So I’m currently sitting in A & E and it’s been eye opening

[Stressedout150]

I’m sitting with my mother who is in here for chest pains. The wait to be triaged is 2 hours and 5 hours overall to be seen.

Here’s a few things I’ve noticed:

1. it’s sitting on the floor room only, and i happen to be sitting next to check in. So here’s what I’ve seen so far.

2. a lady coming in checking in for pain in her toe

3. a lady who was told it’s a 5 hour wait, and after been told that/ was then asked if the wait still applied to NHS staff- as she works for a hospital. She was told yes of course. The cheek of it

4. a chap who checked in his girlfriend due to a headache.

it goes on and on/ I’ve never seen anything like the cheek of some people and also the ridiculous shit people are here for. And even when told it’s a 5 hour waits, they seem quite happy to wait 5 hours for their toe to be assessed.

What the fuck is going on

The problem I think is that generally there are not other services available. In your examples

• the toe could be broken and need strapping up. We live in a big city and so you could go to a minor injuries unit, providing it is not between 10pm - 6am (when the MIU is closed). Oh and also if you happen not to be able to drive because of your toe injury or anyway, the minor injuries unit is about a 30 minute bus ride out from the city centre on a bus route that runs hourly from 7-10pm and then not at all until 6am so hopefully you can afford a taxi.
• Do you really know the details of the headache?

The minors are easy to sort. The travesty is the sick who are stuck on a corridor for 3 days because they can’t get a bed. No doubt there are some time wasters but they are easy and ironically make performance figures look better. Start fining hospitals for the patients stuck in a&e beyond 12 hours and I think you’d suddenly see a laser focus on bed management and discharge. It’s an absolute travesty that we are treating so many (largely elderly) patients so poorly. Hospitals shouldn’t make people sicker than when they went in.

You also can’t judge on how well someone might appear to be. A few weeks ago my daughter was admitted. She skipped into the paediatric ward and you’d have never have known she was actually very ill if you’d seen her from a distance.

Yeah that sucks but I’ve had meningitis as well and I wouldn’t describe that as a normal headache - there is a huge difference and I don’t think that is what OP is talking about.

Last time at an and e with suspected broken bone of my kid - you could hear everything. …

I have seen people on their phones telling the people they are speaking to that their kid has a cough and it’s been for about a day and they didn’t want to wait for an appointment. Kid was running around the paediatric an and e and didnt cough once in two hours.

Another parent brought their kid in because their three year old hasn’t pooed in a day. Hadn’t tried anything, just thought they would check.

Someone else brought their kid in with suspected broken bone (ankle). Kid running around and fine. Parents told it was a bruise and not even swollen.

Another kid had a cut - not gash - cut on his arm. It was cleaned up and a plaster was applied. I kid you not.

Another kid with a cold.

When everything is free and there is no triage for a walk in clinic to sort out the non emergencies plus no penalties for frankly wasting time this is what happens.

If it’s minor then you might not need to go there and then, MIU isn’t supposed to be 24/7, people can take a painkiller or do their own first aid until it opens again. I went to MIU a week after I broke my thumb because it was minor.

Even if it is a broken toe, going in the morning with less queue would make so much more sense. (And anyhow buddy taping sorts out basically all toe breaks where the toe seems still to be toe shaped visually).

I agree with you OP, there's tons of time wasting patients in ED that don't need to be there. It's a hard thing to fix though. I heard an interesting interview with Wes Streeting on political currency podcast recently. He is sincere in trying to make things better overall, but I don't think he understands just how out of control A&E departments round the country are. And I don't really know how they could fix it.

A few years ago I worked in ED and if we had patients getting to 3.5 hours (of being present in ED including time taken for treatment too) we'd get multiple managers descend and hassle us to hurry up and treat them, do the paperwork, and discharge them or admit them STAT before 4 hrs. If they breached 4 hrs it was a Big Deal. They published the 4 hr breach numbers and fined hospitals that didn't do well enough. Patients would get triaged by 15 mins as per national guidelines, and seen quickly, and most often were discharged (or admitted) by 2.5 hours.

That's totally gone out the window now and I do think it's worse. Nowadays if you're triaged by 1 hr and seen within 4 hrs (and treated and discharged by 6hrs) you're doing well!

In every ED I've been in recently, there are signs on the corridors and hooks for iv fluid bags as they are now numbered bed spaces along all the corridors. Patients often stay more than 24 hrs in ED when awaiting a ward bed for admission.

Fixing GP services will help, at least they've allowed ARRS funding to pay doctors now (labour did do well there to put that right as soon as they got power).

Any other ideas how to fix ED anyone??

People have died of preventable and curable illnesses due to the pandemic. Drs refused to see and refer patients which has led to premature and preventable deaths. I'm so pleased your consultant friend is delighted by people being too scared to seek help.

This is what happens when health is free at the point of use. Everyone thinks they are entitled to use it whenever they want, for even the most minor complaint.

Charge at point of use. Some sort of system to claim back for GENUINE A&E situations from insurance, exemptions for those who genuinely can't afford it etc etc.

What about all the tax we pay? We need an additional insurance now to?
And it's normally those who can't afford to pay who take the piss or suffer ill health

YANBU. If I had either a headache or a pain in my toe I’d take ibuprofen with a Chardonnay chaser and see how i felt in the morning!

The one and only time I’ve ever attended A&E for myself (not my kids) my mum had to drag me there against my will and I was admitted for 2 nights (Covid complications).

Spot on. It’s the ambulance / majors & resus / admitted pathway where the harm occurs. And this is not affected by the volume of low acuity walk-ins.

You can strap your own toe, it’s basic first aid. Plus minor means it doesn’t need to be dealt with at that exact moment, you can wait overnight until the service resumes, minors are just that, minor, they don’t need to be open 24/7. Living close to or not close than MIU isn’t the fault of the NHS - but all are on bus routes - I’m not sure what the health service is supposed to do in terms of proximity. They can’t be on everyone’s doorstep.

Ha ha Chardonnay chaser - I would too

Yeah I once had an infected toe it took a long time and many, many appointments to sort out, it was absolute agony and having to have in lanced was grim.

However I also have a father who once went to A&E for a cold and a mother who sees visiting the GP as a social occasion so likes to go as much as possible (she is disabled but goes to the GP for the stupidest of things) so I kind of get where OP is coming from.

Start fining hospitals for the patients stuck in a&e beyond 12 hours and I think you’d suddenly see a laser focus on bed management and discharge. It’s an absolute travesty that we are treating so many (largely elderly) patients so poorly. Hospitals shouldn’t make people sicker than when they went in.

But where can they put older people?

In the last 5 years I've been to A&E 4 times- once for anaphylaxis, once for DS baby who had a 40° fever and was floppy, once for DS's 1st asthma attack when we didn't have inhalers, and once for DD baby who had chest retractions when breathing.

Every time, treatment was delayed because staff were massively over stretched. There were definitely people there who didn't need to be there.

People need to start using A&E properly, it's a bloody joke.

In Ireland they charge €50 for a visit (or more maybe?). I understand why that's controversial but when we had to wait 25 minutes for an ambulance when my child was struggling to breathe... yeah, I think the system needs to change.

I had to get my little toe pulled back into position with gas and air. I’d left it a few days as did think maybe I was over reacting as it didn’t look out of shape. But the pain was unbearable.

I agree with PPs about minor injuries- that's not something we have where I live, and everyone is directed to A&E. From A&E they're often sent through to a minor injuries unit after being triaged, but everyone gets shoved into that same initial waiting room regardless of severity.

My worst A&E experience was in London; I was there in the middle of the night for almost five hours and I would have loved to have had a pair of headphones! I don't cope well with those sorts of sensory environments, especially not when I'm tired and in pain, so some music would have made a world of difference and I may well have been bopping along in my seat to pass the time. If I wasn't there for abdominal pain I also would have liked a burger, because I was bloody starving by the time I was discharged in the small hours of the morning. Personally I think as long as people aren't making the experience worse for anyone else- and I do appreciate that the smell of hot food threatens to tip that careful balance- then people should do whatever they can to make the wait somewhat more bearable!

Well to be honest you would probably have costed less of the NHS’s time and money if you hadn’t waited to be dragged to A&E and had gone before the complications were severe enough to lead to admission! If your mum hadn’t dragged you in then you may have been far more unwell and taken up an ambulance and a lengthy, costly stay in ICU for weeks so that would hardly be doing the NHS a favour!

Im not saying people should be going to A&E for anything and everything but equally the almost competitive encouragement not to go for anything unless you are almost at the point of death isn’t helpful either if it means people who could have been treated quickly as an outpatient leave their condition to get so bad they need to be admitted and need more invasive (and costly!) treatment.

You really don't have enough information to cast a judgement. Headaches are such a broad term. My cousin went to a&e with a particularly painful headache and no other symptoms. It was being caused by an undiagnosed brain aneurysm. If shed been 'thoughtful' and stayed at home, she would've died. If you don't know the full story, don't judge.

People need to start using A&E properly, it's a bloody joke.

We have an ageing population which means more sick people so healthcare will continue to be put under strain

The receptionist here is clearly feeling the annoyance too to be fair

she just told someone who was whining about the wait

“as you can see we are over stretched and over used and we are just trying to find out whose most likely to die first and working backwards”

it’s getting to then clearly

@MolkosTeenageAngst yes the general consensus on MNs is you shouldn't go to A&E unless dead or unconscious. 🙄

Last time I went to hospital (Bath RUH) with suspected gallstones I was in and out of the waiting room about 5 times. I arrived at midnight on a Monday/Tuesday. I was triaged with a couple of hours, despite the waiting room being 3/4 full. Then I had to go back to the waiting room to wait to be called for bloods, then sent for a pee sample. Back to the Waiting room. Then i saw a doctor. Back to the waiting room. Back in for a Ct scan and back to the waiting room to wait for results. They proved inconclusive so I had to go for an MRI. Back to the waiting room to wait for results. Then another consultation with a doctor when the results came through.
I was admitted 15 hours after arrival due to an omental infarction (I had to Google it too), not gallstones.

If she really said that then I’m shocked. She’s in the wrong job.

she 100 percent did, wish I was making it up. But word for word what she said

In Ireland it's €100 if you take yourself to A&E without a referral. (GP visit is €50). It probably does help but our local A&E is still very full. I dont know the waiting times though.