scrubs- as the Dr was earlier in the week. Today that person was some kind of nurses' help. It's hopeless.
It is chaotic.

When I was in there was a young girl in front of me who had been brought in by her mum because her hand had hit the ball hard when she was playing netball. She had no swelling and could move her fingers.

When I was walking to X ray I passed then in the corridor with the mum ranting down her phone that it was an outrage that they hadn't even bandage the hand and she was now going to have to get a GP appointment for a second opinion.
Reading some people proclaiming it's not the users who are the issue is not a take I can fully get on board with.

The trained medical staff aren’t letting her down, the system is. You seem to have a very rose tinted idea of a&e. The reality is, due to workload and staffing, it’s hard to get the MHT to even see patients who have acute mental health concerns. The wait can be hours for somebody in utter crisis; where should we, for example, have people with health anxiety waiting? In the waiting room that is like a war zone sometimes? We barely have free chairs, let alone beds. It is absolutely not the place for worried, but well vulnerable people.

Mental Health Care is in crisis, widely acknowledged to be the worst in living memory. Severe health anxiety is a chronic problem needing long term support and intervention. The chance of a person receiving this support via the NHS currently, is about zero. I am not saying that this is right, it is sad and letting people down. But it is reality.

I’m just waiting for someone to suggest yoga 🤦‍♀️😆

I'm not in the UK but we have a 24/7 telephone advice service here which is staffed by nurses and paramedics, which surely makes more sense.

The constant cancer adverts/ catch it early adverts/ horror stories every day terrify me and fuel my anxiety.

I don't have health anxiety but these constant horror stories and bombardment with vague symptoms could be cancer etc. even makes me worry at times.

I’ve noticed (over a long life) that some people seem to derive an identity and a certain amount of pride from being constantly ill. “Oh even the top consultant just can’t work out what’s wrong with me” and so on. I guess if people aren’t lucky enough to have a lot else in their lives, this sort of thing can make them feel special.

NRFT as v long.

I felt a mixture of anger and despondency when watching the clip.

1. Look how the numbers have jumped since covid and this doctor didn't even consider covid infections in as a factor? Millions in England already have health issues brought on as a result of covid infections - a number that keeps increasing every wave. That does not include the 'silent' damage - increased risk of heart attack and strokes etc. Has he been hiding under a rock?

1. It's winter, so numbers are higher. It's a pretty brutal winter with various viruses hospitalising people.

1. 111 or NHS guidance may guide people to A&E. Some of this advice might be inconsistent with

1. NHS runs hot. There is little room for additional pressure. At the height of the pandemic, this impacted on ability to access treatment and screenings. NHS had to actually counter government messaging to tell people to come. There is an obvious knock on effect from this and austerity.

1. Over the years, Mumsnet has had realms of posts about health concerns being dismissed or put down to anxiety / hormones / life. How many is this doctor dismissing?

1. Health anxiety sounds horrific. The messaging in this clip was awful.

1. People find it hard to see their GP. In addition, hospitals postpone appointments, waiting lists are long. People are discharged too soon from A & E sometimes due to pressures. Health issues deteriorate.

1. Lots of people already put off going to A&E due to wait times. Some put it off because the risk of catching something in hospital is so high (hospitals could do something about this - it's a choice). Some put it off because they believed their doctor who said they had anxiety. Of course people are going to Google - for some it's saved their lives.

1. Some people shouldn't go to A and E when they do, but despite those people, there are still trolleys stacked up, people sharing bays on drips etc. The dire situation in hospitals is pretty well known - those who will go for very minor things are still going to go, irrespective of this clip. Of more concern with clips like this is how many that should have gone to A & E now won't and how will those consequences play out?

Most of all, I still can't get my head around the mindset that says things like 'appointments have shot up since covid arrived', yet doesn't even consider covid itself as any sort of factor in this - maybe they should 'google' a couple of research papers - they've had five years to not be this wilfully ignorant.

My friend is a GP, he says he sees the same people week in week out. They are either older and lonely or have health anxiety. It's very sad but also a huge cost to our health services.

We do, certainly in some cities, but not in great numbers. I used our city centre walk in when I developed a really painful UTI. Saw an ANP who prescribed antibiotics. I’d had a few really unpleasant episodes needing antibiotics. With regard to self help, a friend suggested trying extract of cranberry tablets, which I’ve taken ever since, never had a recurrence in several years.

GPs have quotas and targets for screening programmes like smears etc. So there's financial incentive for them to get people tested.

No but if you have an ongoing condition and this happens day after day?
There are plenty of issues that could've been treated by a Gp early doors but if left for weeks ends up in a serious condition that does require an A&E trip

So i assume he's referring the lonely people to social prescribing and the people with health anxiety he's medicating and referring to mh services or is he just slagging them off

@Differentstarts he's extremely frustrated with lack of mental health services and lack of adequate social care - no slagging off was part of it. But great way to make a giant assumption.

I’m an ex nurse and had mild anxiety before COVID and now have fully blown health anxiety. I have an illness where I required surgery and aggressive treatment. No one listened to me for years and my fertility issues were down to me not trying hard enough!!! I had missed miscarriages where I was told I was over anxious and my baby was fine.. I think health anxiety is often sparked by not being listened to. I’m lucky that I’ve now got a consultant who is fantastic and very supportive.

This 100% this is what caused mine and lm slowly getting better by now having amazing drs who listen to my concerns and don't dismiss me as just an anxious, hormonal woman

OP presents a narrative blaming patients. The picture is accusing people of making too many demands on the system.

Patients blame GPs or receptionists, accusing them of not caring enough.

It's not individual people at fault - not HCPs nor patients. It's the larger systems and processes and organisations.

Triaging, appointments, communication. Badly managed, unusable, unworkable systems.

And yes wider issues - ageing population, underfunding, anxiety due to lifestyle factors and social issues.

It's not the fault of people with health anxiety, and its unfair to blame them. If health anxiety is causing such big issues then the NHS should address them directly.

I think this is what so many people don't understand.

When you're brushed off for so long as anxious, it being due to your weight or your hormones etc etc., everything feels so much worse because you genuinely don't know what's wrong with you

Please don’t spread misinformation

OCD and health anxiety are two different presentations of mild to moderate mental health issues. Though some aspects of OCD overlap with health anxiety in relation to germs and fear of illness. Some health anxiety also develops into death anxiety.

Both are treatable with CBT in talking therapies. This is consistent with NICE guidelines and evidence based research. It is not the only approach that maybe successful.

Mental health or physical health?

Better education about managing your own health is needed. I think social media is unhelpful. Any post is given either option
a) don't ask on here, ring 999
b) a confirmed diagnosis because that's what my auntie had

TV shows dramatise health so people see always the worst cases

It all adds up to people unable to make good decisions.

As a child my mum treated us...we had a medicine cabinet and she knew how to use it and recognise signs to escalate.

I know some people have health anxiety for a number of reasons and their use of the health service tends to be huge. Not sure what the answer is but it does mean the actually sick are in the queue with the worried well. Both need help and neither are getting what they need

Do you think the walking anxious as you name them want to be feeling like that???
Anxiety is still a illness yes a mental health illness but still a illness.
Maybe if the country wasnt on its knees and the government actually sorted nhs issuses out we wouldn't be at this point!!

But you had actual and obvious cluster of symptoms that needed to be assessed. I hope you are being better cared for now and reviewed on a regular basis.

Health Anxiety manifests as repeated singular minor bodily sensations being misinterpreted for something catastrophic. This passes until the next time. It tends to fluctuate but will often have a theme.