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?

Biggest "abuser" of NHS emergency services is sadly, the government. I work in critical care, this year we have an unprecedented rise in people bring brought in following a suicide attempt. The story is always the same. Desperately trying to access mental health services, long wait or told not severe enough (to people with clearly very severe symptoms!), Then found overdosed or hanged.
Cue ICU admission ( £2000 per night for standard treatment, more if you require dialysis, surgery, scans). Untold emotional pain to patient and family.
Of those who survive, most STILL have to wait ages to see a MH professional. Some go home with no MH support- none available. Or a leaflet for "talking therapies"
Some bounce straight back. Some are left waiting in the horrible ICU environment for days as they are under a section but there are no beds in PICU. for those of you who have been to an ICU, it's noisy, busy, occasionally chaotic environment with little in the way of privacy or comfort ( no patient showers or toilets on my unit)totally unsuitable for someone who is mentally ill, maybe hallucinating or hearing voices. None of the nurses or doctors are trained in psychiatry. We do have a liaison team but they are so stretched and hard to get hold of.
My city has seen a 30% cut to acute MH beds, also cuts to community services- don't have a number for that.
Yes people do come in with broken fingernails occasionally, but this is nowhere near as much of a problem as half of A&E staff either resuscitating someone after an overdose, or restraining someone who is in fulminant psychosis- neither of which should have happened if that person was able to see a phychiatric nurse or doctor earlier!

I'm sorry for the dramatic essay. I had a bad day, and they are becoming more and more common. We are at breaking point, we feel so powerless, and it's affecting the mental health of a&e and ICU nurses and doctors

Graphista
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 completely agree. This should be legislated against.

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

This is shocking. Employers need to be stopped from this abuse. It's exploitative because they know their employees need the money, and it's just pure abuse at this point. People are being pushed to such unhealthy extremes because of work, and it needs to stop.

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.

If the NHS went back to its core purpose, ie healing the sick, there would be fewer problems. As long as they, and the police, have to deal with the drunks etc. there will always be problems. Leave them to sleep it off in the street and leave the hospitals for the sick and the police to deal with crime. Self-inflicted non-illness should not be in the remit of the emergency services.

Similarly vanity cosmetic surgery should not be performed on the NHS, if your child has a big nose, sticky out ears, small boobs teach them to learn to live with it, as a tax payer I'm not remotely interested in their 'self-esteem'.

I don’t think people are time wasters as such. But I don’t think they realise that it is so expensive to ‘pop along and get something looked at’. I think that the people who often complain the most about the NHS are the people who do not use it correctly. If you really were unwell then it would not matter than it is hot outside if you needed to see a GP, surely you just would?

Agree that MH services are so bad that the NHS is taking the burden. I don’t know if I can see that changing. Lack of social care support is also a huge drain

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

What was meant by this is that employers and schools often ask people to attend a GP appointment to get a sick note.

a. i dont know if you have noticed but workers rights have been eroded so people are a bit too worried about refusing an employers request to do this Schools have also gotten very heavy handed.

b. the thread title is "AIBU to be frustrated with the abuse of the NHS!!!!!!!!!!!!!!!!!!!!!!!!

not AIBU to be frustrated with the abuse of A and E

If the NHS went back to its core purpose, ie healing the sick, there would be fewer problems. As long as they, and the police, have to deal with the drunks etc. there will always be problems. Leave them to sleep it off in the street and leave the hospitals for the sick and the police to deal with crime.

Do the police here have no where they can put belligerent drunk people? In the US, there are "drunk tanks", which are basically rooms at police departments where they have to stay until the morning.

Trouble with " drunks on the street " is that you don't know if they will sleep it off, or die from a head injury, or obstructing their airway with vomit. Most such admissions we see are not lads on a night out who had too much, but alcoholics, usually with a host of physical, mental and social issues. They are sick people, you can say it's self inflicted but most turn to alcohol after abuse, bereavement, homelessness, illness. " It's their own fault" is not in any way a helpful attitude. These are people, humans with feelings, loving families, and it could happen to any of you.

I agree cases like this are ridiculous but they must be in the extreme minority. I have to say all of my recent encounters with the NHS have been pretty awful.... I feel like you aren't allowed to criticise the NHS at all as if it's a perfect service but it's really not.

I've just had a baby and every single time I went for an appointment the receptionists couldn't have been ruder. Midwives lovely but always in a rush. When my baby was born I had severe blood loss and my colostrum just didn't come in. Was desperately trying to get baby to latch and despite being told how important bf is... every single midwife was too busy to help me for 4 days, eventually my baby had lost so much weight they just handed me some formula. But the thing is... every night I could hear everyone chatting at the nurses station about their plans for the weekend or the TV - whilst repeatedly getting told they didn't have time to help me.

Took my DS 6 months - to a&e last week because his temp was 39 and he wouldn't feed or take any water, this went on for 6 hours and I was very worried. It took the nurse an hour to come and see us and we couldn't honestly see them just ahead, 5 nurses sitting looking at Instagram videos.

These are two different hospitals but both experiences within a couple of months.

I'm not saying health care workers aren't entitled to a break or can't have a conversation with each other... but this should be done away from the public.

The thing is, in an area like mine, where there is a chronic shortage of gps, and no minor injuries or walk in clinic, (there is an out of hours service, but last I looked it was only by referral from NHS24, no drop ins) then you are going to get people showing up at A&E who shouldn’t be. Because there is nowhere else to go. If you improve primary care services, and properly signpost people to them, I think you’d hugely cut down on “abuse” of A&E.

"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!"

Nobody said that is what's happening.

What myself and possibly others said is that some employers and schools are INSISTING on a sick note from GP (some won't even accept one signed by a nurse!), they're refusing to ACCEPT self certification and threatening people with job loss (in the case of employees - and if you have less than 2 years service you have pretty much sod all rights PLUS legal aid for employment rights has been removed) or being "reported" to social services or even court action in the case of school pupils.

There's even been threads posted on here by people threatened with these actions and I certainly know people in real life who have been too.

This means those people are making unnecessary GP appointments to get unnecessary sick notes for fear of losing their jobs or getting embroiled in action regarding school absence - which could also impact their ability to work and could involve financial costs.

This means fewer appointments for the sick who then either actually get more sick and NEED to go to a&e or get fed up trying to get a gp appointment and go to a&e out of a mixture of frustration and fear that something more serious is wrong.

Employers and schools that do this are the ones that SHOULD be getting told to cut it out and fined if they don't!

It's generally low wage employees that are treated this way too - people who can very ill afford to risk their employment.

"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" and how does that work for areas where those services don't even exist?!

As I've already explained we have limited a&e services and no minor injuries and no walk in centre where I live and when I say "where I live" I'm actually meaning across 2 very rural counties!

We also have limited GP availability, no local maternity service (we now come under the hospital 90 mins for me which for some patients they now cover is actually about 3 hours away!) no paeds service, the sexual health clinic is also only part time now, we've lost dentists and opticians from our "high street" - in fact just this week on my local Facebook page another dentist is closing as he's retiring and has been unable to find someone else to take over. Limited pharmacy coverage. The mental health service barely exists!

How are people supposed "use the right services" when they plain don't exist?!

Your comments re mental health and self care are disgustingly prejudiced and ignorant. Do you even understand how mental illness can make self care incredibly difficult to achieve? I'm mentally ill and getting precious little Nhs support partly due to cuts partly poor attitude within mh services. I really struggle daily to manage just eating and sleeping let alone bathing or anything more than the very basics. That's not because I don't WANT to manage my own care and needs but because I am TOO ILL to do so without support.

"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" that doesn't mean those patients were in a&e inappropriately

"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" do you even consider that there may be medical reasons for those frequent attendances? The most obvious that will spring to most people's minds is mh and learning disability factors.

But those aren't the only reasons.

At one point (each) both dd and I were frequent a&e attendees - BECAUSE we had undx conditions causing symptoms that landed us in a&e, that we WERE seeing GPs about regularly too but which were NOT being appropriately dealt with. Ie we were being fobbed off and prevented from getting appropriate referrals to specialists.

In my case it was endo, in dds it was eds.

This is far from uncommon. I posted a thread last year regarding misogyny in medicine. That thread had some shocking stories on, quite a few of those posters would also at some stage have been frequent a&e attenders BECAUSE their medical condition wasn't being recognised, diagnosed and treated at the primary care level and ended up worse necessitating a&e admission.

"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." I'm definitely guessing you're not an hcp BUT even with (and the thread topic of "common sense" makes this somewhat ironic!) can you REALLY not think why people need more healthcare in winter months?!

A people away on holiday in summer - not only not needing appointments while away, but less stressed as a result of holidays and stress impacts on MANY health issues not just mental health.

B colds, flu, stomach viruses are more prevalent in winter

C bad weather - particularly snow and ice and wet areas can lead to more accidents in winter particularly for the elderly and disabled

D people are more isolated in winter meaning the vulnerable have less support, are less able to get to pharmacies etc and their health is likely to suffer

"Or dont want to sit waiting in a building where it doesnt drop below 34 degrees." Could definitely be a factor too.

"Some places people have to travel 20 miles to see someone which is stupid" try 25 here!

"Agree that MH services are so bad that the NHS is taking the burden" why do you seem to think the Nhs isn't for the mentally ill? Mental health is just as important as physical!

GingerbreadSprinkle - no we have nothing like "drunk tanks" my brother and several friends who are police officers are really overwhelmed with the strain of dealing with alcohol and drug addicts and also other mentally ill people. He is frequently having to "talk down" people who are suicidal - for which they have minimal training and precious little support for the effect on their own mental health!

"These are people, humans with feelings, loving families, and it could happen to any of you." Well said!

And I am speaking as the daughter of a violent, abusive alcoholic. There is a small aspect of personal choice but there are also strong aspects of learned behaviour (he's also the child of a violent alcoholic, was an employee in environments where drinking hard was not only allowed but encouraged even feted - manual labourer and then army) and from a generation where such things were normalised too (now in his 70's) plus while he'd always been "a drinker" there were some traumatic events (some personable some work related due to serving in army) which triggered his descent into alcoholism, partly self medicating to deal with PTSD I believe.

There's also strongly now believed to be a genetic component. That doesn't surprise me at all! I'm not a drinker have only even been drunk a very few times in my life - never once had a hangover, takes a LOT to get me drunk. My father is not the only addict in my family, most of whom are now in recovery and work so hard at that. In discussions with them over the years I've learned that they too even prior to becoming alcoholics, even when they first started drinking it took a lot to get them drunk and none of them has ever had a hangover. Among those in my family I believe to have this genetic predisposition which includes myself we also have problems with analgesics and anaesthesia really having very little effect on us.

It's really not as simple as "selfish addicts self inflicting their illness"

And as I said upthread - are those of you that hold that attitude perfect in your own self care? I very much doubt it (indeed to paraphrase/reference Marian Keyes in Rachel's holiday I'm wondering if the very people making such comments are guilty of similar themselves)

@NEtoN10 yes as an ex nurse myself I have also found a shocking increase in poor staff behaviour too.

Not only of the type you mention but even things like poor infection control practice, poor obs taking practice etc

I worked in the NHS for 30 years and one of the things that really pissed me off (obviously there are genuine issues with some people especially frail elderly so please can we skip those) were people constantly complaining about the food.
The same food that I had to eat on my break on a 12 hour shift.
Its not a five star restaurant, if you are having a routine operation and have family get your family to bring food in if you are that fussy.

You can be offended by me saying MH services are absolutely awful, as you have experienced and the NHS in terms of A&E is taking the strain of this, as also was mentioned by a nurse working in critical care on the thread. People should not be becoming so unwell with their MH that they need to go to A&E. It is not misinformed in any way. A&E should not be the point of entry for people mental health issues. Mental health services are one of the most underfunded parts of the NHS. The discussion was about A&E. At no point did I infer MH services is not part of the NHS, I said that acute hospitals are taking the strain for MH underfunding. So you can twist whatever words you need to to make yourself angry, but it is still true.

This was not about people with MH issues ‘abusing’ the NHS, it was about a woman with a small injury attending A&E. I actually do not think it is abuse and said as much back when I posted. It is a combination of issues, some of which are there are not enough urgent care centres, minor illness clinics, access to services which cost a lot less than A&E but are very effective for patients. The NHS decided to cut down on their estates long ago and move to PFI buildings because their property was in such a bad state but this has resulted in lots of towns and villages having no access to services which is wrong.

People are also blocking beds because they cannot go home as there is no social care packages for them which is because of underfunded social care. This is another huge drain on the NHS which has become over burdened trying to ‘do it all’ for everyone and fill the gaps

As for self care I was clearly talking about going to the chemist and getting some cream and antihistamine for insect bites and stings, not going to a pharmacist for advice on your mental health

You are getting mixed up in your anger at people talking about the main OP of using A&E for minor ailments. Not using it correctly for urgent/serious problems

Good posts from onion and Pookie and also from Graphista. Victim shaming and blaming solves nothing.

Reducing frequent attenders is about exactly that - examining WHY they are going to A&E so much. What is wrong. Why are they presenting. What could we do to help them. What is missing in their care. It is not about giving them a telling off! It is really helpful to find out what your gaps are as you can assume that the people who attend the most are elderly and frail, but often not. So in the case of my area, once we have identified the problems you can make moves to help those patients. Then you can monitor whether it has made any differences

I think you seem to go out of your way to target me when I post on these NHS threads and angrily obviously dislike anything I ever say. I am sorry you do not have good access to services but I am not personally responsible for that. I am trying to help and make a difference to my local population believe it or not, although I see that you have obviously had bad experiences and do not have a good opinion of ‘people like me’. I have no judgement of you and what you use A&E for but because it is my actual job, I have to look at these things in a more objective way which you obviously feel very emotive about for your own personal reasons, and I am not posting about it from an emotional perspective at all which I think you find upsetting

I obviously know that winter is worse hence it is called winter pressures and money is specifically allocated to boost services in these times. but it is frustrating that you have essentially wasted 20% of your available appointments during each summer month and there is nothing you can do to get those back. You have to offer them, contractually. And you can’t ever regain them for another time when demand will outstrip capacity. It was a frustration of mine. Not a personal attack. Like I say, I have no judgment of you but I can’t talk to you on these threads as you just quote and shout determined to pull me down!

When the police got called on us because of my son's violent meltdown from his OCD (he has autism, too) they forced us to go A&E. Believe me, it was unnecessary but we were not given a choice. We were eventually let go with no treatment.

Every time I've been to A&E (serious ailments/injuries to self/accompany partner with head injury), its been full of drunk men wailing and crying about getting their blood taken and harassing other patients.

I'm sure there are plenty of other timewasters but I do question why women like this are singled out when everyone knows its male drunks (and some female drunks) that are the problem, and which also means that police have to waste their time basically spending a whole night shift at A&E. Why not publicise that instead of the woman with the broken fingernail?

Yes Pookie but the thing is its always the low wage employee users of the NHS that get moaned about on these threads for going to A and E or the GP surgery for these bloody sick notes NEVER the companies they work for that demand they do this Ditto schools.

@IAskTooManyQuestions Part of my role at my previous trust was to try and claim back monies from non-British nationals. Sometimes we were successful, sometimes not. It most definitely isn’t a myth that people come over then leave without paying.

Does A and E keep records of how many admissions are caused by heat stroke

It's more complex than 'advice and guidance=time wasting. My mother fell and hit her head, briefly losing consciousness. She had an immediate swelling at the back of her head. She has a complex medical history and her 'usual' is confused, because nobody will take responsibility for looking at her plethora of medications and work out which one (s) are causing her mobility and cognitive difficulties.

111 accepted that I couldn't say if she was 'more' confused, because she has intermittent confusion as her 'usual'. I said I didn't think she was more confused, but I also couldn't say that she wasn't confused because, well....she is. They wanted her to go to A&E.

We went, we waited, the doctor reviewed her and said that, on balance, she didn't think a scan was needed because she hadn't become drowsy, etc., so we gladly went home.

We didn't waste their time. We went and got expert advice.