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

But they're not just "not answering the phone", they are already on the phone, GP receptionists are constantly taking calls for the first few hours of the day because so many people are trying to get through....

Chronic underfunding of primary care and NHS in general by Conservative government for the last 11yrs?

@Geekygeek

Chronic underfunding of primary care and NHS in general by Conservative government for the last 11yrs?

yes and hiving off of money to PFI and poor value private providers by Blair before that.

Please less of the GP bashing. We have phone call and face to face appointments. My dd age 14 was seen within a few days of me phoning for her to do with mental health and my lovely dm has been seen by her GP referred and had colonoscopy all within 3 weeks. When I was waiting in the surgery a few weeks ago for DD it was just as busy as a pre pandemic. I don't think the GPS are just sat twiddling their thumbs.

@sparemonitor thank you for all you do. Our GP surgery is nothing short of marvellous and I've also had really good experiences with 111 lately.

Ive three young children and now schools are back they're constantly getting unwell. I had a F2f app with GP within two hours last week with my 9 month old. No telephone nothing. He was brilliant. He did say now we are all mixing again they're seeing a huge increase in typical illness that we've not had much of for the past year so I expect this has something to do with it.

I really hate the GP bashing. Of course they're will be instances where they're not great but in the whole they're doing they're best on a under funded, under resourced, over subscribed service.

Thank you to all those posting nice things and for the supportive PMs I have had. they do make a difference.

@Angelik

According to DH, a paramedic, utter misuse of a&e service by people generally, pointless 111 service and mot enough GPS - last one being down to funding and shit infrastructure planning

I also work for the ambulance service and completely agree with your husband. I took my Ds to A&E last week as he had been attacked and kicked in the head, we were told by police investigating the attack that he needed to be checked. In the waiting room were at least three children who Clearly were not ill enough to require emergency treatment. One had apparently hurt her elbow ( the mother kept informing people loudly on the phone) however said child was happily using her arm without so much as an ouch. She was literally in with the doctor for less than 2 minutes before being sent home. Two toddlers running riot around the waiting room while the parents loudly complained about how their " very poorly" children were being made to wait far to long! A teenage girl who obviously had mental health issues and had slashed her arm to bits ( would have been far better off in a mental health setting). This is just a snapshot of one night, so imagine what its like day in day out! People take the NHS for granted.

@sparemonitor my GP is worth his weight in gold. I've experienced grumpy GPs in the past but mostly can't fault the service. Incidentally my sis in law has just got her 11 Yr old dd into see the GP this afternoon, same day appointment. Thanks for all you do xxx

@Prestissimo

Yes *@Sidge* agree it’s the language that’s upsetting. I think we can all agree that the current situation is dire, but it does feel as though GPs are really facing the brunt of the criticism from everyone from the Govt/NHSE downwards.

Every time I see these threads I think I won’t look. And then I do, and I regret it.

Me too @Prestissimo

I don’t doubt there are some badly run surgeries, and I fully understand people are frustrated at not getting the service they require. I really do. I’m a patient too somewhere! And with a disabled daughter I’m also a user of services.

I just wish people would realise we’re not just ignoring the phone, or sitting around eating biscuits, laughing because we’re not seeing patients. We never stopped. We were TOLD to stop seeing people last March/April for about 3 weeks but since then we’ve been business as usual. With some modifications obviously, but also playing catch up, and delivering 70% of the biggest public health programme in history.

We’re also human, have children at school that are regularly being sent home, staff who had to shield last year (but then worked from home with their own mobile and a laptop), have had illness or isolating instructions ourselves.

We’re busy, and we’re tired, and we’re doing our best. But thanks to years of underinvestment, under provision, a population who often demand instant gratification along with an absence of common sense, we’re on our knees.

You’ll miss us when we’re gone.

Yep 111 and GP’s have added to the work load massively. Additionally people turning up with issues they can absolutely deal with at home aren’t helping. Violence and aggression is up. Plus no one had accidents like scooter falls etc because they were so limited in outdoor activities. We have even had people calling for wait times and getting angry we aren’t giving them out because of the volume of people attending. If you have time to call round for the quickest wait I would question the severity of the accident of emergency. It’s truly awful.

@ Orf1abc why can’t someone say they are struggling as much as the patient. MH in healthcare has dipped massively. People have such high expectations and think that there’s a simple answer to everything. When you are working under such extreme pressures (particularly on top of the Covid situation) it’s walking from one disaster to another. Sickness is through the roof and many nurses and doctors I know are on the brink. We have had so many leave over the last few months because the way they have had to work is shocking. It doesn’t mean that a patients suffering is meaningless or less important but it doesn’t mean either that NHS staff aren’t allowed to say they are suffering. They didn’t create this shit show at ground level.

My Gp is absolutely fantastic. AnE has always been abused and I know sadly a lot of GPs aren't pulling their weight. I work in a dental hospital and we've been seeing patients for routine treatments for over a year now so I don't know why all GPs aren't seeing people face to face or at least a phone call. I actually prefer my Gps new system as I'll always get a phone app that day. It's a shame not all practices are the same

@TipTopHat

I work in a diagnostic setting in a large hospital and we are at breaking point. Incredible increase in GP referrals, cancer referrals have been our highest on record over the last 2 months but this week A&E has been at peak winter levels. A massive increase in query DVT patients have been sent to us, we think partly due to the news stories around the vaccines and a query DVT requires a scan. We are absolutely drowning. Also people not being able to get an appointment with their GP is having a massive massive impact on our A&E numbers I'm pretty close to giving up.

We are absolutely drowning in GP land too We feel close to giving up in GP land too

DDs consultant wants her to have a blood test at the GPS. I cannot get through though. I’m going to have to do an e-consult to leave a message and hope they will book it in that way and message me. I can’t sit on the phone for hours at work just to try and book in.
I’ve been in for a blood test (GPs rang me for it) the phlebotomist wasn’t that busy - I suspect because no one can ring and book and usually she is a drop in service.

@Mrs08, you are so right.

It seems that many people want a better-resourced NHS, but not enough of them are prepared to vote for it.

@sparemonitor I think a lot of people do understand that GPs are snowed under but their frustration with the rubbish infrastructure leads to GPs getting the backlash. My surgery is now allowing F2F appointments without e-consult first, much to my relief. My GP is excellent, she immediately organised tests when I had a F2F appointment with her two weeks ago, and I was able to explain exactly what was going on. The two e-consults during the previous 7 weeks were a waste of time and led to prescriptions that weren’t appropriate (GP admitted that). My care overall is excellent but technology has limitations - not the GP fault, it’s been forced on them.

It's GP surgeries not doing the routine stuff, such as routine tests, and their unwillingness to actually see patients generally.

My OH is in the middle of chemotherapy. This is his second course. First time was 3 years ago. First time, he could easily get access to the GP for side effects, regular blood tests, etc., and was having his chemo in the oncology dept so there were specialist cancer nurses to do checks and deal with issues etc. and a couple of time, a consultant was called to check things before the chemotherapy session started.

This time around, there's none of that. Chemo is being done at home via tablet rather than drip. He's not seen the consultant for 6 months. Only having one blood test per month. No other tests, no blood pressure, no blood sugar checks, etc. He's basically being ignored and can't report side effects. His GP isn't interested. The oncologist is non contactable between phone appointments.

He's had a couple of serious side effects and can't contact anyone for advice. He's had to call 111 and they just say to attend A&E.

@FakeColinCaterpillar

DDs consultant wants her to have a blood test at the GPS. I cannot get through though. I’m going to have to do an e-consult to leave a message and hope they will book it in that way and message me. I can’t sit on the phone for hours at work just to try and book in. I’ve been in for a blood test (GPs rang me for it) the phlebotomist wasn’t that busy - I suspect because no one can ring and book and usually she is a drop in service.

You are getting cross at the wrong person. This is what I meant about secondary care dumping unfunded work on us. If DDs consultant wants her to have a blood test s/he should give you a form and you have it done at the hospital. Delegating this to GP is a big part of the reason why we are struggling, but it's also unsafe - it blurs the lines of who is responsible for actioning the results.

@FakeColinCaterpillar I would suggest ring your DD's consultant, ask their secretary for a blood form and if they refuse complain via PALS. The tariff that a Trust is paid for outpatients includes doing all the relevant tests. And then I would suggest a complaint about the fact that the consultant didn't give you the blood form in the first place.

@Menora

Also the most common reason for clogging up GP surgeries is skin rashes. People do not know how to help themselves

Bloody hell.

I've only ever once been to the GP with a rash, and that's because I also had a fever, felt like shit and a neighbour had chicken pox.

I thought it might be chicken pox, and it was.

@Badbadbunny

It's GP surgeries not doing the routine stuff, such as routine tests, and their unwillingness to actually see patients generally.

My OH is in the middle of chemotherapy. This is his second course. First time was 3 years ago. First time, he could easily get access to the GP for side effects, regular blood tests, etc., and was having his chemo in the oncology dept so there were specialist cancer nurses to do checks and deal with issues etc. and a couple of time, a consultant was called to check things before the chemotherapy session started.

This time around, there's none of that. Chemo is being done at home via tablet rather than drip. He's not seen the consultant for 6 months. Only having one blood test per month. No other tests, no blood pressure, no blood sugar checks, etc. He's basically being ignored and can't report side effects. His GP isn't interested. The oncologist is non contactable between phone appointments.

He's had a couple of serious side effects and can't contact anyone for advice. He's had to call 111 and they just say to attend A&E.

I doubt that the GP 'isn't interested' but patients having chemo should have open access to their chemo nurse. This is way way outside of our area of expertise. If you get a side effect of the chemo, other than something very basic, do you really want me managing it, me who has never before managed a patient on that particular type of chemo, or do you want your oncology team who know what they are doing? Again. what you should be cross about is the not seeing a consultant and no access to chemo nurse.

@LakieLady

Random spots and heat rash are the most common
Not rashes with an obvious illness
Rashes

@pabloescobarselasticband

A teenage girl who obviously had mental health issues and had slashed her arm to bits ( would have been far better off in a mental health setting).

The way you’ve written this at the end of your list of kids who didn’t need to be there sounds as though you didn’t think this girl should be at A&E

If she’d ‘slashed her arm to bits’ then surely that would need cleaning and stitching? And it’s not as though you can just present yourself at a mental health provision and be seen. As an ambulance worker you surely must know how very very difficult it is for anyone with mental health issues to get the care they need, especially at the moment.

I wonder if we live in the same area, @funtimefrank?

My surgery has been excellent throughout the pandemic. It may take 40 minutes to an hour to get through, but I've never been unable to get a telephone appointment the same day. If you can't answer the phone when they ring, they will ring you every 30 minutes or so until they get hold of you.

They do e-consults where appropriate and if they need to see you in person it will be later that day or the next day. And we have an excellent minor injuries unit where they can do x-rays and have them assessed by a doctor at A&E in the main hospital several miles away. I've been in twice for blood tests and was seen bang on time.

We also have an excellent pharmacist in the high street and one of the women working in there used to be a nurse, so that covers a lot of bases.

This is a small town in a rural area, so maybe the pressures are less than in an urban setting, but I can't fault them.

In support of GPs, nurses and medical administration staff, I hugely appreciate the care we've had from our GP surgery over the years and especially since the pandemic started. My parents' GP surgery have also been fantastic and my dad, who needs fairly regular appointments with the GP, has been thoroughly well cared for throughout which has been very reassuring to me as I'm hundreds of miles away.

@Badbadbunny do you not see the irony of your statements?

You say GPs aren’t doing the routine stuff, then say he’s having monthly blood tests.

His specialist care isn’t being done by the specialist team (ie oncology) but that’s the GPs fault? Once again, secondary care specialist provision is pushing the workload into primary care. Why AREN’T the oncology nurses delivering chemo in their unit and doing all the appropriate checks? That’s where you should be directing your anger.

(I really hope he is doing ok by the way)