AIBU to think this is a crazy reason to go to A&E?

[JemimaPyjamas]

Bit of background; I am a (well controlled, no history of complications) Type 1 diabetic. I have had it for 40+ years and the medical assistance I have ever needed is minimal, and I have been at the same GP practice for 14 years.

I am not sure how, but I got a splinter in the end of my big toe. Not a massive splinter, or anything remotely dramatic, but it was hard to see the area where it was. I think I removed it, pretty sure, but the area was sore - probably as it's a very sensitive place - so I called the GP, apologetically, to ask if there was any chance someone could have a quick check to make sure it was okay. (I didn't have anyone else to ask, hence me pestering the GP which did seem like semi overkill in itself.)

I was told they'd call back and then got told that 'nobody at the surgery is prepared to check a wound of that nature in a diabetic and we have been told to tell you you need to go to A&E.' I reiterated that it was a double check, for something the size of a very small papercut, and it was purely precautionary rather than necessary.

I got the same reply.

Needless to say, I have not gone to A&E during a pandemic so someone could double check a splinter had gone from my toe. I have instead soaked it, felt it and double checked it and it seems fine.

AIBU to think the (quite large) surgery was bonkers...? Or

@Psdoff

How utterly incompetent! Their district nurse could have done this, heck a GP! Report to CQC

This is wrong and terrible advice.

@samwitwicky which is why I called them in the first place! Its still not an A&E issue though, particularly at the moment.

A lot of the foot issues are linked to poor circulation and other diabetic complications, which I don't have. The GP's surgery would have been able to see this, but seemed to be reacting as if I was a diabetic disaster zone!

This may well be a commissioning issue. The standard GP contract does not cover minor injuries. In some areas, GPs have an enhanced contract to offer basic minor injury assessment and management - but many GP surgeries aren't commissioned to provide this service. In my neck of the woods you might well be redirected to a minor injuries unit. I appreciate it's frustrating, but please don't blame the surgery - apply pressure to the commissioning body.

As PPs have said, diabetic feet need special care - do seek medical attention (via a minor injuries centre or walk-in centre if you have one locally, perhaps?) if there is anything left in there.

I don't think it's terrible to get it checked, even well controlled diabetics can have issues where feet are involved! Definitely a practice nurse job. It's very disappointing they wouldn't see you, I work with GP practices and they've been seeing people face to face as normal, with a telephone or video consultation first.

@Psdoff

How utterly incompetent! Their district nurse could have done this, heck a GP! Report to CQC

Awful advice.

You should ask for a referral to podiatry, as a type 1 diabetic you should meet the criteria. Or just call again and ask to see the practice nurse, say you are concerned about a wound on your foot as a diabetic.

Disgusting to just pass you on to an incredibly overstretched A&E service!

I was at A&E recently and the HCP who was doing my ECG and bloods was telling me how bad the last few months have been for them with GPs sending people they could quite easily see to A&E. He said it was so bad that day all the bays and beds were full and hosp was on alert and still GPs were sending patients who could be seen with them up to hosp. He said they often see people who's emergencies could have been much less serious had the GP seen them too. It's madness. I'm half thinking there will need to be an enquiry into the way GPs in particular have been dealing with patients during this time...doubt there will tho...

I don’t think I would have even called the GP to be honest!

Unfortunately, diabetes can cause peripheral vascular problems & infections can set in very quickly with potential complications

Have you tried magnesium sulphate cream (drawing ointment) overnight to try to ease it out?

Don't want to worry you but a few years ago I got a large splinter in my finger whilst gardening and thought I'd managed to get it all out but a week later it was very red and looking infected
I'm in my mid 40s and type 1 diabetic since I was 2 and very well controlled and no problems at all.
By the time I was seen it was so infected that I ended up have my finger from the knuckle up removed.
As a diabetic infections can spread quickly so if I were you I would get it checked asap.
I was very blase about it all as like you never had any problems

Sorry not the knuckle up lol from the joint, not sure what it's called

This doesn't surprise me. My DC, type 1 also, had an ingrown toenail. When I spoke to the practice nurse they said they couldn't look at it due to the fact they were type 1.
They has to refer us to the podiatrist at the hospital, who to be fair called with an appt with a few days but I thought it was ridiculous that the GP's practice passed this on to the hospital to deal with.

But many practice nurses clinics are fully booked for weeks. Mine are. My next free appointment is mid August. No good when something needs checking relatively soon.

Clinics that have plenty of patients booked in by the way referred to us by the hospital who they won't see, all the way through the pandemic.

You can buy a drawing cream from the chemist, put some where the splinter was, if there was any left the cream will draw it out

An ex in law of mine got a small cut from filing her foot skin, she had diabetes. It wouldn't heal, she ended up having to have major surgery to move a vein to act as an artery, which failed and she ultimately died. I know this is worst case scenario, but diabetes massively impacts blood circulation to your feet- I would go to a and e, just to be in the safe side.

And this is why there are 14 hour waits in A and E,what are GPS actually doing?

And being Type 1 does not automatically entitle you for podiatry in many places. You need vascular issues and other relevant co morbidities to qualify. Another service on its knees.

@cptartapp I agree with this. Not from personal experience but anecdotal, definitely.

I phoned the GP a couple of weeks ago for advice on a minor injury. I was told they wouldn’t see me and had to queue for 5.5 hours to see a hospital doctor. As we were triaged, I got a sigh of frustration and a bit of an eye roll that the go wouldn’t see us.

The whole system seems to be crumbling at the moment, I’m not quite sure what the answer is tbh (except a lot more money to fund actual nurses and doctors on the wards and in the surgeries).

I asked my GP to look at a splinter in my daughter’s thumb, it was infected, they referred me to A&E. The receptionist gave me a dirty look when I told her why we’d gone. I felt such a dick.

Our four GP's are seeing patients every ten minutes, interspersed with telephone consultations, visiting care homes, home visits, etc. Their clinics are all full for at least two weeks. Some more.
So even if they were all in today, again, no appointments soon enough. We are not a walk in service.

Diabetes and foot wounds of any kind can be a real concern. I'd want it looked at and if I couldn't get my doctor or office nurse to look at it I'd go to the ER or an Urgent Care.

And these issues will only get worse. Three of our most senior staff with over 100 years experience between them all out in September, leaving massive gaps.

As part of your yearly diabetes check you should have been given a foot advisory leaflet giving contact details if you have issues with your feet. We’re you not given this?