AIBU to be frustrated with the abuse of the NHS

[MrsFrankCastle]

www.wakefieldexpress.co.uk/health/nhs-asks-for-common-sense-after-woman-attends-pinderfields-hospital-a-e-with-broken-fingernail-1-9901334?fbclid=IwAR00MYep6y1lX4mHKqnRYCWIlamHiyfs4NMnS3WOAO4p6G_BLLoRVPM4Pdw

This case just highlights the issues we have with the NHS and being over worked. I love the NHS(I am a NHS worker) and thank god the people involved had the sense to turn this person away!

The Dr involved did say that people need to be re educated about the use of the NHS but how do we do this? Do we share stories of what we consider abuse of the NHS in the hope that other people read them and never make the same decisions?

www.wakefieldexpress.co.uk/health/nhs-asks-for-common-sense-after-woman-attends-pinderfields-hospital-a-e-with-broken-fingernail-1-9901334

Education, and access to appropriate services in a timely fashion.

You also need to separate the cases of abuse (people with irrational expectations), and people that genuinely don't know where else to go. There's a big issue with people going to A&E because they can't get GP appointments, referrals aren't happening in a reasonable time and so on. People get desperate.

And some people are just stupid, like the nail woman. I still wouldn't class that as abuse as she left as soon as she was told it was inappropriate, abuse would have been her kicking off or insisting on help that wasn't needed.

A broken false fingernail is clearly a piss take, assuming that the article is 100% correctly reported.

I did once have to attend A & E with what did eventually turn out to be just a damaged nail. I was a student at the time and went ice skating with my friends. I took a fall and the blade of someone else's skate ran right over my fingers, particularly the little one. It was messy. Cut and numb and we didn't know how bad for sure so the first aid team at the ice rink strongly recommended I went to A & E. So I did and was patched up.

It seems people can no longer use common sense.

And sometimes you don’t know. I collected my 16 year old from work on Wednesday to be met by the boss/First Aider and the boy bandaged up in a sling. Boss told me the cut was deep & needed stitches - minor injuries was closed. So we headed off to A&E - when we got there, DS absolutely refused to go in & as it was short staffed & likely to be a 3 hour wait, I let it go. At our local minor injuries the next morning, we waited 20 minutes & it didn’t need sutures - steri-stripped, iodined & bandaged. It would have been a waste of A&E time, but I didn’t know that, not having seen it. To be fair, I would probably have thought it needed sutures anyway ...

I'm aware that my incident above would now probably be for a minor injuries unit, but I don't think we had those back in the mid eighties and this was a Friday night.

I wouldn’t say this particular case is abuse, more ignorance or lack of education. Maybe she genuinely thought it could get infected or could cause some permanent damage?

There clearly is abuse going on - people who use ambulances as taxis (yes, stupid SIL of mine, I’m looking at you...), people who use hospitals as a bed for the night, but what can you do? If you provide a service to everyone like that, there will always be people who abuse it. And not just the NHS.

My mother is a midwife back in the U.K. and despite giving women a list of what they need to bring when they come to the hospital to have the baby, so many of them come with almost nothing. No clothes for the baby, no nappies, no bath things such as cotton wool or a towel for the baby, no sanitary pads, no toothbrush, etc. When my mum suggests to those who haven’t brought anything that their husband/boyfriend/whoever is with them might many to pop to the nearby 24-hour Tesco’s superstore they look at her like she’s hot 2 heads and say “I thought you provided all that”. They think it’s a hotel.

Is this partly a red herring?

The tiny number of people turning up at A+E with broken nails is hardly going to make a difference.

Yes, we need to stop abuse but when it comes to patients on trollies for hours on end it is not due to broken nails.

Not that we often use A&E, but I only very recently discovered that there is a walk in clinic in my town. It's not widely known and it's not well advertised.

GP appointments are like hen's teeth, two week wait usually, so that's hard to access. Probably in part because of twats like my SIL who is a ridiculous hypochondriac with a penchant for litigation, so has the GP at her beck and call.

But aye, abuse of A&E is an issue (my cousin is a consultant in a city A&E).

I think people who are drunk or on drugs and need treatment should be billed.

Maybe walk in centres and A&E should be in the same building? Then when someone sees the reception at one (hopefully staffed with a nurse) then they can direct the person to the correct place.

I agree with @gingerkittykat We need to be less concerned about one off stupid instances like this and more worried about health tourism where trusts have no way to claim back thousands from foreigners coming over and having expensive treatments.

23 million A&E attendances 2018-2019 of which 7.3 million needed advice and guidance and 2.1 million needed no treatment at all

Its cross referenced with tables from 2014-15-16
Page 12 -
researchbriefings.files.parliament.uk/documents/SN06964/SN06964.pdf

Table B summarises the most common recorded first treatments of those attending A&E. Of all valid records, almost 38% of attendances resulted in guidance or advice, and a further 11% resulted in no treatment - totalling almost half of recorded attendees.

So 49% are time wasters

@HotChocolateLover more worried about health tourism where trusts have no way to claim back thousands from foreigners coming over and having expensive treatments.

This is a bit of a myth, people cant just rock up and demand eg drugs or an operation; there has always been a budget for trauma eg road accidents or spontaneous labour. Largely its right wing propaganda - British people abroad cost the government TWICE as much as externals cost the NHS

According to the Department of Health some of the biggest culprits are British expats who live abroad but come back and use their old GP when they no longer live in the UK.

www.channel4.com/news/factcheck/factcheck-health-tourism-cost-nhs-billions

You can’t deem the 38% who needed advice and guidance as time wasters without knowing what other facilities were available to them.

Here at the weekend there is no out of hours GP service and there is no minor injuries. So technically a&e may not be the right place for people, but there’s absolutely nowhere else.

I took my toddler to a&e last night - she had a fever, was a bit lethargic and then came out in a weird rash that spread really quickly. After being checked over she was fine and they gave me ‘advice and guidance’ what to keep an eye on, but I don’t believe I wasted their time at all, and neither do that.

gingerkitty'makes a good point. In fact where we are there is no A&E and the one we have to use in an emergency is the only one for miles so has to cover a large area and population.
One of the A&E consultants actually came out and gave a sort of press conference last winter saying that although the time wasters (e.g. Nail woman) were a pain, they could be sent away.
He pointed out it was the huge amount of very poorly people they didn't have the room to admit but requiring urgent treatment that try struggle with. And that lack of space (it's an old hospital that's just been added to over the years) and facilities it's what causing the issues and that the govt etc needed to sort the problems out by providing more, bigger and better equipped hospitals.
This hospital runs at full capacity all year and it's dangerous and people are dying as a result. It's scary
(Not to diminish the impact of time wasters, but there are a lots of issues)

People do not seem to take the time to read the information provided or they think they need to bypass it. It is a bit of both. People are also often looking for a quick solution. People do not want to wait. I say this with over 20 years NHS experience and it is more and more evident in recent years as NHS services seem to get tighter with resources - but also better in other areas who are open longer hours, better technology and services where everything is all under one roof are especially popular as they are time saving

I managed a walk in service and despite posters, leaflet, online info people would still ‘try their luck’ at attending with conditions we could not treat, get cross with you for saying no or redirecting them to another service. Some conditions were exempt for a good reason of patient safety but they would still argue with you to make an exception for them, when you aren’t clinically able to!

People also use the NHS at their convenience - they want to be seen during school hours so it doesn’t interfere with school pick up times and I had one woman who on telling there was a long wait to be seen went shopping and sauntered back in with 4 carrier bags from clothes shops. Lots of people saw the walk in as a check up on something annoying rather than perhaps googling ‘why is my foot sore when I walk’ and reading about plantar fasciitis they want an X-ray of their foot, some crutches and signed off work. The number of people who attend A&E with an 8+ week old sore knee, no visible injury or history of injury and think it’s better than going to the GP because someone will give them an answer NOW and not have to get an X-ray form and exam from GP, wait for results when it’s entirely possible they may have arthritis are clogging up the system like mad

I’ve also had people very upset and angry at waiting list times of a few weeks for things like MRI which I understand they are anxious, but it’s not likely that radiology have a surplus of MRI slots (which are long and depend on how many machines they have) and unless it’s extremely urgent, you may have to wait a couple of weeks so then suddenly they want to pay for their own when they realise that it isn’t a quick way in. It’s not going to be I don’t know why people would assume that

We thought DD had a broken leg, as she was acting the same way she had when her leg had broken previously. We were sent away with advice and guidance. Should we not have gone?

Same when she fell and had potentially broken her wrist. NHS 24 told us to take her for an x-ray.

Also employers are not always reasonable and so people don’t want to take the time off for seeing gp etc.

People want sick notes because otherwise their employer will not accept they have legitimately become ill. I know sickies cost employers money but they also cost healthcare workers time (which is money). In an under-resources nhs, we do need to consider how we prioritise resources and whether we need to vote in a govt who will not under fund.

If people were billed for their own stupidity.. drugs/alcohol and rocking up with a broken finger nail... it’d be half dead in our local a&e over the weekend. I sat just over a week pp with a suspected clot in my lung from midnight until 5pm, our local doesn’t admit if they don’t have a bed so I sat in the hall with an ambulance driver checking me until 5am.. when I was actually put into a&e. I sat n watched only two other people in the whole building were sober/hadn’t been in a fight and those two were from nursing homes.

And don’t get me started on how it went from there, 12hours sobbing on a hard plastic seat with no pain killers (prescription at home obviously) with a third degree tear asking for a cup as I was massively engorged never got it.. total lack of common sense with more porters than anything.

"I think people who are drunk or on drugs and need treatment should be billed." Why? Genuine question

Alcohol is legal, addiction is not as simple as personal choice (though it's certainly a factor)

You start down that road - of denying treatment because of "irresponsible behaviours" and health issues being "self inflicted" there are VERY few ailments that DON'T have a behavioural factor.

Are you perfect? Never smoke, drink, take recreational drugs, overeat, drink caffeine, never use mechanised transport OR cross a road without paying full attention, live in an area with pollution, exercise regularly (and no sports injuries), only eat healthy foods EVER, not on hormonal contraception, never have unprotected sex, don't use items that can cause illness or injury? Etc etc...

I highly doubt it!

Yes we need common sense applied and education for the less knowledgeable.

We also need more GP's AND practice nurses and other primary care hcps so there's more appointments available, more minor injury and walk in units (neither of those where I live and even a&e is on restricted hours).

A significant number of people going to a&e in certain areas are doing so as they're struggling to access primary care - homeless people need to be helped to access primary care too.

I don't believe time wasters and health tourists are the major issues claimed by right wing propaganda.

The main problem with such services being overwhelmed is lack of funding and support - not only directly but also in dealing with the "overflow" of underfunded and under supported primary care - and I truly believe that's deliberate, to make us think a privatised USA style healthcare system would be preferable.

We also need employers and schools stopping this crap of insisting on sick notes every time someone has a day off! Now they SHOULD be charged for wasting Nhs resources!

I think the OP and many other MN people just bang on about this to give themselves a virtue signal pat on the back. The fact is that the NHS is not on its knees because of its users, it is because of a chronic lack of funding combined with generations of incompetent management and poor decisions on procurement, supply chain etc. The people who make me sick are the ones who harp on about how flgreat the NHS is - currently it is not. It is killing people who access it in good faith. There is practically no mental healthcare left and the buildings are often unsafe and unsanitary. The NHS is a great idea and will hopefully one day be a great source of national pride but dictating how others use it for your own feel good reasons isn't going to help, any more than avoiding bothering people when you are entitled to care which some of you also seem to think is ok.

The systematic destruction of the NHS is ideological. The slow creep of privatisation is already present, and it really is wonderfully convenient to push the official blame on regular folk 'abusing' the NHS

No one is getting a sick note from A&E you self cert for 7 days and either your employer
Prints you one off or you get it from gov.uk website. Do people not know this? This is part of the problem!

It’s using the right care. The NHS is constantly campaigning for people to use services correctly so this is not me virtue signalling to anyone. There are endless campaigns explaining to people where to go, and for what

People still don’t seem to use pharmacists in the way they should do - they will go to minor injuries and A&E for bites sprains and stings without even bothering. Last summer we really tried to crack down on this because the waiting times were horrendous and not one person went to the chemist 100 yards away before coming to the walk in centre

every presentation to A&E and minor injuries is costed per patient per presentation. It makes perfect financial sense that someone going to A&E when they should not be there is a wasted patient cost. If this cost is £100 per patient for an attendance, and £70 per attendance in minor injuries but a pharmacist wouldn’t be a cost to the NHS why do you think they would prefer people to take that route first?

NHS services are now recruiting clinical pharmacists to take some of the burden of prescribing, patients are also encouraged to self care (like taking own blood pressure) to reduce needing to see a GP for a medication review.

NHS choices have developed their symptom checker and many GP surgeries will be using some form of e-consult to triage their patients. If this was a case of a few patients turning up in the wrong location I don’t know why they would be spending all this money on A&E clinical navigators either, or social prescribers! It is required. Many A&E departments now have to have a GP service because patients turn up with GP related issues, not an accident or an emergency. An 8 week old sore knee is not an emergency either

The lack of funding in mental health and social care is putting the burden into the NHS alongside people not wanting to manage their own health needs and self care and inappropriate attendances. As part of my job I see stats and figures as to how many A&E attendances result in admission and it is very low, we also work on targeting frequent attenders and trying to reduce their hospital presentations because it is so expensive when they use it as a walk in centre and not their GP

More appointments is not always the answer, because the more GP appointments you have the more this will result in referrals and tests being requested and the burden on acute services continues to increase. I work with GP’s and this week due to nice weather we had a huge surplus of GP appointments we couldn’t fill because people do not want healthcare when it is nice outside. Winter is usually horrendous with summer very quiet. But we can’t just employ GP’s in the winter time it doesn’t work that way

The answers are:
Fund mental health services properly
Fund social care properly
Educate/navigate people to other services
Redefine GP services and how they operate ie using advanced nurse practitioners and pharmacists and paramedics
More urgent care centres and access to specific minor illness appointments
Better joined up care for people with long term conditions
Better drug and alcohol services. Some places people have to travel 20 miles to see someone which is stupid

Of all valid records, almost 38% of attendances resulted in guidance or advice, and a further 11% resulted in no treatment - totalling almost half of recorded attendees.

So 49% are time wasters

I don't think that's valid. DF was discharged from A&E with no treatment despite having had ambulance called on instructions of GP. So was the GP time-wasting?

If we were all medically trained, we would be able to look at our symptoms and make the decision re A&E. But we're not. So we either go to A&E if we're really worried and don't know what to do, or we dial 111 (who will probably tell us to go to A&E).

WAs just coming on to say what Graphista did. Employers and schools dont get mentioned as often on these threads I wonder why

I wonder how many ambulances had to attend Amazon warehouses this week.

www.vice.com/en_uk/article/7xm4dy/ambulances-were-called-to-amazon-warehouses-600-times-in-three-years

"I work with GP’s and this week due to nice weather we had a huge surplus of GP appointments we couldn’t fill because people do not want healthcare when it is nice outside"

Or dont want to sit waiting in a building where it doesnt drop below 34 degrees.