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

I really quite like the phone triage system but I need a smear test. I've tried to phone my GP what feels like 100's of times and haven't managed to get through yet. They aren't offering any online appointments so I have NO idea how I'm supposed to actually book this.
GP's etc are, in general, I think doing a brilliant job but it really feels like the IT systems supporting them need a lot of shoring up if this is to be the way we manage our health systems going forward.

The infrastructure isn’t a vodaphone call centre, this is one issue we have run out of seats to put people on, so there is a limit to how many people can answer a phone and it’s not a role that works well at home, they need support and privacy which a lot of homes don’t have. I WFH and struggle for private space. we can’t expand into consulting rooms it’s really difficult to meet demand within limitations - a GP surgery can’t just go and rent a new building, or rapidly expand their staffing

Also about injuries... I haven't stitched anyone for 15 + years... we don't have the kit or flexible enough timings... I cant just spend 30 mins stitching up, in the middle of a booked surgery.. and that stuff needs to be done in the nurses room with the adjustable bed and good lighting, which is full of a nurse doing all the things they apparently don't do any more either. I wouldn't want me stitching me ! Wound glue has a massively short shelf life and is stupidly expensive.. we can't afford to stock it on the off chance. Im happy to clean assess and steristrip if needed but anything else.. we can't do 🤷‍♀️.

Slightly off the subject.

Every time I see a large planning application I see the planners offering to build a primary school and medical centre.

What they don't offer - and neither can the council - are the teachers and medical personnel to staff them.

The Tory government stopped nurses bursaries as an example. They've brought them back at 30 per cent of what they used to be. A Labour govt also upped the ante so nurses need expensive degrees. All governments have demanded more accountability meaning more form filling whether it's GPs, hospitals etc.

Dido Harding (she of the failed billion track and trace) would like to be head honcho at the NHS. She has purportedly said she would like to employ fewer "foreigners" if she got the job. Great move (not), though I agree we shouldn't be poaching much needed medics from round the world.

I wonder if she's done the sums about how much it would cost to train British replacements and how long it would take (7 years for basic, and much more for an A&E doctor) . And whether they would have to lock into contracts to serve the NHS and not disappear into private practice, or abroad to places with more tolerable systems.

Not the same, but I think the whole system is absolutely shit and they create problems for themselves. We moved overseas several months ago, I followed all the advice on notifying everyone, GP’s, hospitals for appointments yet I’ve still been contacted regarding hospital and specialist appointments, because they weren’t cancelled. I’ve been phoned twice by consultants to conduct telephone appointments, got a notification about some testing I was supposed to have in hospital and also a notifications for an appointments for two of my DCs.

On the appointments that I’ve had text reminders the day before, I’ve spent hours going round in circles trying to cancel these appointments, much needed and sought after appointments that could have gone to other people on the waiting lists. In the end last week I actually gave up and just didn’t show up for an appointment, I hated it but I was getting no where with phones ringing out, being disconnected, finally getting someone only to find out I’ve been transferred to the wrong department.

Then the nhs complains about missed appointments costing them money. Even before we moved I needed to cancel an appointment as my dd had covid, I called the main appointments number but because it was so close to the appointment date they said call the consultants secretary direct, I did, luckily I took her name and recorded the date and time. A few weeks later I get a letter explaining I couldn’t have my medications reviewed as I had missed my appointment and was being discharged, cue going round and round in circles trying to stop the discharge 🤯

Our GP practice was dire before Covid and now it is like Fort Knox. They have disabled the online service and you need to ring each morning at 8.00am. By 8.05 you get a message on the phone saying they are full today, please try tomorrow. 3 reception staff have left in the last 2 months, 1 of them, my neighbour with 22 years experience told me she had left because of 5 GPS at the practice only 2 of them were pulling their weight, the other 3 were doing as little as possible and generally expecting the nurses and other staff to run themselves ragged. I now find out that 2 of the 3 are coming back part time and the other of the 3 has resigned. I work in an opticians and the number of people we have had in who say that the doctors staff told them to book eye appointments, when they needed doctor attention has been so much higher than usual. I am sure the very many GPS are working very hard. Ours is not. 1 of the messages you gave to listen to on their phone lines relates to covid and says not to contact them about covid related matters as the practise does not deal direct with their patients on covid related matters. They are not giving injections through the practice and not working elsewhere giving injections either. They are so well known locally for being shit that even a and e are sympathetic. My husband ended up being blue lighted to hospital due to a total failure to see him, even had a telephone appointment but they never rang. So pleased we are moving.

@spacefrog35 I used the e-consult to request my coil removal.
I had asked if they were doing them at my vaccine appointment and was cheerfully told they were. The nurse tried to book me in there and then but I thought I should give DH the 'chat' first .
I filled in the e-form as best as I could but wrote in the first free form text box that I just wanted my coil out and could they book me in on a Monday or weds at any surgery on the group. A clunky way of doing it but it worked.

@Gettingbiggerandbigger

Not the same, but I think the whole system is absolutely shit and they create problems for themselves. We moved overseas several months ago, I followed all the advice on notifying everyone, GP’s, hospitals for appointments yet I’ve still been contacted regarding hospital and specialist appointments, because they weren’t cancelled. I’ve been phoned twice by consultants to conduct telephone appointments, got a notification about some testing I was supposed to have in hospital and also a notifications for an appointments for two of my DCs.

On the appointments that I’ve had text reminders the day before, I’ve spent hours going round in circles trying to cancel these appointments, much needed and sought after appointments that could have gone to other people on the waiting lists. In the end last week I actually gave up and just didn’t show up for an appointment, I hated it but I was getting no where with phones ringing out, being disconnected, finally getting someone only to find out I’ve been transferred to the wrong department.

Then the nhs complains about missed appointments costing them money. Even before we moved I needed to cancel an appointment as my dd had covid, I called the main appointments number but because it was so close to the appointment date they said call the consultants secretary direct, I did, luckily I took her name and recorded the date and time. A few weeks later I get a letter explaining I couldn’t have my medications reviewed as I had missed my appointment and was being discharged, cue going round and round in circles trying to stop the discharge 🤯

You are spot on. We in GP often get frustrated trying to contact hospitals though now they are largely more available by email than before.

We are seeing it too in icu , a busy almost at covid levels.

People with stomach ulcers that have perforated, chest infections that are actually cancerous, conditions normally mild that haven’t been managed in the community. No one who works for the nhs said that life outside of covid was good, we just tried our best.

There’s also a mental health crisis and the amount of suicide attempts is heartbreaking

I've been so impressed with our GP lately, my daughter's allergies have been dealt with over the phone, meaning I've not had to pull her out of nursery for them to see her snotty nose and hear her cough. I've filled out e consults several times for me in the last 8 days, have always had a call the next day (done in the evening out of hours) I've been seen in person twice and referred to a and e today when it was established I needed iv therapy. I get cross when people in my local Facebook groups say the practice staff are lazy,have had 'all this time off' and 'wont see people' they'll see you if you need it, they're doing their best!

When you live in a country where you have to wait three weeks just to speak with a GP this is the result. No idea why people don't protest on the street about this nevermind lockdown protests.

And when you finally see a GP you feel like they're health service bouncers not doctors. Each one I have seen takes a wait and see approach or the least clinical intervention. Must save loads of cash but paid for in lives ultimately. This has been going on pre covid so can't imagine it now

In our area you are meant to call 111 to be triaged and get a time to go to A&E. I had no idea and took a friend in who had a fall (broken wrist). The receptionist grudgingly said she could wait but in future to call 111 first!

For loads of different medical stuff, if you google it then it always says “You should discuss this with your doctor or go to A&E.”

Can’t get a same day appointment with the GP - therefore a lot of ppl feel they have to go to A&E to be on safeside.

@Skysblue

For loads of different medical stuff, if you google it then it always says “You should discuss this with your doctor or go to A&E.”

Can’t get a same day appointment with the GP - therefore a lot of ppl feel they have to go to A&E to be on safeside.

yes but it doesn't always say 'you should discuss this with your doctor today or go to A&E'

So what does it mean - when does it think you should go to A&E?
If its important enough for A&E then it's fairly urgent surely.

I can’t help reminiscing back to a time when people didn’t feel they needed to ring an advice line to be told what to do for minor ailments. How did our parents manage? Did they rush us to the GP for every temp, vomiting episode or allergy rash, maybe they took us to A+E for every cut/bump or fall?

I bet they didn’t. I bet most applied some common sense, treated at home, and I bet most got better themselves. Of course I KNOW GP’s were more easily accessible, but I know it was a rare thing to be dragged there. Of course there will be rare events whereby serious ailments are picked up by advice lines, but they are dwarfed by the enormous inappropriate use 99% of the time.

I feel whichever deluded fool decided a ridiculously risk averse advice line would reduce the impact on emergency and primary care, should spend a week listening to the never ending ‘111 told me to come/ring for an ambulance/ “ I didn’t think I needed hospital I just rang for advice” on repeat. 8, 10 times a day, hearing the same thing, again and again is soul destroying.

What’s the answer? I don’t think there is one. The need for people to be advised what to do for anything medical is so entrenched now there’s no way out. Charge, maybe? And there goes another can of worms. But what else will feasibly reduce demand? I honestly don’t know.

My local surgery won’t see patients.

I’ve heard of telephone consultations for physios. Wth? If district nurses can continue to work and see patients throughout both lockdowns, then it’s time the gps and physios etc start to see patients face to face again.

Oh I was offered a telephone consult for my arms with physio.

Yeah husband got a phone thing with a physio and emailed some stuff to do.

“then it’s time the gps and physios etc start to see patients face to face again.”

When DD was referred to physio (some contracted out company, which is inaccessible to people, in the town where we live and can’t drive, like her), we offered to pay for private physio for her in our town. Private physio saw her face to face the next week for assessment and treatment on her hip - so fairly close to her! A course of hands on treatment for a few weeks and now all done!

The cynical part of me thinks that this shit will drag on. The GPs doing their stuff (i mean it's pretty obvious they're living in a world that is overwhelming them while the rest of us just can't get to see one, doesn't mean either side is lying) that we'll come out of the his with the 2 tier system. Pay to see someone quicker or wait a while for NHS. Until NHS isn't a viable option anymore. The Tory dream

I'm genuinely curious about how the telephone triage helps? I understand that it stops people that don't need it getting a f2f appointment, but they are still using an appointment slot (on the phone), and people that do need to be seen now have two use 2 appointments instead of one. It seems less efficient

This is really sad to read. We are really lucky that our amazing GPs will do a same day phone call, and then will see you that day if needed. My little boy was really poorly recently (including having a cough, he’d had a negative test but I wasn’t sure if they would be funny about it) and they saw us in person very quickly and transferred us to hospital which was needed. I don’t mind the new system because it’s a good blend and some things can definitely be sorted over the phone! But it sounds like some still aren’t seeing people in person at all which is mad.