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.

Someone earlier said you can’t be that ill if considering going home.

thats not true.

a bloke in my town died in the car park of the hospital after waiting a long time and giving up, had only left a&e 5 mins before.

i look back at when i took Dd in a few years ago. Thankfully we didn’t have to wait long. She’d been in twice before with the same symptoms over the past couple of weeks and each time was told it was anxiety. I didn’t think she needed to be there and if we’d had to wait a long time I think I’d have told her we were going home. Turns out she had massive clots in her lungs. She’d have died if we’d gone home.

I’m glad he has a bed now and that you can get some rest.

I think that until you actually experience what A&E is like at the moment, you have no idea! You hear the tales of hours sitting in chairs, but think that it can’t really be that bad… it definitely is.

I’ve been taken to hospital by ambulance twice in the last few months and the last time I sat in the waiting room chair for about 4 hours in horrendous pain, then I was moved to a small room with 4 chairs overnight where I was given pain relief etc. The next morning I moved to a different room with 4 chairs where I stayed all day and night. Then finally I moved to a chair in the corridor of a ward the next morning and to an actual bed that afternoon!
So Wednesday evening til Friday afternoon in a chair!!

The staff were all lovely. They’re just so busy with too much to do.

On the upside, the ambulances were with me within minutes of 111 arranging them and I got straight in to A&E and didn’t have to sit in the ambulance for ages, which I wasn’t expecting!

Hope that your DH gets the care that he needs now he’s on a ward.

I'm afraid that just isn't true. Sorry to hear about your husband, OP, and believe me that the medical and nursing staff aren't happy with the situation either

Where I work patients can often be on a chair for 24hrs or more, including people with significant problems like heart attacks etc. Every shift I work, I end up saying to half a dozen people "I'm sorry that you are in a chair/in the corridor" and having to document a limited examination because there is no space/trolley to lie down so I can examine them properly.

It's not that there are secret beds that there are a shortcut to, it's just that there are no beds - every ward will have 3-4 additional patients that are placed in a bay where there is no official bedspace e.g. under the window, and the corridors around A&E are still full of patients.

If your husband does have a perforated bowel confirmed on scan (rather than just a concern about it and waiting for a scan, then the surgical doctors should be seeing him soon and organising an operation.

We definitely need to look at what has gone wrong and how things can change.

Our GP surgeries are broken and causing some of the issues. Extended hours and the new systems of booking appointments should help, but confidence is gone. The funding calculations don’t work and so there are enough clinicians in them and they are often dangerously over stretched. If we could have more clinicians running a 6am to 10pm service many more people would likely be seen and treated before they are an emergency.

Adult social care is a complete disaster. Many elderly are dumped into a&e where they don’t need to be and then on to wards where they block beds as there isn’t care packages for them. We need to open geriatric specialist centres where they can be admitted short term while minor issues are sorted, they are properly triaged and they can safely wait. The social care and NHS systems do not work together and it ends up in chaos. We underpay care home staff so people don’t want to work there and the care given can be sub standard. There are many hard working and dedicated individuals in the care sector who are unrecognised and battling the system.

In general NHS staff are underpaid, over worked, poorly treated and fed up. They are dealing with overwhelming numbers of patients with departments that are not fit for purpose or the size of the population.

Bureaucracy and waste are massive issues, contracts and finance is a total black hole for money and the money does not go where it needs to.

A European model of health insurance may work, but the US model is terrifying and definitely to be feared.

The advice of the ladder of need whereby you go to pharmacy / 111 / GP does not work. Pharmacies are so massively overrun that they don’t have time or capacity to be giving out advice and dealing with minor ailments. 111 are either overly concerned or overly conservative. Many areas don’t have good Urgent Care or Minor Injuries.

I believe and hope that it can be fixed. Doing away with the four hour wait has been horrific.

So sorry for you - I had similar last year, I was really ill with appendicitis- I am pretty sure the wait contributed to the damn thing bursting - I was hot - in awful pain and left in a waiting room for 12 hours. Which looking at these stories - isn’t the worst of them. My partner (all partners who were not designated carers ) was asked to leave because the room was so full. I was told I needed IV antibiotics at 11am but did not get them until I was put on a trolley 11 hours later - by which point I was hot and worrying about sepsis. I ended up having emergency surgery the morning after which I think was more complicated because of the wait. I spent a couple of days in intensive care hooked up to morphine and best part of a week in another ward - with 6 weeks recovery after. I don’t think they would have a) had to open me up like they did if it had not have burst and b) I would have required a week in hospital after if it had been treated when I got in ( and that’s having been sent by GP). I am grateful for the treatment I received once I was out of AAndE - it saved my life- but that experience was probably the worst of my life. You have my sympathy- advocate as much as you can for your husband - my partner rang the chief nurse of the hospital and stuff happened after that ( but he is a lawyer - and you shouldn’t need to be!). My sympathies are with you.

So glad your DH is being treated now, OP. This is just horrifying to read and makes me so worried for my elderly parents who live in a town with a pop. of 160k but the Tories shut the hospital's A&E dept and now the nearest hospitals are a 40-min drive in opposite directions. If either has a heart attack I don't think they'd make it. Meanwhile I'm in London and I'm no further than a 15-20 min drive from three major hospitals. I recently sprained my wrist – so badly, I was certain it was fractured – and I was in and out in three hours and that's with others more seriously injured being (rightly) seen ahead of me.

Isn't the issue that's causing 40+ hour waiting times not just diminishing NHS funding but the fact it's so hard to get a GP appointment that people take themselves off to A&E instead?

Actually, whilst making it look bright and shiny, Tony Blair escalated the phenomenal growth of PFI which left trust with huge debts. It was also Tony Blair who introduced the new GP contract and the overwhelming layer of bureaucracy called Primary Care Trust. Hundreds and hundreds of them, all with a CEO on c£50k in 1998.

I'd take him home let him lie down and call an ambulance if he deteriorates. Is he getting any care that you can't give him while he sits in a chair . My son was sent to A&E by the gp with dangerously high blood pressure 230/120 and he sat there for 21 hours. He's had previous mini strokes but it didn't make any difference.

Glad it's progressing for you now OP. I was shocked when an A&E left my FIL in his 80s vomiting blood, sitting on a hard plastic chair for hours recently :( it's not unusual.

If it were me i'd lie on the floor and would not be moving if told. If i'm in pain and no help is coming, the least i can do is lie down.

My 84 year old father spent nearly 48 hours in a chair in A&E. It is BEYOND inhumane that we treat people like this. I do not know how the NHS gets away with such poor care.

Meanwhile, I recently got an email from the Digital Network Manager at my Primary Care Network. It was offering me the opportunity to get involved in social networks digitally. Evidently, those who live alone and have difficulty making social connections use GP services as suppprt and unnecessarily and it was felt that chatting about crafts over a cuppa would support me. It was sent on behalf of my GP practice because there was evidence that if people had community support it freed up GP time to do more important things for them.

It was the most badly written email I have seen for a along time in relation to grammar and syntax notwithstanding the patronising tone that assumed people were as dim as they were potentially socially incompetent.

Apart from the fact that I have a husband, grown-up children and a full-time job, there is very little research based evidence to indicate that such initiatives have any positive outcomes/return on investment data.

It was confirmed that the IT people had run a data search using the wrong parameters and the data hadn't been properly checked. It was also confirmed that their comms team needed to reflect and noted that, actually, I'd been to the GP twice in 18 months so should have been excluded for that, notwithstanding the fact I have a husband and family and shouldn't have been offered it in the first place because despite living just a mile from my GP surgery and being within their catchment, I live out of the PCN Borough.

There are 170 primary networks in the UK, each with a budget of about £10m. That's a huge amount of money to spend on cottage industries of probable incompetence and contributing to the crapocracy at a time when it is very difficult to get GP assistance.

I very much hope I shall never hear the whine of "we are under-resourced" coming from my GP practice ever again. I hear no GP voices raised against this sort of nonsense.

A lot of people on here are under the illusion that it is free and therefore you should be grateful for what you get. Our health system desperately needs to change.

GP surgeries are run as businesses and as such can be run brilliantly or woefully. They’ll be paid based on the number of patients they have and by meeting targets primarily and then for offering additional services. It’s in their interests to have lots of patients that are healthy and not in need of any care. So any sort of initiatives and social prescribing probably will be pushed to try and balance their books.

I do wonder if there is a better way to run primary care that is not based on clinicians running business and rather piece meal approaches. But I don’t know enough.

I’m glad your DH has a bed; I hope he’s ok.

We haven’t had great experiences with emergency care. Earlier this year my DGM had a stroke. The ambulance took hours to come despite being told it was a suspected stroke, and by the time they arrived it was too late to administer the medication that can help increase the chance of recovery. Apparently it wasn’t even a major one but she now has no movement down one side, and has gone from being relatively fit and healthy and living independently to being a shell of her former self, and unhappily confined in a care home.

Two years ago my DGF in his mid 90s had to wait for over a day in a tent outside a&e, despite being brought in by an ambulance.

I’ve had multiple surgeries myself, including emergency, and more than once have been ready to go home and free up a bed but there hasn’t been anyone around to discharge me.

I was once in a & e with acute back pain. I lay on the floor in the waiting room until they found a trolley.

Our hospital scanners do work 7 days a week, early til late. (Given the appointment times) But the ER is still really shit.

My friend has always worked as a nurse for our local a&e but on a zero hours contract to fit around school holidays and to not work nights while her dc are small.

A couple of years ago her NHS Trust outsourced all their bank nurses like her to an agency. This was to 'save money'. However, this agency made them all have new uniforms, new ID badges and re do hours of online training. They all had to have new apps and online accounts to book and sort pay and leave etc. They now have to attend their annual training in hotels, with trainers who come from miles away and stay overnight in the hotels themselves.....we are all paying for this. They had training and all IT etc in house before.

She tells me that the hospital have lost absolutely loads of staff who had worked for them for years over this. The agency brings in nurses from around the country who stay in a local travelodge and do a week of nights. But the hospital says it's all been great and saved lots of money.

The maths makes no sense at all.

I've been in A&E twice in the last year and both times there were several people lying on coats the floor. Every single seat was taken, a few lucky people had managed to beg extra wheelchairs.

We were at least x-rayed, bandaged up and sent on our way within 6 hours (which felt like an eternity at the time). I hadn't realised that there's a whole category of patients who are being held for days in this purgatory.

I'm sure we can comment on the maths if you can tell us the actual spend before and after the contract change.

It sounds as if the hospital, sourcing their own zero hours staff, couldn't cover all the shifts it wanted to due to locals cherry picking the shifts that suited them.

There may also have been savings arising from outsourcing RTW and DBS checks and often a catalyst for this sort of move is coming very close to getting fingers burnt over an immigration issue.

What happens in one of the places where they won't let you lie on the floor and you do it and refuse to get up? They can hardly arrest you, can they?

Or can they?

Send this thread to Wes Streeting.

DP is a gardener and has been doing work for the local village primary school. They got him in because DC were at the school so they knew what he did, and they were really unhappy with the current team they had in. Basically 3/4 “gardeners” in a corporate van, completely untrained, who’d come in, charge top whack and totally desecrate the shrubs and plants, they’d start late and finish early. Now, in a small village primary with a hands-on head who actually runs gardening club, you can’t get away with this. He noticed the poor workmanship, rushed job and damage to plants, and he can tell that DP on his own does a better job for about a fifth of the cost. But if this was someone in a big organisation, who never had time to look at the plants, or is even aware what’s there, the team of chancers would get away with it time after time, and indeed they do, as we see the vans all over. It’s scandalous and it’s taxpayer’s money being thrown away when there are independent tradespeople who could make a good living doing a far better job.

Who knows. I'm not party to it but I believe my friend when she says there is now evidence of huge spending for much less benefit and huge dissatisfaction among what were local loyal staff.

The end result for patients is random staff, parachuted in, unfamiliar with local processes and policies, plus duplicated uniforms, IT and training provided off site in hotels that the NHS is paying for.

Maybe the totals add up due to not paying pensions or something (seems unlikely) but the value for money and patient and staff satisfaction is much worse.

Despite some horrendous experiences in A & E I still rate our NHS over some European healthcare systems.

I’ve travelled all over France and Spain and my DH has had to access healthcare in both these countries. Whilst the wait for emergency care was short, the actual care given was poor.

He has severe nerve damage/paralysis and oedema and could not bear the pain of sitting any longer. I don't think you'd understand unless you've seen what it's like when they have a nerve pain attack. The doctors phoned him and he went back to get an air boot a couple days later.

They made him wait for more than 12 hours in total when all they needed to do was given air boot.