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!

I work in an A&E with wait times regularly over 12 hours. Sometimes people die in the waiting room which would suggest they probably did need to be there. Although its possible they died of old age having waited so long. Don't blame the people. There will be a small number who shouldn't be there but most people attend because they have no other option either because no one else will help them or because they are in pain or unwell

@PheasantsNest

The whole system needs to change. They can't admit anyone from A&E as there are no beds free on the wards. Too many people go to A&E when they don't need to. You only have to read threads on here where people are advised to go to A&E for all sorts of things that aren't Accidents or Emergencies.

The thing is, nobody on here can tell someone if they need immediate medical attention or not. It's dangerous to say that the poster will be fine and does not need A+E.

You need to hire an old school matron to go around A&E going 'no, go home...pharmacy for you...wait for GP'

I agree with you @User134342134 but I understand it's a very emotional attachment to 'free' healthcare in the UK

Personally I think the French system is best as it's means tested, so a huge number of people do have free healthcare, many more pay something very small, and people with resources pay more.

You can buy private top-up care for things like vision and dental and prescriptions.

But I can't see any UK government trying to change the whole system, instead they will just let it get more and more dysfunctional so people are driven into private and then the government can wash its hands of them completely.

True and ever increasing population. Lots of elderly people with conditions and lots of younger unhealthy people with chronic conditions.

I worked in A and E for many, many years before I jumped ship because I was fed up of the abuse and how unsafe it was. There were indeed some people who loved hanging out in A and E for many hours

[quote dreamingbohemian]@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.[/quote]
Thank goodness it's working somewhere 😅 you've got to wonder what goes thru the mind of some people - although I suspect it us heightened anxiety. Our mental health services need more resource! Best wishes

@blissfulllife

I've recently had to go through a and e that had an 8 hour wait. I was triaged and seen within an hour luckily. Waiting room was full with a queue to book in going right out the door. I was in a lot of pain and two ladies also waiting were talking to me to keep my mind off it. Both were there due to ongoing issues that would usually have been kept on top of with outpatient appointments with their consultants. But the pandemic stopped clinics. This meant their conditions worsened. GP can't help much. Complications then arise and they've had to present at A and E.

Same thing happened with my youngest. Seen by dermatologist since birth for a rare skin condition. She's a teen now and with dermatologist help and immune suppressants prescribed by him she was living a relatively pain free life. Then pandemic hits, no clinic, no meds review or blood tests to check on her liver, she gets sick very quickly and ends up in hospital 4 times that year. All could of been avoided with continuation of clinics even remotely.

The cessation of clinics was a disgrace, in my opinion. DH has been attending regularly for reviews of an eye condition which can result in loss of vision. During lockdown he received a letter cancelling his scheduled appointment and stating that as his condition was considered ‘stable he was being removed from the consultant’s list. Madness! Strangely, some nine months later, he received a new appointment as it was considered ‘important that he attend for his condition to be monitored and treatment adjusted as necessary’. One can only assume this was some sort of fudging of statistis.

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.

The word is obtuse. Most women with heavy bleeding and abdominal pain would describe that as a period and period pains because that is their frame of reference. It doesn't mean it is "just" a period.

Another issue is not being able to register with a GP. My youngest is at University and cannot get a GP in her University city, so has no choice but to go through 111, who then may send her to A&E. The system is broken, don't blame the poor victims (by which I mean the staff and the worried patients) blame the system.

You were sold an illusion.

The NHS has always been pretty bad, with some (although far from all) heroic individuals working in a terrible system.

There is a reason that most who can afford it but medical insurance.

It never had any contingency built into it and, under a little stress, it has cracked wide open.

It is underfunded, managed by ex nurses and overpaid management consultants, and a recipe for any additional funding to feed mainly into inflation and only a small percentage into better medical outcomes.

It needs a combination of a major uplift in funding and root-and-branch reform. Not going to happen , though.

Good religion for some, though.

@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

Add on broken bones and cuts that need stitches… a&e isn’t just for those on deaths door.

@BingBongToTheMoon

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

Of course you would . What if you have a broken limb?

@BingBongToTheMoon

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

THIS !

A real accident or emergency is seen very quickly.

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

In some cases this is true, but for example, imagine an elderly person (no family support) fell at home. No injuries, but couldn't get up so called an ambulance. Ambulance took them into hospital as they were clearly not coping at home safely.
The person is not ill and does not need medical attention as such. However, they can not discharge them as their home is unsafe. There are no community services. The person probably needs to go into a care home.
They are safe to wait for many hours over emergencies. They probably shouldn't be in A+E, but there is nowhere else for them to go.

Or someone who is suffering from a mental health crisis, but in no immediate medical need. They can sit in A+E for hours and hours waiting to see a MH professional. They probably shouldn't be in A+E either, but MH services have been cut to the bone.

They are all just so overrun at the moment!

I know people who have gone to A&E with minor problems - ear infections etc - and been clearly told that their GP could have dealt with it but it’s been that they simply can’t get in

But then I know others who haven’t gone because of the wait and actually needed to go - for example eventually finding out their child had indeed fractured their arm and needed a cast.

I think GPs need to get ‘back to normal’ before A&E will. TBH though I really don’t mind a telephone appointment with the GP if it’s something that can be discussed over the phone - for example knowing you need a particular medicine or requesting a referral. It does save a lot of time for the patient! And in fact if they do need to see you after that telephone appointment they are normally quite quick at getting you in.

My adult niece had agonising pain due to gallbladder inflammation. Five separate GPS refused to believe her, gave her pregnancy tests, then sent her off with painkillers.

Even when my sister got involved and finally got a diagnosis she was told that it wasn't an emergency and that the waiting list for the surgery she needed was over a year.

We were going to go private but then the pandemic shut down the NHS and everyone dashed to get on private lists, making them months long.

One very difficult night my sister could take no more of her daughters distraught agony and took her to A and E, at which point a doctor said 'gosh yes this does need emergency surgery' and my neice was operated on the next day.

So I'm sorry but yes, if all other options fail, a and e can indeed act as the nuclear option to actual treatment.

As an aside, throughout this entire process, NOT ONE hcp has mentioned diet to my niece. Not one. She was given tramadol.

This is where we are.

@Tistheseason17 Yes that's so true, people are not at their most rational when they're in pain and scared.

They really should have minor injuries units everywhere, I've used one in London and it was fantastic.

At least half of you voted for this.

The first thing the conservatives did when they took over from (new) labour was to remove the 4-hour waiting time target.

@Mybalconyiscracking

Not sure why people are so fixated on face to face GP appointments. I find that telephone consultations at least initially, are much more convenient.

Not everyone can express themselves on the phone clearly-even verbally confident people are not great describing medical problems on the phone.

Not everyone can describe how a lump feels or what consistency a rash or change in colour might be. Photographs taken with a mobile phone are next to useless.

A good GP knows that often patients present with one problem but, as they talk, the real-sometimes more frightening-reason for their visit will improve.

Talking to a GP on the 'phone is no where near good enough to actually seeing a doctor and if doctors are saying they get through more patients on the phone, that that will be because each patient is not getting enough time.

What has actually changed for them pre-pandemic that they can no longer give appointments. I mean, what has ACTUALLY changed?

I think that the staff checking people into the system should be able to refuse access to those who do not need to be there. For example, people who really should be directed to their GP or for fractures redirected to another service (I know that’s not available everywhere).

I recall waiting in the walk in surgery once and someone went to the desk and said that their issue had been going on for 5 days and a&e redirected them there. The staff eye rolled and asked did they even consider to make a gp appointment?

It must be infuriating to see so many people wasting time in already overstretched services.

This just doesn’t happen when the services need to be paid for by the patient. I think that something like a fine needs to be brought in, people will die because of it I’m sure but people need to be able to access the correct services without the risk of not being able to use them correctly due to time wasting people that abuse their free healthcare.

For balance, I had to take my child to A&E recently - we were questioned on the door before even allowed in as they were dealing with illnesses separately from accidents. It was for a broken bone - triaged, X-ray, doctor, cast all within 1.5 hours. It's not so bad as some of these anecdotes everywhere.

Where I live people would love to have a telephone consultation with the GP’s but you can’t even get that.
Dr’s surgery opens at 8.30. By 8.40 all appointments are gone and you’re told to ring back the next day.
If you’re lucky to get an appointment it’s usually for about 3-4 weeks time.
No walk in centre anywhere near and a MIU that’s either on short hours or closed due to lack of staff.
Not excusing everybody who turns up at A & E but can kind of understand it if a condition gets worse and you can’t access the first point of call.

A lot of people abuse GP appointments too and even book in and go when it’s not really necessary.

We have pamphlets for everything! Why isn’t there one about things we can ignore and things that need to be taken seriously?
What sort of issues you need to have to need to attend a&e.
All the services available in the area if you need help etc.

It is all helpful.

Had to wait hours upon hours and then some more for a dislocated finger. Definitely needed to be there as it was deformed and at a complete right angle. I did look up online if I could put it back into place myself but it wasn't recommended due to potential complications. So yeah, those who are waiting a very long time sometimes do need to be there. It's for accidents as well as emergencies, hence the title. Saying that I did have a look around though and wondered why certain (most) people were there when they seemed absolutely fine, in good health, with no visible injuries or any inclination of being in pain. It felt more like an airport lounge with a delayed flight than a hospital, but then again who am I to judge.