AIBU to wonder what the heck is going on in hospitals right now??

[Rinoachicken]

Before I start, I want to make it clear I am NOT blaming the hospital staff in any way.

13 hospitals have declared state of emergencies or whatever it is.

Why is everyone suddenly descending on A&E all over the country all in the same week? Has there been an outbreak of something I don't know about?

I don't get it. A&E is always stretched to the limit, but Why this sudden crisis all over the country?

Am I missing something??

I don't think sticking all new medical graduates in a and e is the best idea to be honest...

In the news not that long ago
Women are encourage to give birth at home as this is the safest way give birth. This will also relieve the pressure from delivery suites as there isn't enough MW.

Except that there want enough MW in the community for home birth, let alone more home births...

What do you think the result would be? More women giving birth on their own Maybe and then what? More 'accident' during delivery?

It's the whole system of support in the community that has been reduced to nothing. As chronically ill patients, elderly aren't cared properly in the community, they end up in A&E.
As the hospitals have to reduce cost, they go for minimal care. Minimal care means people aren't treated properly, they are 'released' into the community ASAP, so they end up back in hospital sooner, maybe with more issues than before.

MH teams are reduced again which means no support fur people with serious MH problems. Who end up at A&E etc etc

Welcome to the world if cuts of NHS care what most people still believe they have fantastic care and free NHS. And still haven't woken up to the reality of a system that has been privatised.
Welcome to world where patients are told it's their fault if the system us failing. Even when there is a clear structural problem.

We had been told though that's what the conservative wanted to do. And we let them.

Increasingly OP and physio are now becoming 7 days a week services. In any planning I do I will be aiming for 7 days a week for anything inpatient related. It's just pointless trying to improve a situation with anything less.

Regarding med school etc - after 5 years in med school junior doctors then have several more years of training and it's in those years that they are the workforce on the floor in hospitals. Senior leadership is needed from consultants but the F1s, F2s and upwards are all also very much needed. They do their time believe me and tbh I don't want to be treated by a doctor only there to pay off their training. Plus what about maternity/paternity leave. If a doctor takes out three years to be with their kids are we going to add that on top of their national service?

It's all well and good saying open the GP surgeries for longer hours and weekends etc, but until people actually start taking some responsibility for themselves and using their common sense then they will just continue to be clogged up.

We see it on here all the time when people are rushing to GPs and A&E for minor ailments that good be dealt with by the pharmacy, or by just waiting to see how the ill person is the next day. People actually have to consider the impact of their actions.

I work at the other end of the hospital 'process' - on a ward for people who are difficult to discharge for many different, complex reasons.

My hospital has been on 'black alert' since before Christmas and I thought I'd add my tuppence-worth!

As already said many times: ageing population. People living longer with chronic conditions.
Relatives live further away, and if they don't, can't or won't assist with the care of their relative.
Reductions in social care funding - not just homecare, but occupational therapy as well. Even small pieces of equipment/minor adaptations can make a big difference to someone's independence and ability to cope at home.
Care homes. They are all privatised now (please someone correct me if I'm wrong, do any local authority homes exist any more?) and in my experience, 'cherry pick' the 'least troublesome' patients, leaving the ones who are hoisted, have dementia or behavioural problems or more complex needs, to sit in an NHS acute bed until someone will take them. And that's if the family will agree to the placement...
People with dual diagnosis eg a mental health problem and physical condition such as MS. Where do they go if they're not getting the right support to stay at home?
I could go on about this all day, but a start would be funding social care and the NHS from the same pot.
Local authorities always make cuts to social care first as vulnerable people are easier to target.

jarofpickles, does that appointment system mean that patients can't make advance appointments? I have a couple of friends who have surgeries with that system and while it is good for patients with one off ailments that just need to see a GP that day, it can be a PITA for people like me with long term conditions. If I book routine appointments a week or two in advance I can get a choice of times and organise it round work. If I have to phone up on the same day I have to go with what's available, possibly having to take a day, or half a day off work, or refuse an appointment and phone every day until they have one at a suitable time., which seems a massive waste of everyone's time.

Ours do both, plus drop in after am surgery which seems to work well.

I honestly didn't realise we had black alert, Fred. I thought red was as far as it went. Something new I'd rather not have learnt last week.

Figures I was reading yesterday show 7% increase in numbers going to A&E and 31% increase in bed days lost to bed blocking from last year. I think the first figure would be difficult but manageable if it wasn't for the second.

Unfortunately so Rafals, our hospital occasionally dips into Red Alert, but seems to be in Black Alert, emergency measures most of the time.

I'm not sure I'm overly keen on this feeling of working flat out and still feeling like you're going backwards. Every time you think you've got a grip on it there's another avalanche of stuff and you end up with more than you started with. We'll get there but it's hugely frustrating.

want what about making the jobs in the NHS more attractive instead?
Because you know what, with a system like the one you are proposing, no one will ever want to become a doctor. And the only you will get are the ones that shouldn't never become doctors in the first place, either by temperament or because of abilities.
Not really the way to go to get better healthcare.

Fred completely agree to your list.
I toyld add to that the fact that politicians have managed to convince everyone that it's all the fault if the patients fir 'overusing' the system. The uk is the only country I know where patients hdvevtomd to self meducate

I strongly suspect that nothing had changed much recently, but that journalists have just noticed the over-stretched state of the NHS. Probably because their editor came back after Christmas, saw that it was an election year and pulled out the Big List Of Things To Talk About When People Are Voting.

Sorry pressed Post by mistake.

The uk is the only country where politicians have managed to convince people that it's all the fault if patients over using the services.
Where people are expected to start with self medication and to do their own diagnosis to evaluate if it's worth a trip to the GP or not.
Seeing that NHS leaflets are made with a 8yo in mind (anything else us considered too complex), I'm wondering how these people are also supposed to make the difference between a bad cold and a chest infection (example taken as I know a few nurses who considered they had a cold when they actually had pneumonia).
Or between D&V and a more serious condition. leaflets at our surgery are telling people NOT to come with D&V. The S&S they are giving as a green light to come are red flags (such as blood in the stools). Being medically minded I can see how you would make the difference between the D&V and a possible serious condition. But someone who isn't? There is no way they can.

CPtart just to pick up on your point regarding professionals allied to medicine clocking off at 5pm on a Friday. That has never been the case wrt to physiotherapy (well not in the 19 years that I have been a physio) as in hospitals there is 24/7 on all coverage for respiratory patients. Physios have always worked on the wards over weekends and bank holidays to see patients requiring assessment and treatment of respiratory problems.
In all the hospitals I have worked in over the years there has been orthopaedic cover over the weekends and bank holidays too.

In the hospital where I work now there is a respiratory team (on call for 24 hours), an orthopaedic team, and a team which targets patients who need to be seen in order to be discharged (ie stairs or walking aid assessment) or patients whose discharge would be delayed without recieving physio. This team also covers the stroke unit.

There is also 7 day cover from Occupational Therapy.

It is too easy and simplistic to just blame GPs. We have too many people and not enough GPs, the problem is capacity and resources are not sufficient to meet demand. I also wonder how much crap is referred to A&E from 111 these days, probably a lot. Cuts to social care and community services does't help either.

The telegraph article is a good one: www.telegraph.co.uk/news/nhs/11319627/AandE-in-crisis-a-special-report.html

You can see the majority of those people needed hospital care.

I would love to know much of NHS budget is spend on managers and bureaucracy. I suspect it would be possible to make large cuts in the agencies that manage/inspect the NHS without seeing any decline in patient care. It seems every party wants to re-organize the top level structures without ever dealing with the issue of training more healthcare professionals and making the working conditions acceptable in order to retain them.

I don't if this has already been said but let's not forget that A&E is a massive victim of it's own success.

The best known single point of access in the world, 365 days a year 24 hours a day 7 days a week access to specialists who will see you within 4 hours.

Why would anybody go anywhere else?

I just don't get people with flu going to A&E. Unless they are very old or have a chronic condition, the average person with real flu feels far too ill to move one centimetre, let alone all the way to hospital.

I agree about the ageing population. Cottage hospitals simply have to be brought back. Why were they ever dispensed with? When fil was on a ward post hip replacement, every single person on the orthopaedic ward was over 80. Their needs were not purely medical and this was causing a lot of problems. They were classic bed-blockers. I was speaking with a nurse and she said that the problem was if they were discharged they'd be back in A&E two days later.

I also think a "gatekeeper" section consisting of a GP at all A&Es would be useful in weeding out people with non-A&E ailments.

Agree with Thereyouarepeter - if you go to the GP with chest pains the first diagnosis will be indigestion. If you go to A&E you'll get the full monty of checks.

Cottage hospitals haven't been dispensed with, certainly not where I live. I work in a 44 bed community hospital atm.

Darnitev- that's sounds like a massive improvement. I haven't worked on the wards since the early 1990's though when there was a very definite feeling of everyone bar doctors, nurses and porters abandoning ship come Friday afternoon and every three days before Christmas.