Why are A&Es getting so busy?

[User112]

www.google.co.uk/amp/s/www.independent.co.uk/news/health/hospital-emergency-black-alert-barnsley-hospital-b1870819.html%3famp

Basically what everyone else has said with the added factor of people being out and about and all that entails. During lockdown there were fewer cars on the roads, pubs closed, shops and restaurants closed, visitor attractions/soft plays/sports centres closed, gyms and kids clubs closed, workplaces closed, and so on. Now they're (mostly) all open again you've got all the various bumps, scrapes, sicknesses, and injuries associated with all of those things.

@tiredanddangerous

I expect GPs not seeing patients has something to do with it in some cases.

Funny. I must have hallucinated all the patients I have seen in 2020 and 2021. Not a single working day when I (a GP) didn't see someone face to face. I also must have imagined the fact that I only stopped fitting coils and implants for a couple of months at the height of things in 2020 and have been doing them ever since, to try and protect my local population from unwanted pregnancy.

I don't have to imagine the number of people who ring me up for a sore throat of 3 hours duration, athlete's foot, conjunctivitis or a myriad of things for which the pharmacy is far more appropriate. The problem is successive years of underfunding, but the inability of the general public to look after their own minor self-limiting illness is also a factor.

Gps not seeing patients must be impacting on A&E.

My elderly mum is very unsteady with a bad leg and has already been ambulance in after a fall. Her gp refuses to see her so its inevitable she will be back in A&E soon.

Also with phone triage for gps - that adds to the issue as some people cant advocate well over the phone

Not all GP's aren't seeing people, ours are still seeing people. You fill an econsult form in and you get a reply the next day, offering either drugs, appointment or advice depending on need. The longest I've had to wait to see a doctor is a day.

@LadyMcBee

I phoned GP yesterday, I was told by the receptionist before I'd even had a chance to speak that GP will not see anyone face to face, before she then went on to ask me to describe my concern.

This may have something to do with it.

I don't understand why GPs, the majority of which will be vaccinated and would have been some of the first to be so, won't see people face to face. But when I go to work in the hospital, I'm literally wiping bums.

OK if this is true, if your practice really has a policy of no F2F then you need to report them to the CCG and the CQC. I believe there are a very tiny number of GP practices giving the rest of us a bad name - but I suspect you will find that there was a misunderstanding. If you have genuinely found a practice doing no F2F then please report them

@IncessantNameChanger

Gps not seeing patients must be impacting on A&E.

My elderly mum is very unsteady with a bad leg and has already been ambulance in after a fall. Her gp refuses to see her so its inevitable she will be back in A&E soon.

Also with phone triage for gps - that adds to the issue as some people cant advocate well over the phone

funnily enough we aren't idiots. we have a much lower threshold for seeing people who can't communicate on the phone. The practice where I work has done phone triage since 2013 and it works well - in fact is the only long term solution where supply doesn't meet demand.

[quote TheMotherlode]@helpmeeee11 - genuine question, why are GPs busier? It is all covid related, because they’re busy managing the vaccine rollout, or something else?[/quote]
I'm going to let @sparemonitor take this one

@Souther

You've got new housing developments being built but no thought about how these people will access healthcare, or even school places.

I always find this an interesting argument, I know you're right but is it that:

• new houses convince people who wouldn't otherwise have children to have children?
• new houses make people move from other areas? If so isn't thay just creating capacity elsewhere?

Or something else? Sorry for picking on you, you're the first person expressing this argument I've been able to ask directly.

Our local hospital actually had a shit fit at all the GPs in my area trying to send kids straight there rather than seeing them at the surgery. For stuff you 100% do not need A&E for.

I’ve ended up on the e-consult loop which tells me my symptoms are urgent and need contact surgery. When trying to contact surgery told I need to use e-consult forms. Factor in websites and forms and don’t covid lists no wonder people crack on until something is urgent then end up in hospital.

I swear if majority of Gp or hospitals did UTI test dip sticks pop in’s like they used to you would get rid of loads of people. “We don’t do that anymore” helps no one when in agony with such a common complaint.

A friend has been waiting for a gynae appointment since before lockdown.

At the weekend, the pain she had been suffering became intolerable and she went to A&E on the advice of 111 and had a massive ovarian cyst removed as an emergency procedure. It had gone into torsion.

She probably wouldn't have been in A&E if she'd been seen sooner.

Your poor friend. I’ve heard a number of these types of stories - problems that weren’t emergencies 6 months ago but became emergencies due to lack of treatment.

@sparemonitor I complained to DMs practice manager about the dreadful service. They haven't even acknowledged my email, should I take it further?

My DD is in agony with a sinus infection, she needs antibiotics. Contacted GP surgery yesterday by email (only method) she was, today, given a phone appointment on Friday. The NHS is broken and unfit for purpose.

[quote TheMotherlode]@helpmeeee11 - genuine question, why are GPs busier? It is all covid related, because they’re busy managing the vaccine rollout, or something else?[/quote]
Whilst I appreciate that not all surgeries are working the same, we are so busy.

It’s pretty much back to normal for us - business as usual. We’re still triaging everything by phone, which is actually more efficient for patients as they’re brought in if needed either the same day or later that week. My GPs are seeing approximately 10-15 patients a day each.

Us nurses are seeing 20-30 patients a day each.

GPs are also delivering the Covid vaccine programme with no additional resources - we’re doing it as overtime. Apparently GPs have delivered 70% of the vaccines given. Quite an achievement I think.

ED has always borne the brunt of chronic understaffing and under provision in primary care, in combination with inappropriate attendance and general demand. The pandemic has exacerbated that.

@Akire many many pharmacies offer a urine dip service. Think all in Scotland and certain brands in England. They then prescribe the antibiotics required if appropriate.

OK if this is true, if your practice really has a policy of no F2F then you need to report them to the CCG and the CQC. I believe there are a very tiny number of GP practices giving the rest of us a bad name - but I suspect you will find that there was a misunderstanding. If you have genuinely found a practice doing no F2F then please report them

Yanno, this stuff grinds my gears. 'if' indeed like people must be lying about their own personal experiences.

YOU might have been. Doesn't mean they all are. My surgery is part time GPs, can you imagine what it's like there?

I think also people forget GP surgeries aren’t an emergency service.

Sprained ankles, possible broken bones, cuts, chest pains, acute asthma attacks, falls, etc aren’t what we’re there for.

Last week my GP advised me to take DS to A&E after he got a tick bite and we couldn’t get all of it out. Flat out refused to see him and said “we don’t deal with stuff like that”. I said A&E seemed rather drastic and he said I didn’t have any other option.

I did not take his advice and managed to get an appointment at a local minor injuries unit via 111 where the remainder of said tick was dug out by … a GP. Surprising that.

Our GP is still doing face to face appointments.

new houses convince people who wouldn't otherwise have children to have children?

New houses mean trapped people in their twenties living with parents have more opportunities to move out, move on with their lives and move towards having families of their own, yes. The population grows.

It moves capacity around too, yes, but with infrastructure like schools they don't materialise over night in time for the new housing. Councils cut corners and put in temporary classrooms to meet demand and before you know it you've got cramped overcrowded schools. This happened a lot in my town in the 90s, as a result about a third of the large secondary was in huts, many if which had leaking ceilings held up by support posts. A couple of older departments were full of asbestos, and the whole school site was not fit for purpose.

Where I live there's a proposal for thousands of new homes and nothing whatsoever about school places, despite all the local schools being oversubscribed and the two larger sites already having been expanded to the max!

@Robostripes what stopped you removing it yourself? Rather than a GP who as people are saying could have used that appointment to see the PP elderly mother?

New houses mean trapped people in their twenties living with parents have more opportunities to move out, move on with their lives and move towards having families of their own, yes. The population grows.

Surely the problem isn't too many young people. we have an ageing population & a declining fertility rate. Obviously more older people mean more chronic conditions. There is a huge issue in social care that no one wants to address.

. The problem is successive years of underfunding, but the inability of the general public to look after their own minor self-limiting illness is also a factor. @sparemonitor this with bells on.

Im a paramedic, we've seen call rates take a massive increase in the last 3 weeks to what they were at peak covid times.
The majority of calls are frankly utter shite. There is absolutely no ownership of mild to moderate health problems, no self care, it's always someone else's problem.

Back pain for 4 weeks? Ask a patient if they've taken any analgesia, usually met with a perplexed 'no' or 'well I took one paracetamol yesterday but it didn't help'
Vomiting for 3 hours is deemed a medical emergency.
I could go on but you've heard it all before.
It's absolutely soul destroying knowing that the 85yof with a probable #nof that's been on the floor for hours will have to continue to wait whilst we clear a backlog of capable adults who call to be 'just checked over, had vaccine, feel a bit funny' usually comes down as chest pain or SOB which in turn are higher priorities than said 85yo whose mortality takes a nosedive.

It's just so fucking morale sapping.

All those that point their fingers at woeful GP services/long ambulance waits/a disgrace of a MH system need to look not to those that provide it but the successive governments that are like death eaters to the NHS.

@Thedot90 the poster literally said they couldn't get all of it out.

My sister had been calling the GP repeatedly asking for help with pain in her back. She had a history of cancer. For months they told her it was a trapped nerve and gave her painkillers. In desperation with the unbearable pain she went to A&E, they finally scanned her and diagnosed her with cancer. She died 7 days later