To think this is why our A and E are failing?!

[DaisyLilyFlower]

Currently in A and E with suspected ectopic pregnancy (told to come here from 111) and current wait is around 4 hours, already been here two.

I’ve been sat by triage next to the reception desk, so not deliberately being nosy but in the last hour two patients have come in with

One with an ear infection
And another with a ingrown toenail

Cannot believe it! Reception asked them both if they’d been to see GP or rang 111, tried overnight pharmacy etc and both said no!
I do not doubt that both of those conditions are extremely painful, but I sort of can’t believe that people turn up to A and E without trying other methods first?

I’m probably just being wingy as I’m in pain and the wait is long and ABU, but I guess my question is,

What’s the worst thing you’ve seen at a and e?

Also Name change as don’t want this linked to my other posts but reg poster.

Very sorry to hear this Daisy take i had an ectopic pregnancy in 2015 and lost my left tube also , all worked out well in the end take care

They are failing their targets but not always their patients. Sorry you’re having a rough time OP. A&E is used and abused day in and out - often because of failings in other parts of the system (it has become the path of least resistance).

About 3 months ago I went to the chemist with an eye infection, they said I needed the doctors because of some of the symptoms. I did the online doctors form, they called and told me I needed the chemist - told them I had been and they wouldn’t treat me. I got a phone appointment, they then said I needed to go to urgent eye care that day. Called urgent eye care and they said they couldn’t get me in so I needed to ring 111, they advised me to go straight to a&e. 6 hours later I was told I had the conjunctivitis I thought I had when I went to the chemist. They wouldn’t treat it and advised I needed a doctors appointment for a prescription. The next day I did the form again, the phone appointment and then an in person doctors appointment. The doctor told me I should have insisted at the chemist.

It was ridiculous, I ended up taking 2 days off work when I could have just got what I needed over the counter.

I've been to A&E twice for ear infections, both times taking someone else. The first time was my sister after she'd rung her GP 3 days before and been given an appointment that was still a week away. They'd refused to bring it forward when she rang to say she thought her eardrum had burst. She lost 40% hearing in one ear.
The second time was with my the 3yo DD. We'd been to the GP who didn't even look in her ear, just gave us a prescription and fobbed us off. She started fitting and vomiting a couple of hours later and we were blue lighted in. We probably looked like time wasters to others in reception as my daughter was playing and singing happily by this point, but she had sepsis and spent a night on a drip.

The problem is access to primary care and the feeling of not being listened to even if you can get access.

I have an ongoing condition that affects the soft tissue connecting your ribs and it often gives me horrendous chest pain. I've had a long series of cardiac investigations that were all clear but whenever I get a bad flare up my GP sends me into A & E to have bloods and an ECG done just in case. They've never been anything less than amazing with me, but I feel like a complete fraud when going in. The last time I went in, the nurse I saw was so kind and even got me a sandwich and drink of tea (I'm diabetic).

So I wonder how many people have judged me when I'm sitting waiting in there

The second time was with my the 3yo DD. We'd been to the GP who didn't even look in her ear, just gave us a prescription and fobbed us off. She started fitting and vomiting a couple of hours later and we were blue lighted in
My DS had quite a few febrile convulsions due to ear infections, not sure what you expected your GP to do to prevent a febrile convulsion, its usually the first sign my ds was ill.

You responded to me it's like you're purposely misunderstanding what I've said both times. It's not up to me to decide and I'm not deciding. The NHS has a ton of adverts and leaflets guiding all of us to attend a GP/minor injuries/phone 111 before a & e for a sore ankle that you're able to use but to come into a & e for chest pain which is an emergency. I don't even know how this latest story is supposed to prove that people should go to a & e instead of a GP for non emergencies against NHS advice? A chest pain is an emergency, the man went to a & e, a & e failed him several times, specialist agrees a & e failed him. Therefore, people that are able to walk on a sore ankle should ignore NHS guidance and go straight to a & e without a referral? Okay. I'll keep seeing my GP for things that aren't an emergency as the NHS requests, you feel free to use a & e whenever you want to. I'm not deciding and I'm not judging. Being a 'medical doctor' I'm sure you're good at deciding where you need to be, apart from the time you misdiagnosed yourself.

I'm sorry OP that you had such a stressful and painful time in hospital and that you have had to have your tube removed. I really hope you make a speedy recovery.

I almost went to A&E this morning.

Been in agony with abdominal pain, discharge, dizziness and vomiting.

Phoned the GP every day. No appointments. Nothing.

Phoned again today and got one of the nice receptionists who got a GP to call me and I can be seen later today.

If I hadn’t got in today it would’ve been A&E. I feel awful. Been in bed now for five days. But I just couldn’t speak to a GP.

@MorganKitten didn't say anybody wasn't entitled to care 🙄 I said a twisted ankle wasn't an emergency. I stand corrected now after the many posts telling me different. I still don't think I'll be turning up at a & e without seeing my GP first for a sore ankle, I still can't see it as an emergency for myself. I understand other people feel differently and don't judge them. There's another poster here that thinks I'm trying to dissuade heart attack patients from visiting a & e so I guess I have not been very good at explaining my personal point of view.

When I was at uni one of my flat mates would go to A&E at the drop of a hat - she had no concept that anything else existed.

And once I worked in the radiology department of an acute hospital. Will never forget the report I did for someone who came to A&E for a foot x-ray stating she'd been dancing in high heels the night before and her feet hurt.

I totally get it OP

HOWEVER... yesterday I was sat in GP waiting room (midwife was massively overruning) for 50mins and so overheard a lot of the receptionists' conversations with patients calling for GP appointments. In the 50mins I was sat there, the receptionist told 4 patients to call an ambulance or go to A&E. Now, of course, the patients may have been in real danger, but judging by the initial triaging conversation went like this: 'the GP can't see you/has no appointments/isn't doing f2f but if you think its bad then go to A&E and they will see you f2f instead.' As such, I think the problem is also being exacerbated by the inability for anyone to access GP appointments anymore.

@WaitingForNormality

I totally get it OP

HOWEVER... yesterday I was sat in GP waiting room (midwife was massively overruning) for 50mins and so overheard a lot of the receptionists' conversations with patients calling for GP appointments. In the 50mins I was sat there, the receptionist told 4 patients to call an ambulance or go to A&E. Now, of course, the patients may have been in real danger, but judging by the initial triaging conversation went like this: 'the GP can't see you/has no appointments/isn't doing f2f but if you think its bad then go to A&E and they will see you f2f instead.' As such, I think the problem is also being exacerbated by the inability for anyone to access GP appointments anymore.

The problem is, If the doctor isn't able to see a patient face to face, and the person on the phone is insisting they need to be seen that day/are desperately ill, then the doctor (or receptionist) has no choice.

GP services have been cut to the bone, but it's a false economy as it just means hospitals are busier (both in A+E and everywhere else because things that could have been treated at an early stage are left until they become emergencies)

I agree, my DD broke her leg while the two of us were out on a bike ride a few years ago. No where near home, so I called an ambulance, they told me it wasn't an emergency and wouldn't come out to us. Her foot was the wrong way round, it was horrific.

My brother had to come and pick us up, I left our bikes with some random kind person and drove to A&E.

Gets there and one man had 5 family members with him taking up chairs, like it was a family outing. I had to sit on the floor next to DD. Then a woman came in an ambulance with a twisted ankle and was raging that she had to wait in the waiting room with everyone else, she thought an ambulance equals quick treatment.

There was one guy with toothache and one girl with a ripped off finger nail! 5 hours we waited and DD ended up being admitted for surgery.

[quote WrongWayApricot]@MorganKitten didn't say anybody wasn't entitled to care 🙄 I said a twisted ankle wasn't an emergency. I stand corrected now after the many posts telling me different. I still don't think I'll be turning up at a & e without seeing my GP first for a sore ankle, I still can't see it as an emergency for myself. I understand other people feel differently and don't judge them. There's another poster here that thinks I'm trying to dissuade heart attack patients from visiting a & e so I guess I have not been very good at explaining my personal point of view.[/quote]
What's the point in wasting the GP's time with a twisted ankle?

It's not something he can fix.
Its likely to need an x-ray to rule out a break and if it just soft tissue damage its going to need a rest.

DS had bashed his toe. I knew the issue was bruised blood under the nail it needed something to relief the pressure.
NHS24 sent me to GP, i couldn't get GP so settled for nurse appointment.

Nurse said- ooooh I can't deal with that. I'll get the GP.

GP said - ooooh I can't deal with that it needs x-ray and we don't have tools. Go to A&E.

A&E - X-Rays to ensure the bone was OK, before they burnt a hole in the toe nail.

The GP & Nurse time could have been saved by NHS24 pointing me in the right direction in the first place.

@Lockdownbear idk, I've never done it. I just know if I could walk I wouldn't go to a & e first before seeking other advice, just because I like to co-operate with the NHS. I'm not a doctor so if the NHS recommends seeing a GP I do, if it recommends going to a & e I do. I'm lucky that I can usually get a doctors appointment within a few weeks for non urgent concerns and if I need to be seen more quickly I have a decent out of hours service and a walk in clinic. I'm sorry you had that experience.

Hope you’re ok OP 💐

When I was in A&E recently the stream of inappropriate attendances shocked me.

As did the total lack of confidentiality! Though I guess that’s not their fault really.

A man with a sore toe that he’d had for 3 weeks! He wasn’t even limping. Really annoyed me they saw him first just because he was in front of me in the queue. Though think he had to wait a few hours after triage as he was still there when I was wheeled back and forth from X-Ray.

A mum with a very lively school age child who had earache (but he was well enough to be jumping around playing and climbing on the seats annoying everyone!)

A woman with her teenage daughter, the girl was about 17 and her complaint: constipation 🙄 the receptionist asked if she’d tried any over the counter remedies: nope, not even a laxative!

A woman with a cut finger (clearly not badly cut as she only had a small plaster on it, wasn’t bleeding through or anything.)

Lots and lots of PE injuries (ok could have been serious but most got sent away with a tubi-grip so clearly not even an X-Ray was needed).

A man who’d tried an illegal recreational drug ‘accidentally’ and felt ‘odd’. Actually was quite entertaining as he kept trying to chat to everyone and spent half an hour trying to work the vending machine to get chocolate! And kept sitting on the seats marked ‘do not sit’ (social distancing).

Lady who had been bitten by a false widow spider (nurse had to reassure her they’re not dangerous unless you’re allergic or the bite’s infected but she was hysterical asking for anti-venom at first!)

Lots of unexplained abdominal pain yet the patients were well enough to walk around, eat, drink, gossip on their phone then suddenly put on an agonised expression and started limping when called to see the doctor!

This was an A&E where you literally heard everything as patients had to shout their reason for attending through a Perspex screen in a mask. And the nurses brought meds into the tiny seating area and explained the treatment plan in earshot of the waiting room. So everyone heard everything including my rather embarrassing issue (cellulitis from a cat bite in an awkward area, that turned septic while I waited so I ended up being admitted on IV antibiotics for 3 days!) To be fair the other patients probably thought I was there for a silly reason too, until the infection spread and I vomited on the floor and nearly passed out 😳 They gave me a bed after that.

I guess A&E has become a sort of minor injuries clinic/alternative GP for people who can’t get a face to face consultation anywhere else.

I remember watching the infection track up my hip past the biro circle wondering how long until they took me seriously! The nurse brought me a strong painkiller and I kept telling her it was tracking and pulled my top up to show her but still had to sit there another 4 hours until I was sick.

You have my deepest sympathy OP and I’m sorry they didn’t rush you through. Years ago when I had a suspected ectopic I was in a bed straight away with lines in and given IV morphine.

I've realised that I'm very lucky as my town has a minor injury unit (complete with xrays) that we've been in and out within the hour each time for stitches, rugby injuries, infected bug bites and burns.

There's also an out of hours GP that we've used twice and been given an appointment for 25 minutes later, we had to rush to be on time. Once for DD as she had a reaction to penicillin and broke out in hives and had a tight throat, and another for DS after his insulin pump site became infected.

The car park for each are also free.

A few towns over used to have a drop in gp service at weekends. You didn't even need to be registered. You turned up, got a ticket and waited. It was always busy so the demand was there but they scrapped it. GPS absolutely need to be more accessible.

@WrongWayApricot

My neighbour told me his a & e story a few years ago. He had twisted his ankle and 3 days later thought he should get it x rayed. I was sympathetic but I feel if you've walked on it for 3 days it's probably not an emergency. Although I did know someone that broke their ankle and didn't know until later in the evening, so I could be wrong.

Ear infections can be really bad though so I wouldn't think that was strange or time wasting. And the ingrown toe might have been stubbed today and got really bad?

I was sent to A&E after a fall. I was told my ankles were badly sprained and to walk as much as I could so they didn't stiffen up. I couldn't walk so got wheeled in. I wasn't asked to stand or sent for an X-ray. I'd arrived at 8am with only 3 people in front of me so not exactly busy.

I saw the GP again after 10 days in agony and was sent back to get an X-ray. I'd broken both. Every minute had felt like an emergency but I toughed it out (and caused more damage). I needed pins in both as I'd displaced both.

I've also seen a 70 year-old walk into X-ray (I worked at the unit for a while) with a sore neck after falling down stairs 6 weeks previously. She was admitted immediately with a broken neck.

Missed breaks are pretty common. If a department has a radiologist who reviews X-rays later on you may get called back in for another X-ray or treatment (ours was a local unit with no A&E so it may be different in bigger hospitals).

Ear infections are horrible and can be dangerous but are not being seen by our GPs unless you're under 12. I can see why they'd turn up but I'd be trying my pharmacist or GP first. Same with dental abscess (worst pain I've ever had). If you can't see a dentist I can again see why someone would turn up.

The ingrown toenail can be painful but see a pharmacist first, then a GP if it's already infected. I've learned to manage my own but some people can't.

After decades of really effective antibiotics sepsis has become a rare thing. However, it still kills if an infection takes hold which is more frequent now as antibiotics are prescribed less due to resistance. I was brought up hearing tales from my grandparents of neighbours dying from sepsis after a small scrape. Better safe than sorry.

@HarebrightCedarmoon

I think we need more drop in medical centres for non-emergencies, perhaps at hospitals so people can be easily diverted from A&E. Where you can just turn up and take a number and wait, like minor injuries.

This would be great, but probably abused.

I am sorry but I am rather annoyed by this thread, 2 years ago I had a bout of serious diarrhoea it didn't go away , on my first visit to my GP I was told it would pass and it was a side effect of the antibiotics I was on, the next week I went back and was told it was a virus, the next week (week 3) my husband found me semi conscious on the sofa and took me to A&E, he made the mistake to asking the triage nurse if I could see a specialist, that was it we were accused to trying to get in to see a specialist by the back door, we didn't even get to see a Doctor, I had an emergency appt with the GP the next day who was shocked at how ill I was and how much weight I had lost, upshot was I was back in A&E that night with a letter from my GP, and ended up being admitted, I was in for 12 days, 11 of which were in isolation, I actually had SEPSIS, I could have died, but according to the nurse I just had the runs and was making a fuss, never again will I be fobbed off never again will I be made to feel guilty for wasting the NHS time, I understand the frustration of medical staff when someone presents with a cut finger, but I was tarred with the same brush as a time waster when in fact I was very seriously ill.

...overheard a lot of the receptionists' conversations with patients calling for GP appointments. In the 50mins I was sat there, the receptionist told 4 patients to call an ambulance or go to A&E

I've been there too, my toddler sounded stuffed up and wheezy to me. I couldn't get a GP appointment until late afternoon. I moaned could he not be seen sooner receptionist said if he's that bad go to A&E, so I did. 3 days he was in hospital. I had no fucking idea how ill he actually was!

I really hate the idea that people go to A&E for nothing. Why on earth would anyone want to spend hours in an uncomfortable chair waiting for nothing.
You don't know what other issues the person may have. That includes MH issues, the small cut might have been a dirty cut, that could easily be infected.

I've also just had an ectopic pregnancy (surgery was last Friday) and have spent way too much time at A&E recently. I'm abroad at the moment and you need a referral from your doctor (in my case my gynaecologist) to be seen and they usually contact the hospital and let them know that you are coming in. If you are a walk-in patient, you need to sign paperwork to agree to in-patient treatment. They don't do out-patient treatments as such.
There were two patients, who spent ages arguing with the lady at the reception desk about being admitted. One needed to get back out because he had a rental car that needed dropping off. The other lady hadn't bothered to see her doctor and just complained that nobody would see her. She then swore at the receptionist and walked out when she was told that she'd need to agree to being admitted. I think she then rang up the emergency hotline, who in turn checked with A&E at our hospital. It was all rather silly.

Yeah, I had way too much time sitting there. To be fair, wait times are a lot shorter here than in the UK. I usually wait about 10 minutes for triage and then no more than an hour to be seen by a doctor. I did have to wait for my blood test results to come back, which is why I had to wait there for a bit longer.

@bruffin I don’t expect he could have done anything to prevent the convulsions. I was explaining how minor things like ear infections ended up with A&E trips in my case. However if he’d shown even a single sign he gave a shit, I might have felt able to call the surgery instead of an ambulance. It might be nothing to you if you’re experienced with them, but at the time I was young, it was the first time it had ever happened (and still is) and I was terrified.

@Changechangychange That's a really thoughtful and thought-provoking reply, thank you. I think people like you who have worked both in the nhs and beyond are the very people who need to be leading these conversations, trying to keep the best of the NHS while identifying good practice overseas and avoiding the pitfalls you mentioned.

I took my autistic son to A and E (twice) with ear infections. He has a high pain threshold and hates to be touched and he was begging me to stay with him and cuddle him (he's 19) and crying in pain.
He had bilateral inner and outer ear infections.

This happened over a weekend of course. We took a covid test but hadn't had the results but thought it was ear infections, we tried the walk in but they wouldn't allow people with fevers (it was 39.5 after paracetamol. Did eventually reduce when double dosing with ibuprofen). So A and E was our only option.