To think the a&e crisis is largely our own doing

[Diemme]

So much on the news at the moment about unacceptable waiting times in a&e departments. And it always makes me think about the few times I've been to a&e in the past few years, and noticed that the waiting room resembled a social club! Full of people eating, drinking, chatting and walking to and from the toilet, vending machine etc. Aibu to think that educating the public to stop inappropriate a&e attendances would come pretty close to sorting the problem?

[DailyFail1]

shovetheholly Not sure how it works elsewhere but locally if you have broken limbs you go to the fracture clinic directly for an assessment (not A&E)

[DailyFail1]

Lljkk - but a bead in the nose would he life/death if it slipped. Not sure what your point is

[shovetheholly]

It's called Accident AND Emergency. Surely if it was life or death only, it would just be 'emergency'?



I do agree that people need to exercise a little common sense, though, and not go to A&E with a mild cold. I think sometimes people very genuinely don't understand that hospital and GP surgeries deal with different things (this can be a cultural thing).

[KittenDixon]

Can't say I'm surprised Jeremy Hunt's GP was unavailable BelieveItOrNot

[randomsabreuse]

Thing is something sharp/scratchy in eye needs relatively specialised kit and if dealt with quickly needs cheap/OTC ointments/drops. If left even overnight yoy have a much bigger problem needing much more expensive treatment.

Likewise dirty cuts in the region of sensitive structures - flushed quickly before infection sets in, relatively cheap to treat, ignored until infected and potential of lifetime disablement.

The issue is there is no provision between "life and death" and "just needs a script/referred in a week or so".

MIU which doesn't have x-ray isn't much use for orthopaedic things, obviously very useful if they do though!

[user1470997562]

I think people go because they need medical treatment and can't access it elsewhere.

Particularly out of hours in our area, are quite willing to leave someone in agonising pain and sometimes dangerous situations if they've estimated over the phone that they're not imminently dying.

When you have a relative in that situation, it's very hard to just wait four days until they've got an emergency GP appointment.

If you have a chronic illness or a relative does, I think you are in no doubt why A&E is overloaded.

[Heatherbell1978]

I agree OP. My ex bf was a bit of an attention seeker (wouldn't go as far to say hypochondriac) and insisted he go to a&e when he caught a bout of food poisoning. We had a huge argument about it with me telling him just to go to bed, eat dry toast and drink plenty water but nope, at 1am on a Sat morning we ended up in a&e. 3 hours later, guess what we were advised by a doctor...yep. And he was a pretty bright person who should have known better so I imagine there are thousands of people who know less better who end up in a&e.

[lovelearning]

Experts from the Royal College of Emergency Medicine say that removing time wasters will do nothing to alleviate the pressure the NHS is under

The NHS is buckling under weight of numbers

'Rising population causing strain on services'

A&E is overloaded

People who can't get a GP appointment are going to A&E

The NHS cannot cope with the current population

And yet we continue to welcome new arrivals

Given the circumstances, immigration is indefensible

[ExplodedCloud]

My GP was an immigrant. She was great. She's retired early due to stress.
There are four GPs in the practice. Two of whom are first or second generation immigrants.

[lovelearning]

My GP was an immigrant

So am I

[stopfuckingshoutingatme]

YABU

people only go to A&E because they cant get help elsewhere, I don't think people go for the craic!

see the other thread, the NHS in very simple terms needs more money, some costs need to be analysed, and some degree of re-organisation too (its need a lot but a massive re-org would take up so much time its easier to address the low hanging fruit)

[stopfuckingshoutingatme]

I do wish we could give pharmacists more dispensing powers too - that would massively help

[Gileswithachainsaw]

Well without immigrants wed be minus very very many highly trained medical staff no doubt...

The immigrants have to live somewhere. That somewhere is a house. That house just as easily could have belonged to someone else. That someone else would still need medical care at some point.

[OllyBJolly]

And yet we continue to welcome new arrivals

Given the circumstances, immigration is indefensible

The NHS would collapse immediately without immigrant workers. We have to challenge the mantra that immigration causes all our problems and start tackling the real issue which is chronic underfunding.

[ExplodedCloud]

I dont care whether you are or not. Unless you're a HCP it's not relevant to your statement that 'immigration is indefensible' in relation to the NHS.

[DailyFail1]

The problem isn't immigration. The problem is that trusts are often unwilling or unable to recoup costs from people who should be paying. I work for a bank and as part as one of their charitable programmes they wanted to give away chip and pin services to local nhs trusts - only one ever accepted and that place is now the only one running a profit.

[shovetheholly]

A lack of resources has nothing to do with immigration. It has to do with a lack of resources. Which means people not putting enough money and personnel and kit where they are needed. More money, a lot more money, is needed.

[BigChocFrenzy]

I live in Germany.
When I phone my GP surgery in the morning I always see them that day, normally my own GP unless they are on vacation.
The A&E also has prompt efficient service, because they have the staff & facilities to cope.

The health service here is brilliant.
I pay higher taxes in Germany to get much better public services. German voters always made that choice. I fully agree with this.

The UK chooses to invest a lower % of GDP in heath than other comparably developed countries.
If you choose lower taxes, then of course you get lower & lower standards of public services, including health & social care.
Problems accumulate over the years, because you aren't paying enough even to maintain the lower standards you've got.
So, the nhs worsens and eventually will cease to be a functioning service. Those who can will buy private health insurance. Those who can't ... ?

EU immigrants are predominantly young & healthy, with many working in the nhs; even none-EU immigrants average younger than the native Brits.
So, blaming imigrants is just avoiding addressing the real nhs crisis (but politicians are delighted if you are distracted)

Much of the NHS resources are required for the elderly and this really ramps up for the very elderly.
This shows the annual spend (£) for the different age groups

[EssentialHummus]

EU immigrants are predominantly young & healthy, with many working in the nhs

This!

See here - "People aged 80+ have the highest rates of A&E
attendance. Year-on-year increases in rates did not
vary substantially between age groups."

NB - if you click on the link it will start downloading "Accident and Emergency Statistics:
Demand, Performance and Pressure" (House of Commons briefing paper, Nov 2016) - I apparently can't link in a different way.

[lovelearning]

More money, a lot more money, is needed

A humanitarian crisis is not solved overnight

Even with massive investment, it would take many years for the NHS to catch up

The crisis is being compounded by record levels of immigration

We are inviting people to leave their homes in other EU countries

"Come and live in a country that can't cater for your basic needs"

Given the circumstances, immigration is not only indefensible

It's immoral

[shovetheholly]

But we need population growth to sustain public revenues, don't we? A fall in the working age population would be disastrous at a time when people are living longer and requiring more complex care, because it's tax payers that fund the system.

So while a rising population puts pressure on the environment and services, it is also needed to sustain the tax base. So the question becomes how much tax is being paid (and by whom) doesn't it?

[TheNiffler]

Incredibly ignorant attitude lovelearning. I've spent a 5th of the past year in hospital, and have only seen two non British people as inpatients on my ward. One was American, so not from the EU, or a traditional country of migration. A&E is the same demographic, very, very few non British people. On the other hand, both the wards, and A&E are stuffed to the gills with elderly people, and it's often the same faces.

The NHS would fall apart at the seams without immigrant workers at every level. The only consultant I see who is British is my immunologist, the others are all foreign. Half my nurses are foreign, a substantial number of the other employees, like the cleaner, are foreign. Without them, there would be no NHS. We NEED them.

[EssentialHummus]

This is very much Shrodinger's Immigrant territory - we're a feckless, costly drain on society and simultaneously propping up the NHS.

[dannydyerismydad]

Our local GP surgery used to have 4 partners and a number of excellent salaried GPs.

It's now been taken over by a private company. They have a single salaried GP and a revolving door of locums. Repeat prescriptions take more than 3 weeks to process. They have no one to take bloods. People with long term conditions are struggling to get their regular drugs and tests. It's chaotic.

[corythatwas]

DailyFail1 Tue 10-Jan-17 10:24:26

"A&E should only be for life and death cases"

How do you define a life and death case? Is it a case where you might die on the spot, or a case where you are sent to A & E by your GP because he knows it is the only way to get you an urgent referral to check if you have a condition which might otherwise kill you whilst you are left languishing on the waiting list?

Does your panic attack trump my possible (though probably not) cancer?

And what are patients supposed to do about the fact that many walk-in clinics are not equipped to e.g. do x-rays or emergency ultra-sounds or take certain blood tests, so they will tell you to go to A & E? It's not as if they would magic up some other appointment if you told them you didn't want to go.