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

what’s the answer done that means that every single person in the UK were meant to have difficulties get the exact treatment that they need?

Magic pills or magic therapy? there is continuously research going on the background but it takes time

we cannot know everything and it isn’t a one size fits all but when the evidence tells us that certain interventions are most successful that is what gets funded
Just like with my nephew there was treatment available for his cancer but there wasn’t enough researching: evidence that suggested it was the most effective, therefore the we had to raise the money for treatment

1. Yes people try and fake psychosis. We know from research where students have been asked to fake psychosis that some people can successfully do this, although some are found out.
2. You do not need mental health support for bereavement or work or life stresses unless it is particularly traumatic. You need to talk to friends, helplines, family, and get support. Being unhappy is not a mental illness.
3. If work is causing you a great deal of stress and unhappiness, you need to get a new job.

My husband has been in A&E numerous times over the past year, only once or twice was it an actual dire emergency but he did need urgent treatment and often hospital admission. He has health anxiety before all this - just because you have that doesn't mean you can't have serious things wrong with you! Fortunately we live near a medium size hospital and have never had a really horrific experience, he's always been triaged fairly quickly and only once had to sit in a chair for hours with chest pain but was closely monitored despite the staff being overwhelmed with patients.

You can’t get PIP from one letter from a GP. You need masses of evidence. So if someone was hearing voices ( psychosis) they would need a letter from a pyschiatrist, and any social workers, or other people involved in their care. So they would need to be involved with all those services. It might be easy to fake psychosis as an illness. But it to fake it to claim PIP is a joke. It’s not based on one letter from a GP. Thats just laughable ( speaking as someone in receipt of PIP not for mental health)

All jobs are stressful. It’s the conditions people are forced to work under that causes the stress. Out of the frying pan into the fire if you change jobs.

I seem to have anxiety (never used too, to be honest) but I don't think mine is Health Anxiety, not if some of the PPs are anything to go by.
Eg,
I have had a rotten week of things, all gut, bowel and bladder related, and it was topped up last night by temporary blindness in one eye (I do suffer Dry Eye and had forgotten my drops, again, so I used them and it did clear but it was scary as that is my biggest personal fear, going blind).
I have recently got over a UTI (as of yesterday recent) and prior to that was constipated due to tablets I have been given as I have colitis, apparently, which is causing the vomiting. I had to stop them due to the Constipation .
I was sick again just now and my kidneys hurt
I will not, however, be seeking out NHS A&E

Lots of people who have psychosis do not have a social worker. They see a psychiatrist for diagnosis and treatment plan, and then either psychiatrist, CPN, or just the GP.
Yes they need a letter from GP or psychiatrist confirming diagnosis by psychiatrist, and treatment plan.
You are assuming people get more care than they do. In most cases it is family providing care. And yes research has shown that some people successfully faked psychosis - they were asked to fake it for research, and some were diagnosed as a result.

@ArseInTheCoOpWindow I have had a terrible job that made me cry every day in the toilets, and eventually at my desk. I got a new job.

The problem is access for people who are seriously ill with a life threatening condition - ie people who genuinely have had an accident or are an emergency. Maybe we need to stop abbreviating it and get people to ask themselves that question.

Fundamentally the costs and expectations of the NHS continue to rise exponentially and we just don't have the economic wealth and wages to fund it through taxation. So either we reengineer the social contract and what is a priority for free NHS treatment or we will carry on moaning about people waiting two years for major surgery and delayed cancer diagnosis forever. What gives?

This problem started when Tony Blair negotiated a new deal for doctors where they no longer had to do call outs (and also gave them more money)
Most doctors only work three days a week so that doesn't help. Whenever I or my family manage to get a face to face appointment the waiting room is practically empty.

So how do you decide who's a priority for treatment?

They triage them, hence 12hr waits. I guarantee if you have had a serious accident or are an emergency you will be seen promptly.

If you have an illness that could be managed by primary care such as colds, coughs or constipation you'll be sat waiting 12hrs. Which is as it should be but people expect to be seen as if they are an accident or an emergency.

@cerisierblossom You decide who needs treating by Triage, the use of assessment to ascertain who can wait and who needs to be seen immediately.

It's now used in most GP surgeries and via 111 for most OOH services as well as A&E.

In the future it might be used even before people can access A&E - there are some units that will tell you to phone 111 to see if alternative services might be more appropriate. This may well be expanded which is hinted at in the article.

I was put in the ‘fast’ queue. And told l should be lying down in another room.

They couldn’t find me a room or a bed and it was a 5 hour wait in the fast queue.

Hope you feel better soon, Malory. Losing sight, even temporarily is definitely not ''health anxiety'' but a valid concern.

We used to live in a city that had a very good eye hospital where one could walk in- it was busy, but nothing like A&E.

My friend's partner is a {now retired} GP - he says he used to get people coming in all the time ''worried well'' and then there would be those that never visited for years, apart from being called for their routine smears.

100% agree,i have a spur on my septum too and sick of living like it.

In general, the triage system has five levels:

Level 1 – Immediate: life threatening. (See immediately)
Level 2 – Emergency: could become life threatening. (See within 10mins)
Level 3 – Urgent: not life threatening. (See within 1 hr)
Level 4 – Semi-urgent: not life threatening. (See within 4hrs)
Level 5 – Non-urgent: needs treatment when time permits.

So you can see that there will be quite a lot of people to be seen before they get to the urgent cases.

Those time frames stretch out when A&E is packed full of Level 1 and 2 cases so I can well imagine Level 3 took 5hrs to see.

I collapsed in the night, paramedics called, taken to A&E. No one assessed me except for a nurse who mumbled something to me about pain levels and then wrote down the wrong answer. I found out later she wrote that I had rated my pain as 0 out of 10 when I was curled over in pain, even after being given morphine. I was put in a side ward, that was clearly for the worried well and time wasters - one guy was sleeping off a hangover, one woman turned out to have piles (she was loud and only protected by a curtain, so I heard her really clearly). Despite the fact that the pain caused me to throw up again when the morphine wore off, I had clearly been written off as anxious and I was sent home. By the time that decision was relayed to me, I was so desperate to go home and just wait out the pain, I went. A few days later, I ended up having surgery because I had a blockage - I was lucky not to have a rupture and sepsis.

So, yes, there were a lot of people there who did not need to be there. But I dont have confidence that they are good at always weeding out the worried from the really ill.

Of course every person needs the right treatment. Giving people the wrong treatment that could help somebody else is a waste of money and you wouldn’t do it in any other area of medicine.

I agree, but health anxiety needs to be identified and addressed so those who have it have some strategies to manage it without taking up inappropriate healthcare resources.

Increased access and ease of booking GP appointments would be helpful in some cases, but not in the case of those who go straight to A&E even though it’s neither accident nor emergency.

To some extent it’s always been an issue but got worse with increased anxiety plus fuelling the fire with obsessive and counterproductive internet searches.

I got ill on a Friday night and knew earliest I could see GP would be Monday. So I went to pharmacy on Saturday morning and asked pharmacist but she didn't know and said call 111. I spoke to doctor over phone. My symptoms sounded like something that couldn't wait so she said go to A&E. I didn't want to spend the day at A&E it was last resort. Turned out that it was something not serious.

Super. A few years ago I had a bad fall. Severely broken wrist that required pinning and plating and a collapsed vertebrae. 2 hours for an ambulance, 6 hours waiting in A&E.

I assume it was non urgent by your definition. I was called by orthopaedics less than 48 hours after a reduction and had surgery about 14 hours after the call. Evidently it was within a whisker of the carpal nerve.

A&E was a third world environment and the staff were being very very rude to the public - it was horrific. I have never witnessed such mismanagement and incompetence in my entire life and I am 64.

I unfortunately have been a frequent visitor to our emergency departments over here in Australia over the years with serious heart/lung issues. Many years ago I was standing waiting my turn holding a little container & a wad of bloody tissues. The man in front of me was talking about his child's ongoing cold. Another nurse walked up to the window & said "oh have you got a nosebleed ?" I said that no I was coughing up blood from my lung. The man in front suddenly said he thought he might leave & take child elsewhere. The nurse suggested the medical centre (that is a walk in centre with GPs) across the road that was still open. He didn't seem to be aware this existed. I was rushed through & he wandered off. It can be pretty bad here at times with people like this man or later when these services have closed but it sounds like over there these kind of options aren't available & everyone goes to emergency.

A and E is the last place anyone would want to go, sat waiting on a seat if lucky, hours and hours, with families on a day out and kids not giving up seats, eating constantly and playing games on phones.

Fortunately our doctors' surgery has stepped up; short wait to be answered, appointments on weekends and evenings, huge change!

Also to say, in my area, some, well many, who live near to the hospital do use it as a walk in Dr surgery.

I agree with that. I've spent many hours with my poor old Dad in A&E. Including one whole New Years Eve from 6.30 -11.30 pm.

If only I'd got to him before he accepted the recommendation to go there from 111. When actually as a very old man two paracetamols and a sleep would've even far better.

Best get on the waiting list instead of clogging up A&E then.