To wonder why adult a&e and children's A&E share doctors?

[lisad123]

Stuck in children's A&E with dd1. The thing is childrens A&E share doctors with adult A&E next door. It sounds completely daft and often we have ended up with a doctor who has little clue about kids.
Why do they do this?
I also don't understand why on the weekend there is alot less doctors, certainly no specialist in over weekend. Why is this?
Surely NHS should get upto date and understand people get sick in the weekend too and do with doctors what they do with nurses and have Rita.
Happy for anyone to enlighten me on why this doesn't happen.

You should have been referred to the nearest Eye Casualty, or directly to the on call Opthalmology team, rather than directed to sit in the A&E queue. This is the problem with A&E; so much stuff ends up with them that is neither an accident nor an emergency, that it creates massive waits for everyone who isn't triaged to be seen immediately. Your being sent to the A&E team was inappropriate.

A consultant is available in every specialty over the weekend as needed....I was in last weekend and the place was awash with consultants in surgery, anaesthetics, paeds, obs and medicine particularly. As others say, there are physically less doctors around as there are no clinics or routine operating lists at the weekend. We do also work to a rota (of 13-hour shifts on call, generally with no breaks to eat/drink/wee because we are run off our feet, and often we can't leave when the shift 'ends' because there are still problems with the sickest patients). I would love it if there were more doctors out of hours too, but given the number of trained doctors we have in the UK, and the hours they already work, you would need to get more doctors from elsewhere to achieve this.

Might be different for the OP (and probably is if she has separate kids A&E) but we would have to go 60 miles minimum to a specialist eye Casualty.

One of anyone's local hospitals will have an on call Opthalmology team even if the Eye Casualty is further afield, and a local GP will know which one it is. My closest one is 10 miles away.

That makes sense.

It's never been the same since Dr Ross left.

it's because the nhs is run by monkeys.

The number of doctors around at weekends is not simply to do with a lack of desire to pay them, its to do with the Working Time Directive. They have to work under 48 hours a week on average. Numbers of juniors in hospitals have increased hugely over the last 5 or 6 years, but whereas they used to work up to 56 hours and can now only work 48, something has to give.

Our local eye clinic shuts at 1pm today and GP tried the other local ones too, all closed nearest eye hospital is central London which is a good 40-50 miles away.

I hate sitting in A&E when it's not needed, but sadly had no choice today, dd1 was in pain and GP was concerned about damage that was being done to the eye.
They were great tonight and fixed her up very quickly considering.

While at out of hours today, was quite to see a little girl struggling to breath come into GP office. Wasn't at all surprised to see an ambulance pull up 10 mins later. That little one clearly needed hospital an instead was at GP

I don't know...when we were in A&E with dd(3) she saw a doctor who seemed to be a paediatrician. The room was full of toys and there were stickers and certificates etc too. He was brilliant with our daughter.

I guess they see others in there too but maybe where possible they send the children his way?

I hope your child is okay.

YABU, an ingrowing eyelash is going to be the same if the doctor was treating an adult or a child. And A & E cant really be expected to have a separate set of doctors for both.

It is to do with paying them.. the EWTD means less hours per week compared to before so the extra hours would have to be taken up by extra recruitment. In actual fact, now I come to think about it the sho rota is a lot less frequent than the registrar rota, so really maybe they could do some extra shifts.. food for thought.
Thankfully its true the consultants tend to be in more these days, though in medicine they only visit, they don't stay as they do in anaes and surgery.

Yes please to more doctors in the hospital at night/weekends. You'd think "On Call" meant being available should someone call, but when applied to hospital doctors it really means "being on your feet for 13hrs with no time to eat/drink/wee as you're responsible for 200+ patients who are often very poorly and spread over a large hospital site". Repeat this for 3 days over a weekend where you are also working a full week before it and a full week after it and it's pretty knackering. More doctors would be safer all round.

In terms of A&E I've always worked in combined units, where staff were allocated Majors, Minors or Paeds at the beginning of a shift, and stayed there unless there was unmet demand in another area. The doctors in A&E are mainly junior, rotating doctors who are not "specialists" so can work in either area, and the A&E specialists are well trained in paediatrics.

OP please ascertain facts before starting rediculous threads
Paediatricians work a 7 day a week service on a shift basis. There will be either a resident consultant or registrar at every unit. A and e is a filtering process which refers as necessary to the relevant specialty - very few units in the country have separate a and e teams for adults and children but refer as appropriate just like a gp would. The threshold for referral is very low so all children who need to see a paediatrician will. A and e are also the best places for seeing very poorly children in resus in which case a paediatrician attends a and e and works along side the a and e doctors

Having spent 4 and a half hours in childrens A&E with my son today I would say the weekend problem is compounded by the fact that most of the people there should probably be seen by a GP as are just given advice or meds and sent home - but of course, in our area at least, they have got rid of all the saturday GP surgeries and walk in centres that used to be on site at the hospital. So less doctors plus all the people who are too concerned to wait from Friday morning (last time it is possible to get a same day emergency appt - if you're lucky) to Monday morning but who really only need GP care = massive over crowding and not enough doctors. Surely that should mean more doctors on at the weekend?

There are out of hours GPs at weekends/evenings/nights befuzzled, I was working as one yesterday morning. You ring up your GP surgery or NHS direct and they will give you the number to speak to the out of hours GP who will assess/see you. Most also see walk ins.

The main problem I find is that with so many different services (a&e, gp, gp out of hours, NHS direct, walk in centres, minor injuries units etc) many people are confused about where to go. And it's not surprising.

We have separate adults and children's A+E in different hospitals. The children's hospital is a nightmare to get to if you don't drive, no train station within 5 miles and 3 buses. The docs there are pretty rubbish too. I took ds3 who has asd there he had been up all night screaming with pain in his calfs, I explained what the problem was and explained that due to his severe speech delay he was unable to tell me anything, the doctor then looked at me and said 'how do you know he is in pain if he doesn't talk?' I just replied that as his mum I knew it was a painful cry and he can actually say 'OW'

'OP please ascertain facts before starting rediculous threads'

Surely the point of posting is that the OP didn't know the facts, but realised that there were probably posters on here who could answer her question with a better understanding of what goes on in A&E.
And they did. Most without throwing around gratuitous insults. Thank you all, I've been in A&E several times and still don't know what goes on.

Nightfalls - no there isn't for us. As i said, we used to have one at our local hospital - East Surrey - Thames Doc. It is no longer there. That is what we went to. We got sent to children's A+E. The other one near us is for over 16's only. If I phone my GP at the weekend I get a recorded message saying ring NHS Direct.

We have separate A&E departments for adults and children in separate hospitals. the two A&Es are actually quite a distance apart - always concerned me if both me and DD were in an accident at same time - silly concern I know! There is another adult hospital very close by but no A&E there, only minor injuries.

A lot of our doctors/consultants/specialists are separate for both hospitals, but some work between both children's and adults. It varies a lot.

"The main problem I find is that with so many different services (a&e, gp, gp out of hours, NHS direct, walk in centres, minor injuries units etc) many people are confused about where to go. And it's not surprising."

I find all this confusing too and have to really think about which one to go to, esp as some of our services will accept children and some won't. I also discovered that minor injuries won't even look at anything to do with the head either - have to go to A&E for that.
Our GO number out of hours refers to NHS Direct and out of hours GP centre.

Why would they have different doctors? You don't see a different GP for adults/children so it wouldn't occur to me A&E would be any different

befuzzled "If I phone my GP at the weekend I get a recorded message saying ring NHS Direct"

That's it?! It can't be, surely? Don't they have to provide out of hours cover under their NHS contract?

I think that it can be confusing. I found out the other day that one of my friends has been taking her children up to A+E every time that they had any kind of health problem outside of normal working hours, and knew nothing about NHS24/OOH services.

Our peads a and e is about 10 miles from adult a and e so does have dedicated paediatricians which is fantastic.

Of course there will be less drs around at the weekend. They aren't having to do clinics, planned surgery etc so there isn't the same need unless there is a big emergency.