AIBU to think it's no wonder A&E are so pushed when other departments in hospitals are sending people the unnecessarily

[WastedWednesday]

I have NC'd due to some identifying info.

I have had some issues with one of my eyes since Sunday. Having googled my symptoms I suspected a corneal ulcer and as it was no better by Tuesday, I called my optician to make an appointment to check it out. I was lucky in that they offered me an appointment for the following day (yesterday). I get there and the optician looks in my eyes and yes, I have an ulcer. He tells me that he'll write a report and says I have to go to the eye department at the local hospital (with a warning there will be a long wait). He did say that he could make an urgent referral for me but that would delay things by a few days (?) and that he classed me as somewhere between urgent and emergency. So I buy 10yo DS a new book to keep him occupied, together with snacks and the like, and we had for the hospital.

When we arrive at the eye department, despite me telling them that my optician had sent me, and giving them his report, they told me I had to go to A&E and that they could only see me with an appointment. They did however say I may be sent back to them (!).

To cut a long story short, 2 hours and 30 minutes later I see the opthamologist for A&E who says she can't treat me and sends me down to the eye department (where I started).

Another 2 and a half hours later I get seen again. The Opthamologist gives me drops and says I have to return on Friday to check how it's doing. I ask if I can get an appointment for that and he says that's not the way it works, and that I have to do what I did yesterday which is go through A&E.

To me it just seems ridiculous given I know that I'm going, they've asked me to go, but yet I have to sit in A&E, taking up space and adding additional waiting time to someone else's discomfort only to end up back where we all know I'm going to be.

AIBU to think I should be able to skip going to A&E tomorrow and be able to go straight to the eye department and start my wait there?

What a bloody faff you should be able to go stra7ght to the eye clinic tomorrow and by pass A & E though becaise you have been seen there already doesnt make sense. I guess if thats what you have to do then thats what you do seems pointless hopefully A&E will just send you to the eye clinic

As much as I'd love that, I doubt it will happen MrsJayy. Obviously A&E have their own procedures in that the triage nurse will allocate me to their A&E optometrist and it'll be the wait to see her/him before he/she sends me back to the eye department. I plan on going early in the hope that there won't be too much of a backlog. It just seems such a stupid waste of their resources.

YANBU I wonder if this is an issue with middle management who (may not) be medically trained but are running it as if A&E are always the 1st point of contact - like customer service?

What a ridiculous way to run an efficient hospital. I'd love to know the rationale behind such procedures...

our local hospital has a separate eye A&E, although you need to know it's there,and have to phone them directly to make an appointment (or go via an optician who makes the appointment). Means you don't clog up actual A&E, which is useful especially since A&E managed not to spot DD1s iritis

Yeah it is such a waste i just remembered when dd broke her foot after going through a &e sent to fracture clinic we had to go back to A&E for her second appointment to be sent to the fracture clinic must be a ridiculous admin thing.

That's interesting My visions .. I wonder if it would be worthwhile giving them a call before hand to see if I can do similar?

You are right however Gatehouse in that it almost seems A&E are used as a filter in that they can sort who they can sort to save the eye department.

That does sound crappy

Larger hospitals have an emergency eye clinic for these situations that you can go straight to. Is it a small DGH?

Sometimes NHS bureaucracy is pathetic. MIL broke her arm whilst staying with us at Christmas. Our hospital put a temporary cast on and said she'd need follow up in fracture clinic but apparently it was impossible for our hospital to talk to hers to book her in. The only solution was for her to sit in A&E all day and rehash everything all over again just to be booked into the fracture clinic there.

You are so right about this. I hate it when clinics send pts to A&E

I wonder if this is an issue with middle management who (may not) be medically trained but are running it as if A&E are always the 1st point of contact

that doesn't make sense because of the 4 hour targets, the 4 hour target is a huge major big deal to the entire hospital. They should be desperate to keep people out of A&E. Sorry I don't understand what is going on, just that treating A&E as first point of customer service would be spectacularly bad planning and very risky.

I had a similar situation with a tooth absess. Saw a dentist through dentaline as out of hours, they immediately said it was too swollen for them to put anaesthetic in to remove so would have to go to hospital to have it sorted at the maxilo facial dept. Dentist wasn't allowed to refer me directly though, it had to be done through A and E. Had to wait five hours in A and E as it was manic, during which time I developed septicaemia and had to stay in hospital for a week.

It just seemed such an arse about tit way to do things and created more work for everyone (and a lot of pain and illness for me).

Oh my god that sounds horrific 5 hours then septicemia poor you

Mamadoc no this is the main County hospital.

Your poor MIL and Anne that sounds horrific. It really doesn't make much sense does it.

It's just ridiculous.

When DS was a week old he had lost a fair bit of weight & wasn't feeding well. The health visitor said we should go to see the infant feeding specialist at the large county hospital. In order to get access to her we had to go via A&E. So we had to go through A&E triage and sit there for 3 hours with a very grumpy newborn (& us all being very tired and me still recovering from the birth, plus there was nowhere free for me to try & feed him), just to see the non-Accident and non-Emergency person we needed to see. Same as your situation, absolutely ridiculous waste of everyone's time and resources.

If I were you I'd call whatever clinics I could call at the hospital to try & get seen by ophthalmology directly, don't hold out much hope though!

omg, I just figured out why this would happen.

If "they" channel an extra 100 people thru A&E, during (usually) relatively not busy times (when avg waits are already below 3 hrs) that might increase their "within 4 hrs" statistic, e.g. from 96.3% to 96.5% seen within 4 hrs. Small fractions can nudge them into the target zone. It's genius. And completely perverse.

4 hour target needs badly to be abolished.

Has one person on this thread who was sent to A&E when it made no sense, sent there outside of 6am-4pm hours?

You could maybe make a complaint about it to PALS if you have the time and energy. From personal experience of working within the NHS, nothing changes unless people complain, unfortunately. Hope your eye is getting better