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.

[PrivateFrazer]

We had to wait over three hours with my head cut open to the bone . Ambulance men were fab and tried to insist we went straight in but no we had to wait
Eventually seen when we told the receptionist . No pain killers offered , no scan
So I don't think it's a wind up
Staff were great but overstretched clearly

[BursarsFrogs]

I agree that it's better to be upfront about long waits etc.

In my most recent A&E experience they dealt with the most pressing issue quite fast, but then wanted me to wait to see a specialist. I was told it would be no wait at all, then that I was the next in line to see them, then that it would be any minute now etc. No one's fault really - he had a more serious case than mine to deal with I think, and that just can't be helped, and I wasn't in any immediate danger anyway. But had I known it would be an eight hour wait, I'd have got DH there with some water at least, and tried to make myself comfortable for the wait (also lying across some chairs in a "cupboard"). Not that that's the most important thing, but hey.

[tilder]

Am sorry you had a bad experience. I hope all is well now.

FWIW I agree with previous posters. If beds are full, people can't be moved to where they need to be.

Am not defending what happened but would say no system is 100% perfect. Just when things don't work properly in the NHS the consequences are more serious than in most systems.

And Jeremy Hunt was considering putting himself forward for PM. When he has been steadily destroying the NHS.

[Sallystyle]

I did a night shift in A&E last night and it was very quiet.

One patient needed to go to the ward, it took 4 hours for a bed to become available. We have an area where people go when they are waiting to go to the ward or waiting for meds before going home, however if that is full they have to stay in the main bay. In my limited experience it is defiantly the other end that causes the main issues with A&E.

Recently men and women were being mixed on acute medical wards because that was the only way to move them from A&E.

Even on a quiet night like last night it still took hours for beds to become available.

One patient on a surgical ward with dementia- took 3 months to find that medically fit patient a care home that would take them. Three bloody months. Then there are the patients who turn up because they desperately need to see a psych and don't know how else to see one because services have been cut left right and centre.

It's all a mess but the staff in 'my' A&E are fantastic and we do the best with what we have, but I honestly can't see how our NHS can carry on like this much longer.

I hope your DD feels better soon

[expatinscotland]

'Why on earth would a qualified NHS medic tell someone to do that? They would know there are no emergency private facilities.

Unless the OP happens to live very near a private emergency facility?'

This.

[lougle]

It is all more complicated than it seems. For each patient there doesn't need to just be a bed, but a bed in the right speciality, for the right sex. So imagine you have 3 beds available: one respiratory medicine bed in a male bay, one surgical bed in a female bay, one gastrointestinal surgery bed that is male. If you then get a woman with breathing difficulties, you don't have a bed: wrong sex. A man with a complex fracture that needs surgery? You don't have a bed: wrong sex. A woman with a suspected blood clot? You don't have a bed. You need a medical bed not a surgical bed. Hospitals get fined now for 'mixed sex breaches'.

[notgettingyounger]

Thanks to all the posters - I did check for replies for about 30 mins then went out as I thought my OP had sunk like a stone or failed to post.

I am saddened to find our experience is not unique. I did think about complaining to PALS but I'm not 100% convinced that anything would come of that. I would not complain about individual members of staff as they all seemed to be rushed off their feet - it's the system that seems so broken. We do have a private hospital nearby with Urgent Care but my DD was Emergency and not Urgent Care so I am sure they would have sent her straight back to A&E, and also AFAIK it would not have been open at 6.30am and it wouldn't occur to me to go to a private hospital in the first place! Perhaps next time I should call an ambulance rather than drive to hospital if a member of the family is very ill (fingers crossed it never happens again) as perhaps you can't be shifted off the ambulance trolley until there is another flat surface to be shifted onto IYSWIM. I will maybe write to my MP. I doubt there is any quick fix available as really I expect it would take the building of a new hospital. It's frightening though. I always thought I could rely on A&E in a real emergency. Now I don't. I don't really want to name the hospital as I don't think it is the fault of anyone there but it is in a poor part of London so maybe that makes them extra stretched. One of the nurses was in floods of tears, and, like I said, the nurse that saw my DD said his shift had finished over an hour before.

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.

[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

[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.

[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]

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.

[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

[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

[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.

[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.

[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

[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.

[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.

[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).

[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...

[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

[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.

[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

[giraffesCantReachTheirToes]

awful

[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.