NHS A&E department telling us to leave and go private????

[notgettingyounger]

I went to my local London A&E with DD, 19yo, on Monday. She was triaged as an "emergency" rather than "urgent care" and told a cubicle and bed would be found. The nurse then returned and said she wasn't trying to kick us out but not only were there no spare cubicles in "Emergencies", but there were no staff whatsoever who would be able to see DD within the necessary time-frame so she strongly suggested we go somewhere privately instead.

I said I didn't know how to even go private for an emergency, let alone how I would get to another hospital in the London morning rush-hour with a very ill young woman in such severe pain that she couldn't even walk - I asked if they would provide an ambulance to blue-light her somewhere suitable but the staff said no whilst at the same time telling me that DD was seriously sick and yet could not be seen owing to a shortage of doctors.

I don't blame the triage nurse, who I think was genuinely trying to help us get medical care ASAP, but AIBU to be shocked to be told basically to go away and find private care when turning up at A&E with a woman triaged as an emergency? Is the NHS actually broken? I shudder to think what DD would have gone through had I not been there as her advocate. In any case, I am not sure that there are private hospitals that deal with acute admissions, are there???

Incidentally, after I conducted an audible telephone conversation with DH about how the NHS hospital was asking if we could go anywhere private as they had no staff who could see her even though she urgently needed to be treated, DD was immediately seen by the Staff Nurse in Charge (who should have just finished his shift so bless him) who at least gave DD some much needed IV pain relief and a saline drip, but she was still left to lie uncomfortably across two metal chairs designed for visitors, whilst attached to her drip, as there were still no cubicles and, presumably, not a trolley in the whole hospital.

7 hours later, we finally saw a doctor who immediately admitted DD, put her on IV antibiotics and listed her for an emergency operation first thing in the morning, so we were hardly the worried well - actually, just one look at DD would have confirmed that.

Has this happened to anyone else? Is there a diktat to NHS staff that people who seem wealthy (I am well spoken and well dressed which is the only thing I can put this down to) should be redirected to private hospitals at busy times?

NB I have n/c to protect my DD's confidentiality.

[MrsGradyOldLady]

I haven't actually been told by anyone within the NHS to go private but after my 8 year old daughter was referred as "urgent" to see a paediatric gastro consultant a couple of weeks ago and we were given a date in September we chose to go private. We've now got an appointment on Tuesday. We've since taken out private medical but it won't cover this as it's pretty existing. We'll have to tighten our belts - especially if she needs an operation but I do think the NHS is far too overstretched. And I'm not prepared to gamble with my daughters health.

We also got her bloods done privately which cost £500. We got in the next day privately but it was a 5 week wait on the NHS.

My daughter is sick every single day and has stomach pain most days. No medication has worked so far and her school attendance is now below 80%. Poor thing has to sit at her desk with a sick bucket next to her.

[notgettingyounger]

70 yes, that was my thinking. I felt it would be far too dangerous to leave.

Sigh, I might contact the Governors at the Trust, or the Chair, to be sure that they are aware. Not North Middlesex.

[70isaLimitNotaTarget]

within the neccesary time frame

this'll be the 4 hour slot.

"No. I'll wait. I'm here in the A&E. Keep a check on DD and keep asessing her.If she worsens, I'd rather be here than in a taxi on the way to another site As with all triaging the Emergencies will take priority so she will be seen"
Really horrendous situation and sadly, the shape of things to come

[ArgyMargy]

I've re-read your OP and other posts. I agree you should make a complaint but purely about the "go private" comment from that particular nurse. No-one else appears to have acted inappropriately and unfortunately there is little point in complaining that A&E departments are busy and understaffed. However what the nurse said to you is completely unacceptable and if nothing else she should be reprimanded. If you had tried to follow her advice there could have been serious consequences. Present the facts rather than being outraged about waiting times etc.

[snowgirl29]

I would definetly complain OP. Complains aren't just about airing grievances. They're about raising concerns. I completely understand nhs I understaffed and overworked - had experience myself in April - JD was going to send me home in the middle of a full blown asthma attack - balshy nurse came swishing round the corner and refused to discharge me until I was seen by someone else. Admitted and transferred straight away, thankfully too as I became desperately ill that same night and was only seconds away from help as opposed to minutes. Was quite scary!

The NHS ethos is free at the point of care and I don't think they should be advising patients to go private.

[MyLlamasGoneBananas]

I read a rsthet disturbing srticle in our local paper a couple of months ago.
Some poor bloke by us had to wait in an ambulance parked outside of A&E for several hours (8 I think). He'd just come home after urgent life saving heart surgery and his famy had called an ambulance after he went grey sweaty and complained of chest pain.
Thankfully he survived his ordeal according to the local paper but was re-admitted eventually.

[Musicinthe00ssucks]

I'm really sorry to ask you a potentially identifying question but was this by any chance at North Middlesex Hospital? If so it has recently been in the news that they have been closing the A&E because of overcrowding and the fact that consultants and senior doctors think it is a risk to staff and patients.

I'm sorry this happened to you and your daughter and wish your daughter a fast recovery

[Noodledoodledoo]

I agree with others its due a lot of the time to not being able to move people on from the other wards to get people out.

I was in Early Pregnancy unit/A&E for 9 hours before I was seen at the beginning of the year with suspected appendicitis - I wasn't in a lot of pain just discomfort. I was finally seen by a registrar around 9pm - who decided I was likely to need to be admitted but was unlikley to be admitted till about 3-4 in the morning, so suggested I went home for a good nights sleep and came back in at 8am!

I was finally admitted at 5pm the following day and put on the surgery list for that evening.

Things do seriously need to be looked at, and I think the biggest issue is the onward movement of patients who don't have care at home. Cottage hospitals seem to be a thing of the past, fading fast, I don't agree with a comment above about charging the patient - if they don't have anywhere to go with support what do you expect them to do. As well as people not resorting to a&e for minor issues.

[giraffesCantReachTheirToes]

awful

[Fedupd0tcom]

I think this has happened due to cuts caused by austerity measures put in place by the govt leading to nhs staffing shortages. Can't believe they told you to go private. Outrageous. X

[notgettingyounger]

Thanks everyone

Phoenix67 I absolutely know that Junior Doctors are rushed off their feet, and don't blame them at all. There is clearly something very wrong (and underfunded) about the system. I am pretty horrified to discover this is not an isolated incident. I do now actually feel like we have no emergency medicine service at times.

[youarenotkiddingme]

Glad to hear your DD was treated eventually. I wish her a speedy recovery.

The other month I rocked up with DS at 6am in a and e with a cracked open head.
Triaged and told peads a and e opens at 8am so we'd have a bit of a wait.

8am it opens, in we go. Only ones there. It was 8.45am when his head was eventually glued and 9 am when we left.

However in the hour I spent in peads cubicle I learnt a lot of hospital gossip

[underrugsswept]

This is terrible. I'm glad your DD is ok but what a scary experience to be surrounded by medical staff but no one about to help you. As well as complaining to the hospital I'd be writing to my MP. Worth a shot...

[Phoenix67]

I am a junior dr in A&E. Sorry to hear about your experience OP. I agree it's completely outrageous but something we doctors can't do much to improve. Other posters are correct in saying there's a complete blockage on the ward side of things. Once we make a decision to admit often there simply isn't a bed on the ward, which in turn blocks cubicles in A&E. I hate it, I've had to see patients in corridors on trolleys, which we all know is not appropriate but we have no choice over it.

Another issue is the understaffing of doctors rota's in A&E. There are 7 slots on my rota but only 4 doctors on it. This is due to a lack of doctors wanting to train in A&E as the specialty is so difficult from a social/family POV, it's not sustainable. This means often A&E departments rely on locum doctors to fill the slots, but if they're not filled then there's not enough doctors to see patients.

To answer your original question, YANBU in the sense that of your DD was seriously unwell, directing your DD to a private urgent care centre could have endangered her life. If you complain, perhaps that nurse could be re-trained re the local facilities available.

In terms of having to wait 7 hours etc, unfortunately it's becoming the new norm. The NHS is being deliberately under funded and stripped of facilities (look at the numerous A&E closures) by this Tory government. Write to your MP and hopefully if enough people do so, the programme of cuts might be reversed (wishful thinking I know).

[ChopsticksandChilliCrab]

In countries where you pay per day I bet there is little or no bed blocking. It would be interesting to see if there are any statistics on medically fit for discharge people staying in hospital per country.

[ChopsticksandChilliCrab]

A medically fit person stayed in hospital for ten weeks as there was nowhere for him to go? That this can happen is outrageous. What a waste of a hospital bed. If patients were charged hotel fees per day after they were fit for discharge that might focus minds on making the move happen. I know no everyone could afford to pay, but lots could.

[AdultingIsNotWhatIExpected]

My Llamas, we have them, they're called nursing homes or rehabilitation hospitals, do you know how much they cost per night? and how short of NH beds we are.

that's not going to be a solution any time soon

[MyLlamasGoneBananas]

My Grandmother used to talk about recuperation hospitals. Where people went after a hospital stay to recover.
Perhaps something like that would be a good go between. It could be run or staffed with Health Care Assistants rather than Dr's and senior nurses.
Everyone should complain to their MP when they experience the problems mentioned in this thread. It's the only way to keep getting it brought up and staying in the forefront of the government's minds.

[lougle]

It's chronic across the whole NHS. I work in ICU and in years gone by, if a patient went from a ward to ICU their bed space was reserved for them in the ward, so that as soon as they were fit for the ward again, they were moved from ICU to the ward. Now, the bed has to be released on the ward. So when the patient is fit for the ward, we have to wait for a suitable bed to become available (in the same queue for beds as the A&E patients waiting for beds) before they can be moved. We can have patients who have been 'wardable' for days on end while we wait for a suitable bed, and we even have patients who become so well while they wait for a ward bed that we discharge them home from ICU!

There really is just no give any more in the system. There are no buffers. We can have 4 discharges, 4 bedspace cleans, including 2 deep cleans, 3 admissions, all in the same shift and there will still be patients who need our care who we can't accommodate.

[AdultingIsNotWhatIExpected]

it might have been a male bay earlier on in the day, and then in order to fit in female beds because there were more females needing that speciality, the men moved where they could safely go, and it was being re-filled up with females, which is why there was a spare bed when your DD moved there (until the bloke in the morning, which they would NOT have done were beds not at a dire shortage as they will have to pay a fine for that). Three hours earlier the whole bay could have been filled with men and no female beds in the whole hospital!

An empty bed isn't as simple as = no problem with bed status

[AdultingIsNotWhatIExpected]

There was even a spare bed that night next to DD's on the ward, although admittedly the next day a man took it (despite it being a women's ward).

it might have been a male bay earlier on in the day, and then in order to fit in female beds because there were more females needing that speciality, the men moved where they could safely go, and it was being re-filled up with females, which is why there was a spare bed when your DD moved there (until the bloke in the morning, which they would NOT have done were beds not at a dire shortage as they will have to pay a fine for that). Three hours earlier the whole bay could have been filled with men!

An empty bed isn't as simple as = no problem with bed status

[notgettingyounger]

MrsDeVere I have just read the thread more carefully and have realised it was you who made the comment about struggling to believe the comment the nurse made about going private. :-( I have always thought you are one of the most sensible posters and I always value your comments. I can assure you it is true. I couldn't believe my ears either, hence the post! We are near a private hospital with Urgent Care but that would not cover this kind of case AFAIK. Maybe the nurse was unfamiliar with what private hospitals can/can't do in the UK (she was foreign), or maybe she had been told to try to reduce numbers waiting any way she could. I did suggest trying another London A&E but a) really couldn't fathom how I could get DD there in any sensible time frame in London traffic (by then about 7.15am) when she was not well enough to take trains and tubes and I have no idea how to get a private ambulance and b) other nurses listening in then told me that the waits would be just as long even though the triage nurse suggested that we would not have to wait at Tommy's. The nurse in charge of the Emergency Dept also said, once he looked at DD, that there was no way she was going anywhere else and he would not let someone that ill leave his department to go elsewhere (bless him again), but DD would never have seen him had I listened to the triage nurse.

[notgettingyounger]

Adulting ah, I didn't think of the traction in the number of complaints but now I can see your point. Thank you.

[notgettingyounger]

lougle there seemed to be no problem getting a bed on a ward - seeing a doctor in A&E appeared to be the log jam. There was even a spare bed that night next to DD's on the ward, although admittedly the next day a man took it (despite it being a women's ward).

I admire the conditions that I have now seen NHS staff work in. Thank you.

[AdultingIsNotWhatIExpected]

I did think about complaining to PALS but I'm not 100% convinced that anything would come of that.
If the hospital are trying to put pressure on the social services funding providers to get more people discharged, the more complaints they have the more it helps the hospitals arguement

I don't understand why, if A&E was so overstretched that they couldn't deal with emergencies, they didn't declare whatever it is that they declare when they are full to bursting so that cases get taken elsewhere.
probably because when one is, other hospitals are too