RCEM Tweet - Hospitals are full

[JabberGiraffe]

"Hospitals are full, Emergency Departments are full, ambulances are queuing outside. This is dangerous for patients and delays paramedics returning to the community + responding to emergency calls. There must be action taken to increase capacity and maintain flow. "

AIBU to think this is scaremongering? Not every hospital is full. The ones near us are not.

Just feels like it would put people off attending who needed to (as happened in March/April).

It doesn’t say all.

You think it's scaremongering so you thought you'd come and post it on a highly traffic forum just so more people can get wound up?

Can't lie OP I'm struggling to follow your logic there.

Rather than scare mongering see it as the canary in the mine. If your hospital isn't yet at this stage then it may very soon be.

These are not political point scorers, these are people who are on their knees with exhaustion and fatigue, witnessing and playing their part in untold human misery every single day with no hope of respite. Unprecedented numbers of staff are off due to sickness, stress and isolation. Wiring conditions are gruelling, the political landscape is bleak and we're not even into the real winter pressures yet.

If they are asking for help and painting a black picture, then know it's really, really, really bad out there.

The plurality implies all...

Just think it's irresponsible to have put this out on their twitter account for all to see - particularly after the rise in non-covid deaths in the first lockdown due to people not attending A and E.

@KindKylie I don't disagree with you that in some places it is really bad, particularly the situation in Southend today, Lincolnshire three weeks ago, and Lancashire six (?) weeks ago.

The messaging though is likely to have a blanket effect of dissuading people who need to attend A and E from attending though. That's what worries me, particularly in areas where A and E is relatively quiet (in comparison to other areas).

Its not scaremongering. I've just finished a 14 hour day and we've had to convert outpatients into an overflow for our ED patients. Our hospital IS full and we have nowhere for the patients waiting outside the ED department to go. It's horrendous.

Sadly this is the NHS every winter, with the double whammy this year of covid. It was as predictable as night following day.

I have a lot of rage at the current NHS / A&E advert, as it basically says unless you are actually right at that point dying don't bother A&E and go to your GP or ring 111.

So the GP that never answers the phone and 111 that is possible to get through to. Maybe I am feeling it more acutely as we did have to ring 999 last week for MIL after exhausting all other avenues. She is still in hospital a week later and is not well. That advert totally lets people down.

@JabberGiraffe

The plurality implies all...

Just think it's irresponsible to have put this out on their twitter account for all to see - particularly after the rise in non-covid deaths in the first lockdown due to people not attending A and E.

So you're equally irresponsible for posting it on MN then...

This has been happening since I started working in health in 1992 so blame successive governments for that!

@Lockheart No I am not - it's already published all over twitter, and I am not a professional body making a statement.

@Thestreets Sorry you've had such a difficult day, I hope you get well rested tonight.

@TheGreatWave Sorry you've had a rough time. I was sent to A and E twice last week, and it was empty - but I was quickly discharged twice without being treated, handed back to my GP who couldn't treat me adequately and thus ended up with a bigger issue so had to go back (this time I went to another hospital, and was actually admitted and treated). It was super frustrating, particularly as it's an issue that A and E have treated all times in the past... but yes, because I breathing and not having a stroke, no chest pains I was sent on my merry way!

If your local hospital is not full, it likely soon will be.
Every winter hospitals are full and this year, with covid added to the mix, of course it will be worse. Community services and convalescent/rehab services have been cut to the bone.
Of course if people need emergency care, they should go to A+E, but that doesn't mean the hospitals are any less full.

Its not scaremongering, they are full to the brim, our inner city hospital is anyway. 38 people, 38!!!! were sat/laid waited for beds on the ward in our A&E the other day for upto 22 hours. More than half of the people in a&e were meant to be on wards, the pressure that puts on a department is crazy. Our A&E has doubled in footprint over the past 6 months, its awful

The major issue is not in the hospitals - which are running with full surge capacity- but with there being nowhere to discharge medically fit people to. Insufficient community and social care beds for the frail elderly.

Add that to far fewer EU nurses and insufficient staff to manage the escalation areas.

We have normalised something called ‘corridor care’. Tragic. Of course this is the NHS every winter. I would hate to require hospital treatment at the end of January at the best of times, but one month on from the Christmas mingling and it will be horrendous.

Good, half of the people attending the ED don't need to be there anyway. And yes, hospitals are full, even if it's not ALL hospitals and they're not full entirely of Covid-19 pts, many hospitals are on their knees, and if the RCEM tweet stops people going inappropriately then good.

@notyourmummy

Good, half of the people attending the ED don't need to be there anyway. And yes, hospitals are full, even if it's not ALL hospitals and they're not full entirely of Covid-19 pts, many hospitals are on their knees, and if the RCEM tweet stops people going inappropriately then good.

Most people don't want to spend a night in A+E. Other than the obviously inappropriate (scraped knees in a kid, as my friend once took her daughter in for), a lot of people do need care- maybe not emergency care, no, but they do need a doctor and community services are shit. The local minor injuries unit in my area closed down. If I want a GP appointment, I'm lucky that my surgery still offers this. Others might have to phone in the morning and hope for the best. People can't stay off sick indefinitely waiting for a GP appointment because workplaces are shit and they need the money.

It's rarely as simple as "people going inappropriately", it's the result of years and years of cuts to other services.

Those that can be sent home from A+E aren't the problem.

@DontStopThinkingAboutTomorrow Yes, theres a lot of blaming of people (every year not just this year) who "go to A&E unnecessarily", ut aside from the inevitable timewasters a lot of those people are there becaue they can't be seen by a GP but need medical care so turn to A&E as a last resort.

Good, half of the people attending the ED don't need to be there anyway.

Would you tell that to the families who lost loved ones in lockdown 1 because they were too frightened to go to A and E? Or is it just reserved for those people with complex social, mental and usually physical health needs?

Our out of hours GP is actually in A and E - you get streamed with A and E patients even if you just want to see a GP (or have been advised to by 111 or your own GP surgery) - it is also marked as an A and E attendance even if it is just going back for another IV drip.

I racked up a whacking 8 admissions in five days to A and E (and all the attitude that comes following that) just because I was going in for IV antibiotics. People don't see that unless they actually read through the notes. It's really pants.

However, people should not be afraid to attend, particularly at the moment. It just makes me very, very sad people may not be getting the care they need.

Normally though, the people who follow a hospital's twitter will live in the area though?

It is only through others posting it on other SM that the message goes to the 'wrong' areas?

It is very sad when people don’t get timely care or are in corridors. It’s is complicated and hospitals are doing their utmost but with having to split care into hot/ cold space and resources are limited.
Add in reduced nurse numbers generally, the impact of Covid19 on staffing (one southern Trust had 60% of domestic and pottering staff absent last week, another had 200 registered nurses off on a single day).
Add in inappropriate attenders - The I’ve had a cold for three days, I’ve got piles, I stuck drawing pin in my thumb, I was drunk last night and have a headache, I’ve got a scratch and can you get rid of my spot quickly people. There are lots of people with no ability to manage even the most ridiculous things. ED consultants treating slightly pink sunburn or a blister from new shoes is a total waste and frustration for hospitals.
Add in that inability to discharge people because of lack of provision or families blocking discharge and flow stops completely.
Then ambulances stack, corridors get used, people who are in genuine need have resources diluted.

Simon Stevens department is very clear the ‘open as usual’ message is seen and trusts are not allowed to send out ‘we’re bursting at the seams messages. Even when all elective work is suspended and staff are being bussed in from a neighbouring county or ambulances are diverted to hospitals fifty miles away.

There is no slack in NHS

Hospitals do sometimes close to new admissions (often in winter bug season, also when they get noro outbreaks)

It's why hospital capacity is a factor in deciding tiers

I was in an a&e recently ( month ago) when my area what at its peak. The waiting room was quiet, handful of people. Through the doors when I was taken through it was car gage, people on trolleys everywhere I went, people say on chairs in corridors swaying transfer to wards. All those people were sick enough to need to be there.

I don’t understand why it’s scaremongering to tell people how bad it is in some hospitals. it happens every year in the NHS at this time of year so it’s inevitable in a pandemic it will be worse... to be honest January probably will be worse.

Surely if you inform people some of those that could be seen by a gp, pharmacists or other health roles may realise it’s not the place to go. And yes I understand how bad some GPS have been. Or those that choose to go will understand their very log waiting times when the dept is under stress from very sick people ahead of them.

Hospitals being full. Last year, in the summer, I went to A&E at 11am for an x ray. It turned out I needed emergency surgery to pin a break back together.

I had to go home and pick up some bits, fed the dog etc as I live alone with no one local to help. I was gone for about an hour, with permission from staff.

I didn't even get a trolley (just a chair) for 23 HOURS - 10am the following day. There was someone in the same room overnight, in a chair, suffering with a slipped disc. I also have well documented spinal problems. There was no medical necessity for me to be in hospital overnight - but I "wouldn't get a bed" if I wasn't on site.

The staff didn't seem to understand why I was in tears when I'd gone 36 hours without sleep and 18 hours nil by mouth - I wasn't being given any real info on when I was going to be treated, so there was no way of going "it's only another two hours" in my mind - time stretched out endlessly.

After that, I really struggle to take "the hospitals are full" seriously. What's changed?!