How long in a chair in a&e?

[ThisMustBeMyDream]

My DH has been diagnosed with a perforated bowel. We've been in urgent care/a&e since 1pm. He doesn't care if they nurse him on a corridor, but he just wants to lie down. He's in a chair and exhausted and in pain. Lying down relieves the symptoms (he discovered when he had an ecg).
There's no sign of a bed for him. I asked about a trolley - no, none of them.
How long is it acceptable to leave someone in a chair? My head's a shed, can't think straight. I've had a hell of a week with my DF after collapsing and having CPR. He's been diagnosed with encephalitis and it's life changing. So having spent Monday night doing a 3 hour dash to my dad, then 3 days down with him. Coming back home and my DH becoming unwell today... I'm an emotional wreck. I just need a sense check on what's normal.

@FlamingoBiscuits I’m not surprised. Clinics are now so bloated that having a big enough space is an issue. There are so many moving parts, nurses, doctors, clerical staff, access to scanning department, OT and physios on hand, having enough equipment …

A lot of clinics could be run virtually, go to a diagnosis centre for bloods / scans / weight and height and then a virtual appointment for the discussion. Obviously some things need hands on, but more willingness on both sides to do things differently and using tech is helpful. Turning up to a clinic and being sent for scans / tests / bloods, back to waiting and then seen again is an utter waste of time. Turn up having had everything done can mean you can be signposted appropriately and triaged to some level.

Isn’t a perforated bowel a medical emergency?! Has he not had any actual treatment in all that time? I’m so sorry you’re going through this, the state of our NHS is absolutely diabolical and getting worse all the time, it’s enraging! I hope your DH will be OK.

It’s absolutely shocking and I feel sorry for yourself with a DH.

A similar thing happened to me but what was annoying was that I actually needed antibiotics which could have been a 10min appointment and cost the nhs very little.

I couldn’t get a gp appointment and then my symptoms continued to get worse. So I had to call 111, they eventually sent me to A&E and then I had the massive wait and it ended up turning septic and I had to stay in hospital, which ended up costing the nhs a lot more money and I took up time and space.

Whilst I was there I was sat near a woman going through a miscarriage, a young girl who had tried to commit suicide and over dose and a man who’d been arrested with 2 policemen - all had to wait hours too.

Something needs to be done.
Perhaps more gps and walk in clinics may help ease the A&E departments I don’t know.

A friend of mine waited over 30 hours in A&E recently to end up in one of these beds without a curtain, table or chair. It's a mess.

I had emergency surgery over the weekend in France and agree entirely. 10 minutes for the ambulance, seen in A & E by a junior dr within maybe 15 minutes, x ray, seen by orthopaedic consultant, plan made, up to ward, surgery, back to ward. Less than 8 hours in total, including 3 hours in theatre. That's how a health system should work.

But wasn’t the issue the fact that they didn’t do that? As in they dumped him in the waiting room with no care/pain relief (which suggests much more than a minor/sealed perforation) or iv abx and then wanted to send home with iv abx but no way to monitor his condition etc when he should have been in a bed with abx pain relief and reg obs awaiting em surgery?

I get that it’s not like his leg is hanging off but surely downplaying his condition in the there and then is inviting trouble further down the line.

Bit like when they sent my mate home with cauda equina because it was “probably just sciatica again - it’s not that bad” didn’t even scan them

My partner has cancer. Went to A and E at 4pm with a treatment complication, in literal agony.

He didn’t even see anyone until 130am then a nurse took his bloods. At 3am he was told there were no beds and he needed to go back to the waiting room until a rheumatologist could see him. Couldn’t give a rough time line as to when this might be. During this time I also had to chase nurses for pain relief, twice.

Common sense told us the rheumatologist wouldn’t be doing a night shift. Luckily we live not too far from the hospital so after an argument, they agreed we could go home where he managed to get a few hours sleep and return at 9am. We did then sat there til 1pm the next day where he was given a generic medicine told to come back in 3 days if it didn’t help. He didn’t see a rheumatologist, or get any further tests done.

If we hadn’t have gone home for a few hours then he would have been sitting in the waiting area for 21 hours.

To make matters worse there were five vending machines and not one of them was working. I had to demand the receptionist got him a bottle of water at one point.

Yes, some perforations can be treated with antibiotics. This perforation had been assessed by a surgeon as needing surgery and stoma. Therefore although antibiotics are of course required, the surgeon thinks surgery is needed, therefore I hope he gets it before any deterioration.

But they didn’t send him home as they did realise that was inappropriate, thankfully!

Cauda Equina is horrific, red flags should have been noted and not arranged an immediate scan. It’s a medical emergency and generally is easily spotted and treated as such.

I think the thread shows the need for advocating for yourself and making a fuss.

Martha’s rule is being ruled out to give patients access to second options.

I totally agree. I suspect they are messing with the trolley statistics by throwing people off them - hence less people on trolleys.

Always bring a yoga mat, blanket and pillow to A and E.

P.S I’m in Ireland and I’ve seen this in Vincent’s hospital.

Why not look at a French model? Why do some people keep yapping on about the US to try and close down what needs to be a discussion now?

Surely those people recognise that the model is broken. Strongly suspect that they will want others to pay for any improvements

Fucking hell, OP @ThisMustBeMyDream Are you still waiting? DH had what turned out to be a perforated bowel in 2019. He was in agony with abdominal pain after dinner one evening. First we phoned 111 and were called back by the out of hours GP. It was about 9-9.30pm by this stage.

The out of hours GP listened to DH and said he could go to A&E, or take painkillers and try to rest, and go and see the GP in the morning*. I was just outside the room and could hear the conversation back and forth at both ends.

DH didn't sound himself at all. He had started to sound confused and slur his words. Having listened to certain storylines in The Archers and Call the Midwife I had sepsis in my mind and googled it. Somehow I managed to persuade DH to get out of bed and put some tracky bottoms on (the only thing that was remotely comfortable or he could get on as his belly was so swollen) and come with me to A&E.

He was triaged straight away and hooked up to a drip with strong antibiotics within an hour. *Glad I hadn't let him try to sleep as the nurse said he had several signs of sepsis. DH made a full recovery and the perforation even healed itself without surgery, but he needed a week in hospital on the strongest antibiotics.

IANAD but a perforated bowel usually means an infection - peritonitis. How on earth has he not been treated yet?

After you get out of there and DH is making a recovery please get your MP on the case, OP. It's absolutely appalling.

In TOTAL agreement 🙂 & wish I’d written that, …to the point I’ve bookmarked, many thanks 👍.

@spoonbillstretford the worst bit is they know. It’s not a one off, it’s not winter pressures. The MPs know. The hospital leaders know. It’s in the data, the reports, the meetings. I don’t disagree with complaining, but they bloody know.

Sure. I was just thinking that although our MP is Conservative, that's quite useful at the moment as she will go to town on current government or local authority balls ups for her constituents, even though most of it was caused by her lot. They can actually do quite a bit.

12 hours two years ago. Dr had no clue either, finally diagnosed w epilepsy a re months later via GP neuro referral.

Way too much money spent on management. And not a penny should be spent on rainbow badges and jobs. It's a hospital for God's sake and every penny should support patient care, not politics. It needs a radical overall first, just throwing more money at it isn't the solution if that money goes on management rather than care.

I think they need to throw money at clearing the backlog, sorting out elderly care and GP surgeries. Underfunding and CoVID plus brexit and cost of living has really damaged the service.

All hands on deck, clinics run at evenings and weekends (and with strict discharge for non-attendance without prior cancellation or exceptional circumstances), as many theatres running extended hours as possible, GP appointments easily accessible. Get back to a point where there are normal waits.

There definitely needs to be a consideration of the structure. Clinical roles get pushed up into management partly due to agenda for change. People get to the top of their band and then have to apply and move it supervisory or management roles to continue to progress. Before agenda for change people stayed in their positions relatively and increased skills and knowledge and had incremental pay increases. They were able to pass on their knowledge and stay in the clinical position they trained for. Some would go for additional courses and move on, but that wasn’t the only option. There has to be a space for extending practice within reason and for those to be paid for their experience and skills.

I would reccomend ringing around a&es before going always to try to find one that's not as busy , you may need to drive a couple of hours but sometimes it's worth it ... my appendix burst waiting for a bed my local A&E is appalling

Please don't do this. There is no 'GP fast track' and GPs aren't an urgent response service. It's shit that you have to wait hours in ED but if you genuinely need to be there then GPs don't have the resources to help you. The safest thing to do is to stay in ED.

@ThisMustBeMyDream hope you're not in Blackburn 😬, although if it is and you work there, you will know what a shocking rep they have.

Hope he is recieving treatment now and has actually made it off the corridor.

It's shocking and worrying in equal measure.

Dd developed RSV at 3 weeks old and went from a normal baby to weak and struggling to breathe within hours.

The ambulance took half an hour to arrive (not awful I guess, but felt an eternity when my baby could hardly breathe), and when we arrived at a&e we were told there were 4 staff to 25 urgently sick babies.

I had to scream for someone to give her oxygen as we were being ignored while she was breath holding.

We were assessed several hours after being admitted. She was so poorly she didn't even move or cry during her lumbar puncture.

The level of understaffing is criminal.

Similar, it's a doom loop now. The fact people can't get timely treatment is costing a fortune. OH was waiting 7 months for a date to talk about a prostatectomy. Then, a known complication, his kidneys and liver shut down landing him in critical care for a week and costing the NHS thousands of pounds.

He recently reached the head of the waiting list for the prostatectomy and was sent his first appointment to discuss an operation to fix the initial problem. We paid privately (thank God we had the money!) and it was done over a year and a half ago.

He would have spent the intervening time catheterised, needing help and supplies for that and probably getting UTIs that would have needed antibiotics.

It's terrifying to be old or ill with the situation as it is. But the figures out this morning showed that the population increased another 700,000 people in 2024. Making 1½ million in 23-24, without increasing the capacity of A&E units or GP surgeries first, so it's not getting better any time soon. This is not an anti immigration statement, it's an anti increasing your population without providing services for them first statement. We have to stop importing more people until we've got the services sorted for people already here!

Oh gosh it seems dh has been exceptional lucky in his A&E visits this year. Well not exceptionally lucky in that he needed to be seen but the speed of his admission. In both cases (heart issues) he was seen by triage in minutes and then ushered straight through for monitoring and treatment. You could argue that if they had done an additional test on first admission then perhaps he would not have needed the second visit (but we dont know for certain it was the same cause at the first admission) and he is currently awaiting a date for an operation to sort the problem out & hopefully won't need another visit in the interim.

We are also lucky that we are equidistant between 2 A&E departments and I had looked up statistics earlier in the year that showed that the hospital we went to had less time waiting for treatment in A&E. Just had another look now and it is showing a lot of variation between different A&E departments so if like us you are within reach of different one it is well worth a check if you can before choosing which one to go to. Avoid Heartlands, Leighton and Forth Valley basically this morning. Appreciate not everyone has more than one hospital within reach