To think this might be why so many people end up in a&e when shouldn't

[wineoclockthanks]

And to wonder how common our situation is?

Spending Easter at my Dsis about 250 miles from our home. On Tuesday DS aged 9 fell and quite badly scrapped his bum on some wood in the garden. It bled quite badly and looked as if there might be some splinters or something in it. DSis phoned their GP for an appointment with either doctor or nurse and first one offered was April 13th! She was told to bring him to the walk in clinic instead.

We got him to the docs but when I explained he wasn't registered with them, we were told they wouldn't see him (despite the fact they could see how distressed and in pain he was).

They obviously just wanted rid of us and their suggestion was wait until we get home (6 days later) or a&e (there isn't a minor injuries unit nearby).

So we pitch up at a&e, triage nurse was initially a bit shirty as to why we were there with such a minor-ish injury but once I explained she said we weren't the first people she sees in our situation.

We had to wait nearly 6 hours (as DS obviously wasn't a priority) and the doctor and nurse that cleaned and dressed his wound were great .

Surely there should be some sort of reciprocal arrangement with GPs so that the a&es don't get clogged up?

YANBU. How ridiculous.

YANBU. My DD registered with a practice near the uni she goes to (6 hours away from home). When she's been ill during the holidays at home the practice near our home either won't see her or make it v difficult to do so because she is now registered somewhere else (even though technically her permanent residence is her home, not halls/student flat). Fortunately we have never had to go to A&E but I can see why lots of people would have to.

Yanbu. My dad woke up the other day with a burst ear. His doctor's said it was a 4 week wait to see a doctor, and a 2 week wait just to TALK to a doctor

I used to work at a practice in Devon, obvs lots of people on holiday and they just used to register as temporary patients, cannot understand why other GP practices don't do that?!

I thought the ability to register as a holiday patient was something all GPs did? How ridiculous if not!

I reluctantly ended up there with my 18 yo DS. He'd been seen at our local urgent care centre as we couldn't get a Dr's appointment and he was in too much pain to sit or lie down due to a cyst. Urgent care have him strong antibiotics and said he MUST be seen by a Dr in 48 hrs to check it was healing or he would need surgical excision. Rang the Dr's two days later (a Monday, had been seen Saturday) and told no appointments for over a week. Rang 111 for advice and were told we would have to go to A and E. Staff at A and E were rather surprised annoyed that we were there but accepted that we hadn't had a choice, I was really embarrassed to be there as was my DS!!

We had a similar situation with a friend's child visiting us on holiday. Fell off a pontoon and cracked their head/face as they fell.

Our the minor injury/walk in nurse at our surgery wouldn't see them as they weren't registered so we had to go to A&E.

The same weekend A&E had put out a plea that they were short staffed and please only attend if an emergency.

The wounds needed treating and we couldn't have left her until they got home (this happened on day 2 and they were staying a week) but it wasn't A&E worthy

Interesting - I had an ear infection this weekend that needed to be seen sooner (given that I have a cochlear implant in that ear) while I was away, and I popped into A&E and they made me an apt for the walk in doctor - no problems at all - perhaps it all depends where you are (I was in Chichester for the weekend)

YANBU. DS1 shut the front door yesterday afternoon on his bare foot and screamed like he'd been shot by an RPG. I phoned our GP to ask for advice as he'd skinned three toes, two quite badly. GP said they couldn't get him in and to go to A&E but that even if we went there they'd only strap them together. Our neighbour is an ICU nurse and I nipped over just to ask for her advice. She cleaned him up, strapped them up and said it would be an absolute waste of A&E time and resources to spend an evening there. But if we'd followed the GP's advice we'd have taken up valuable time there.

The surgery near where I grew up has become very sketchy about registering temporary patients in the last few years probably because they keep over=spending on their drug budget by 250k and pretend that they won't see you if you're not registered. It's only when you specifically ask whether it is no longer possible to register temporarily that they let you do so: so no, OP, I think this absolutely contributes to people going to A and E.

I don't have a solution: other than perhaps there should be some kind of financial incentive offered to med students who decide to become GPs, and the caps taken off student medical recruitment entirely - but this isn't at all my area, so I have no idea if it will work. I do know the practice I am talking about (like my own) struggles to recruit, so I would think this must exacerbate the problems and make doctors reluctant to see other practice's patients.

I had a very sore throat while on holiday. Drove about 15 miles to the nearest doctor, got there just before they opened. Exited the building about 10-15 minutes later, in that time they'd
(a) checked me in at reception as someone they'd never seen before, were not expecting (no appointment, not phoned ahead)
(b) receptionist who checked me in walked me to examination room, second receptionist immediately stepped up to counter to deal with next patient
(c) Doctor examined throat and took swab for "testing"
(d) After a few minutes returned, gave diagnosis, said what he was prescribing, told me how much it would cost at the pharmacy across the road, but said I could buy it at reception for the same price, which I chose to do.
(e) back to reception to pay and collect medicine

Overall cost was completely insignificant. Some tens of dollars. This was in Vermont in 1990. In my life have seen doctors in five countries, never seen such efficiency before, or since. (Though another doctor I also saw on a skiing trip, this time in Austria, did not take much longer to deal with a walk-in twisted knee. I think it was ten minutes waiting as a walk-in, followed by 10-15 minutes consultation.)

In comparison to this, large 6-GP UK practice that I am registered with routinely had waiting list of two weeks for patients, over a period 20 or so years. So presumably the NHS thought that kind of wait represented an acceptable level of service.

111 doesn't help with the amount of people going to a&E either. I once phoned up to ask for advice about my dd and they told me I had to take her to a&E within two hours. It was ridiculous and she didn't need a&e, I just needed advice, but I know from friends experience if 111 say your dc need to be seen and you don't go then you can end up with ss at the door even when it's clearly an overreaction.

Every area should have a minor injuries unit imo, I recently spent hours in a&e when ds had cut his head at school which the school thought may need stitches so off we went to waste half a day at a&e. He only needed steri-strips in the end but even stitches could have been done at minor injuries but there isn't one anywhere near where we are.

Yanbu - I had to take my DS to the Dr's because we couldn't get an appointment at the GP's and the walk in clinic is too far away, two hours and three buses.

They got annoyed with us at first. But after we explained the situation they were okay. It happens a lot I think.

Yanbu op, I was declined an appointment last week with my doctors because it wasn't an emergency, I couldn't have another appointment either, I could have screamed!

If it makes you feel any better, someone turned up to my local A&E with Dandruff!

YANBU. I had cystitis last week (been prone to it for 35 years). Tried Cystemme but it didn't work so popped to my usually brilliant GP surgery on Sat am as it's always been open then (obvs shut on Good Friday) to drop in a sample and get antibiotics. But it was shut. No notice on door etc. So I phoned as previously you'd be given the on call service number. Nope. Just a message to say 999 if very ill, 111 if not. So I tried pharmacist - can't prescribe. Next went to the local walk in centre - nurse led so no prescribers. They recommend a hospital GP walk in centre but it didn't exist. So I tried 111. It took 20 mins to even join the queue then another 20 on hold. Explained to a call handler; nurse called me back then said a GP would call. Finally got a prescription faxed to local pharmacy. Hurray.

But it took the best part of a day so I can understand why people think 'sod it' and go to A & E.

Biggest shock is that I had no idea GPs no longer opened on Sat and had done with local on call. It's going backwards not forwards re a 7 day NHS.

Ok rant over!

We are lucky. We have a walk in centre open 7 days a week early until late and OOH outside of that based next door to A&E. Have never failed to get an appt the same day.

What are the government expecting to happen if they shut minor clinics due to 'cuts '. They haven't properly fuinded trainee GP places for the last 10 years (at least) so now there's not enough doctors the decent ones are retiring/ leaving due to unrealistic workloads Which means you can't get an appointment when you need one ( we can't all drop work / commitments just like that). then The 111 staff seem to send everyone to a+e. Then we hear that a+e is overloaded with people with 'minor' injuries

It's crazy - need some joined up thinking somewhere

YABU in that you were trying to see a GP for a minor injury/walk-in/sort it out yourself at home problem. Can't you pull a splinter out?

The GP surgery likely doesn't see their own residents for this sort of issue - it isn't funded to hold open slots for minor injuries, the nurse workload is made up of asthma clinics, diabetes, elderly patients with dressings and so on.

YABU in thinking a reciprocal arrangement would work. Loads of temporary residents at holiday hotspots like Devon and Cornwall. Not so many in Sunderland and Doncaster though.

YANBU.

'Can't you pull a splinter out?'

Hmm, not if she cannot see them for bleeding or isn't trained to spot any imbedded in the skin

GP practices don't receive any funding for temporary resident patients. As many posters have pointed out, they are struggling to see their own patients at present (for whom they get about £75 per year guaranteed income...), let alone give appointments to temporary residents for whom they receive no income.

It is really frustrating, but sadly many GP practices are really struggling with rising workloads and a GP shortage. Their priority will be their registered patients, not visitors.

The walk-in by my parents had just shut. It was the only one in their city. Which leaves the (massively overstretched but wonderful) OOH Dr at evenings and weekends, or A&E. No minor injuries unit.

Having worked in the walk in centre and my flat mate working in A&E the amount of trival stuff people would attend for was unreal, stuff that could of waited for their GP to see them e.g period pains,colds,minor injuries,ear ache. If they had to pay more than half wouldn't attend people take advantage of the NHS and this is why staff are so overrun and overworked.

It must differ by area. My mother in law has taken my ds to her doctor in another county about 80 miles away twice with no problem. I once had to see a gp in my then boyfriends area and just had to fill in a form - again no problem. Yanbu at all.

The trouble is that we have a combination of people do not value things they don't pay for and people being afraid to use their common-sense after seeing stories of disasters in the media and consulting Dr Google. You have only to look at the threads on here where loads pile in saying "A&E now" when it is not appropriate at all or saying "demand an apt at the GP and don't move till they refer you"

GPs do a vast amount of work now that would have been done at hospitals in years gone by while the demands of the public have risen hugely (some quite rightly, often due to ageing population but some idiotic, for very minor ailments which could be solved at a pharmacy or at home) Don't even get me started on people who don't turn up. Our surgery wastes the equivalent of a full time GP every week on this despite texting, etc