To think 20 hour waiting time in my A and E is crazy...

[Meltinthemiddle]

What the hell is happening to our NHS? Is this all down to covid and GP's not seeing patients face to face or people mis using the system. There's been alot of GP bashing recently and I do feel sorry for some of them as no doubt they are working flat out but their appointment system is shocking!

My friend in Australia took her kid to their emergency department last week with shoulder pain. The wait to be seen was 5 minutes.

In Britain some children with suspected cancer wait a year to be seen by a consultant after the referral.

Britain is not a ‘good’ country anymore. Decades of mismanagement by morons.

I don’t want to leave my family and friends but I’m scared for my health in old age if I stay in UK and conscious that I have the option to emigrate now but won’t have that chance in later life.

Severe pain and heavy bleeding can be sepsis. That kind of thing is exactly what A&E is for. Unless you don't trust a woman to know what is abnormal for her? People don't just post on Mumsnet asking if they should go to A&E if they're having a normal period. Of all the examples to pick, you pick the one that could genuinely need attention. Honestly.

You're being deliberately abstruse here to pick on the poster. In the example, it was clear that she was saying how some people write about a common health problem (quote unquote PERIOD pains) and how MN replies whip it into a frenzy.

It was very fortunate that one MN poster did end up with sepsis and was seen but you do not know the specifics of that case. Eg if the bleeding happened in between periods, if it was post-partum, if it was after a miscarriage then all that could obviously point to more serious reasons.

I needed a GP appointment yesterday, phoned at 8am and was asked whether I needed a face to face appointment or if a phone call would do. I got a call back at 9:30. Issue could be dealt over the phone so we were sorted.

We don’t have an A&E, just an urgent care centre. But the wait here is always 3-4 hours and has been for years.

I had severe chest pains a few weeks ago and had to wait 2 hours to even see the triage nurse. There were people there with head injuries and one woman whose ankle was clearly broken. People were crying and begging to see someone. We were all still there 18 hours later. I had my blood tests and ecg after 3 hours in the end. They are crippled at the moment with lack of staff and a number of people attending due to problems that have become an emergency over lockdown

Second part of the problem of course was there were no beds for anyone that needed them.

I took my daughter recently as she broke her wrist. It was OOO but the amount of people in there for stuff that the GP or even the chemist could have sorted a few hours later was unbelievable. A dressing needed changing on a finger, chickenpox, a cough and cold. I was like what is going on.....there was a young boy in there who had sepsis symptoms and it was a 10 hour wait. It was awful.

In 2008 the BMA voted to restrict the number of places at medical school and for a complete ban on opening any new medical schools. "allowing too many new doctors into the market would risk devaluing the profession"

I'm not sure what the votes have been since then or whether they have had any on this subject.

www.bmj.com/content/337/bmj.a748.full

@BingBongToTheMoon

If you have to wait 20 hours to be seen in an A&E then you don’t need to be there.

Precisely this.

I was 8 hours in A&E (via 111 and ambulance with sepsis), and some of the idiocy I saw and overheard was incredible. Literally basic first aid and home medicine stuff, never mind pharmacist, GP, or MIU.

Frankly if you're well enough to be asking where the canteen is, or where you can nip out for a fag, your situation is not urgent. GPS are not refusing to treat patients, though it might seem more complicated, but bunging up A&E and preventing medical professionals from being able to deal with real life or death situations is abominable.

Surely the people responsible for the A&E crisis is the government for underfunding and understaffing it? And for underfunding the GP service?

My very good gp is sticking with the phone call/video consult where they do thar first, then book an appt themselves if needed. Exceptions made for any that can't use tech. Their view is that it is more efficient, and what many people prefer.

We used to have a fantastic walk-in centre that got closed about a year before Covid, I used it for a suddenly worsening tonsilitis that couldn't have waited weeks trying to get a GP appointment but didn't need A&E - was out with antibiotics inside an hour, problem sorted.

Unfortunately, the A&E queues and GP crisis has been worsened by the removal of all these fantastic surrounding services taking some of the load.

Why it's happening: ambulances no longer able to unload patients onto trolley in corridor to wait to be seen due to Covid restrictions meaning each person needs their own little bay. Ambulances stuck outside ED for hours and hours waiting to unload patients. People can't get an ambulance due to this.
Same with patients walking into ED.
Add in people not happy with GP service so using ED as the GP (instead of e.g. going to pharmacy or out-of-hours GP service).
Add in not enough ED staff because the working conditions are horrendous and nursing as a profession involving a degree and often a masters is grossly underpaid.

Can you remember the days of new labour when the government implemented a 4 hour waiting time limit and the vast majority of the time this was met?!!! I wonder if the conservative government will ever achieve this, even after Covid is under control. No they won't. I say this to those that voted conservative: big mistake

This If you have to wait 20 hours to be seen in an A&E then you don’t need to be there is just not true.

15 years ago waiting times were far lower; we haven't turned into a nation of hypochondriac time wasters in half a generation

Recent examples from my family/friends of things that were not immediately life threatening, could be waited for for some hours if had to, but did nonetheless need A&E:

• adult with sudden loss of hearing in one ear. Saw GP, GP spoke to hospital consultant, consultant said send to A&E so he could take a look, because a referral to ENT any other way would take months. Waited 10 hours, got seen, immediate treatment given and fast tracked into follow up services
• child who had a seizure (first ever). Ambulance called, gave oxygen, took her to A&E for observation. Would have been fine without A&E but doctors wanted her to be there in case she deteriorated quickly or had another seizure. Was there 8 hours
• child with laboured breathing and a few other symptoms. Saw GP, sent to A&E, stayed in an A&E bay for 16 hours, checked every half hour to see if he was deteriorating further. Didn't need further treatment but again doctors wanted him there for quick treatment if he got worse
• elderly adult fell, trouble moving freely, spoke to GP on phone who was worried and sent to A&E.

None of these were immediately life threatening and could (and did!) wait a long time, but all needed more medical intervention than a GP could provide and the GPs followed the system by sending to A&E.

Basically it's underfunded and understaffed and while there will always be some people going when they don't strictly need to, it is not the fault of people attending that there aren't enough staff or beds or equipment. Posts that blame people going to A&E can (a) put people off going when they really should and (b) shifts the focus away from the government underfunding services

I've got mixed feelings about all this.

Telephone consultations are pretty good when it's a straightforward quick query and they have a place in healthcare going forward, especially given demand, but a relative working in healthcare as a consultant says that Face to Face is important because you can pick up on all sorts of physical cues that you can't over the phone. The way someone sits down or gets up, being able to observe their body and see things the patient themselves hasn't noticed whether it's a tremor, rash, discolouration or whatever.

I think the practices do need to loosen up a bit - I have a dermological condition that needed a face to face and I had to queue up outside to wait for my appointment in the howling rain, alongside people with tiny babies, elderly people with no where to sit and the reception staff literally only open a window a crack to check you in. When I was handed a repeat prescription I swear if she could have stuck it on the end of a stick to increase the distance she would have. I appreciate they're trying to stay safe but social distancing and masks in the waiting room could be a reasonable compromise not least as winter's on the way.

In fairness to my GP I've managed to be seen and treated, as have my children throughout the pandemic, with same day appointments, referals etc all going through pretty smoothly so they're doing an amazing job.

The latest rescue offer to GP surgeries from Boris says thst GPS need to see more people face to face.
Then it goes on to say the govt are aware there are not enough GPs so the govt will fund remote digital GP apptmts...
Can everyone not see this for what it is ?
Even the govt knows there are not enough GPs - they failed to deliver the extra trained GPs . They alow the right wing press to demonise GP services whilst govt is promoting payments to digital online GP providers (NOT F2F). The Govt is choosing not to invest in the NHS and we all need to understand this instead of getting divisive. Complain to your MP, not your GP.
Use your vote wisely next time or your GP service will be all digital and very profitable for friends of the govt - who prob have shares in the business.

P.s. hospital wait times are massive due to Covid backlogs and not caused by GPs!

My Nan was experiencing chest pains and shortness of breath the other week. To avoid clogging things up we sat on hold to 111 for 45 mins, she got worse so hung up and called 999, 4 hours later a crew turned up. She has existing heart problems and we and the paramedics concluded likely heart attack so off to hospital she finally went.

My grandad is blind and I don't drive, they live over 10 miles from a hospital in an area where taxis are non existent on a Sunday afternoon.

The care she received once they arrived was second to none, but the wait could have killed her if things had gone south. It is terrifying.

[quote Enb76]In 2008 the BMA voted to restrict the number of places at medical school and for a complete ban on opening any new medical schools. "allowing too many new doctors into the market would risk devaluing the profession"

I'm not sure what the votes have been since then or whether they have had any on this subject.

www.bmj.com/content/337/bmj.a748.full[/quote]
God, they are still of this opinion.

They are not worried about the profession being devalued, they are worried about their salaries being lowered.

Supply and demand. If they restrict supply, the price goes up.

In other countries, they train far more doctors, GPs only have MScs not full doctorates so there are far more of them and primary care is not the shitshow it is in the UK. If your job is to refer people to secondary care, you don't need to be the same level of training as an eye surgeon.

If the problem is time wasters then why not fix the triage system?

Why aren't people showing up with 'dry skin' sent home right away?

I remember in my gp surgery there was a poster showing how many appointments were missed in the last month. Maybe there should be a campaign for similar in A&E departments - 30% of patients could have taken paracetamol and self-care, 20% could have visited the GP, 10% could have bout otc medicines from the pharmacist...

@dreamingbohemian

If the problem is time wasters then why not fix the triage system?

Why aren't people showing up with 'dry skin' sent home right away?

Because the Govt has told the general public they have a right to choice to see their GP for whatever issue they have.

@BingBongToTheMoon

If you have to wait 20 hours to be seen in an A&E then you don’t need to be there.

Well this is bollocks. I waited 16 hours to go to a&e with a broken shoulder. I still needed a&e!

@Lovelymincepies People want instant fixes rather than just letting there bodies get over minor illness and viruses, you only have to look on here to know that! The amount of people that tell people to go to A and E for self limiting reasons or reasons that a pharmacist could sort you out for.
Exactly this but that is not ALL the fault of the government although I agree they are spending our tax contributions unwisely as regards the NHS.
It is the entitled attitude of so many of the rapidly increasing population who think because it is 'free' it must be available for them all the time.
There needs to be more minor injury units with medical staff either present or on call if required and x-rays to deal with minor bone breaks.

Most people if they have had attention and 'been seen' by a medical professional feel reassured.

Seriously no-one really wants to spend 8+ hours in an a and e waiting room.

Because we now have a third world healthcare system thanks to years of underfunding. This was the Tory plan, break it then say it’s needs selling off.
Seems to be going to plan so far….

@WeCalledTheDogIndiana

This If you have to wait 20 hours to be seen in an A&E then you don’t need to be there is just not true.

15 years ago waiting times were far lower; we haven't turned into a nation of hypochondriac time wasters in half a generation

Recent examples from my family/friends of things that were not immediately life threatening, could be waited for for some hours if had to, but did nonetheless need A&E:

• adult with sudden loss of hearing in one ear. Saw GP, GP spoke to hospital consultant, consultant said send to A&E so he could take a look, because a referral to ENT any other way would take months. Waited 10 hours, got seen, immediate treatment given and fast tracked into follow up services
• child who had a seizure (first ever). Ambulance called, gave oxygen, took her to A&E for observation. Would have been fine without A&E but doctors wanted her to be there in case she deteriorated quickly or had another seizure. Was there 8 hours
• child with laboured breathing and a few other symptoms. Saw GP, sent to A&E, stayed in an A&E bay for 16 hours, checked every half hour to see if he was deteriorating further. Didn't need further treatment but again doctors wanted him there for quick treatment if he got worse
• elderly adult fell, trouble moving freely, spoke to GP on phone who was worried and sent to A&E.

None of these were immediately life threatening and could (and did!) wait a long time, but all needed more medical intervention than a GP could provide and the GPs followed the system by sending to A&E.

Basically it's underfunded and understaffed and while there will always be some people going when they don't strictly need to, it is not the fault of people attending that there aren't enough staff or beds or equipment. Posts that blame people going to A&E can (a) put people off going when they really should and (b) shifts the focus away from the government underfunding services

All these examples were sent to A&E after seeking advice from gp/other healthcare professionals, so absolutely the right place for them to be. The extended wait times are what op is talking about - if folk all took the line of self-care/gp/pharmacist/miu etc before heading straight to A&E then a huge number of them would be dealt with in the community rather than blocking A&E for people with a critical need for care.

Absolutely go to A&E if you need urgent and emergency care, but I've seen folk walk out with paracetamol and elastoplast.

@Tistheseason17 I'm talking about A&E triage.

Where I come from if you showed up in A&E with dry skin or something really minor, they would tell you to go home, you wouldn't even be put in the system.

@MissyB1

Because we now have a third world healthcare system thanks to years of underfunding. This was the Tory plan, break it then say it’s needs selling off. Seems to be going to plan so far….

^

This.

It is a strategic plan.