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 had to go to A&E recently & only waited around 15-20 mins to be initially triaged by a nurse. Was taken straight to a bed & treatment so I guess it depends how urgent it is deemed to be at triage

@BingBongToTheMoon

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

It depends I suppose. My friend broke her ankle, phoned 111, tried to find out if there were any minor injuries open but no, so had to go to A&E to have it x rayed and strapped up. She was in agony but not in immediate danger, and was waiting around 9 hours. That wait could have been a lot longer if it was busier, she could have gone home and tried another day, but probably be the same story, not to mention at risk of doing more damage. Its not just GP apps being hard to get, but a lot of areas have closed their minor injury units so cannot x Ray which is ridiculous.

Thank you for posting. I work for the NHS. I hope highlighting the long waits will help to deter people who don't need urgent care from going to A&E, and accessing suitable alternative services.

I do completely agree the NHS is in a very sad state right now. Sadly that's unlikely to change soon.

@User134342134

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.

Funny you mention miscarriage. I've seen posters advise other posters to go to A&E for very early miscarriages. Of all the conditions that A&E cannot help with a miscarriage is one of them (I've had 4)

@AlyssasBackRolls

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.

My GP surgery is the same, it does make me laugh but at the same time you know every other idiot who gets a cough will go to the doctors looking for antibiotics or a cough bottle rather than just staying at home so I can't blame the receptionists for wanting to keep away from them

They clearly don’t need to be there if they are able to wait 20 hours. The only times I’ve ever been to A&E I’ve been seen immediately because it was life threatening.

111, minors or out of hours all seem like more appropriate places. If it isn’t a life threatening emergency A&E isn’t the right place.

My surgery has a huge delay in seeing people. They only see a few things face to face. My asthma review is over the phone - now how does that work, they cannot listen to breathing, check peek flows and BP and chest. Stupid really. I think people get desperate and go to A&E then with things GP could sort.

Why are GP's still doing most over the phone? It makes no sense anymore.

@elbea

They clearly don’t need to be there if they are able to wait 20 hours. The only times I’ve ever been to A&E I’ve been seen immediately because it was life threatening.

111, minors or out of hours all seem like more appropriate places. If it isn’t a life threatening emergency A&E isn’t the right place.

If you still have minor injuries or out of hours appointments available, yes. Here the wild decision was made to increase staffing at the hospital A&E that serves a huge catchment, and close many of the minor units, and limit out of hours apps to few locations and for limited reasons.

@Iooselipssinkships

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.

This is like me - googling to see if you could sort it yourself!

I managed to slice open my knuckle with a Stanley knife doing DIY - it was like a flap of skin on the top of my hand and I could see my tendon - I tried to put a plaster on it! As it is - I eventually went to A&E because I couldn’t line the skin back together and it was just steri stripped BUT they said it was right to attend as IF I had nicked my tendon even just a little bit, it would have required surgery. They actually said they had never seen such an injury where the tendon hadn’t actually been damaged!

I think people do go to a&e too quickly, but I also don’t agree that you practically have to be dead already to go to a&e.

@StormTreader

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.

We are the same - there was a walk-in centre up the road at a smaller hospital which we always used before, when it was closed, they explicitly told people to go to A&E instead. The statement they made in March 2020 said it was temporary because of covid but that was 18 months ago and no sign of reopening:

Services at XX Walk in Centre are being temporarily suspended on 30 April.
News – 1 May 2020

For health advice visit NHS 111 online. For minor illnesses such as ongoing back pain, contact your GP. For minor injury, such as fractures, visit A&E at XX Hospital.

The minor illness and injury unit at XX Walk in Centre is to be temporarily suspended as part of the national effort to combat Covid-19 (coronavirus).

Many NHS staff have been redeployed into new, temporary roles, to increase the response to Covid-19 and to support those treating the most seriously ill patients.

In order to make the best use of resources, local NHS commissioners have taken the decision to suspend services at the XX Walk in Centre from Thursday 30 April. This will allow clinicians from the unit to be redeployed to where their skills can be put to the best use. This could include additional support to the Out of Hours Service, or home visiting to support GP practices in the management of patients with covid-19 symptoms.

Patients will still be able to access treatment for minor ailments via their GP surgery, which they can access by phone or online. Further information is available on their practice website and help is also available via the NHS111 service, by dialling 111 or visiting: www.111.nhs.uk.

Anybody needing treatment for injuries such as suspected fractures should go to A&E at XX Hospital.

This is a temporary measure aimed at making the best use of valuable clinical expertise and resources during extraordinary times.

I work in a hospital and have access to the A&E waiting list. The other day there were 130 people in A&E at 11am. It was absolutely crazy (for context it’s usually half that amount at that time of day). The waiting time was over 10 hours.

You get ranked 1 to 4, 1 being you’re literally dying, 4 being you would probably be better off going to the walk in centre. Most were 3 or 4s. I would say two people did not need to be there (one report of a snotty nose, one had a nettle sting rash - both rated a 4 so not struggling to breathe or in anaphylactic shock). If an emergency comes in then you obviously get pushed down the list.

The most shocking aspect were the number of people there with mental health problems or who had purposely overdosed. Unfortunately I know from personal experience how difficult it is to get an appointment at the GP for mental health reasons. It caused a loved one to have a mental break down which required hospital admission which fast tracked them to get the GP appointment they desperately needed.

The A&E receptionist told me that they are really understaffed (both clinical and non clinical staff) because people keep going off sick with stress. She said on an average week there will only be two days where everyone who was scheduled to work will be in. It’s gotten worse since Covid.

In response to the comments in here saying that people go to A&E too easily, I was actually advised to go to A&E by my GPS reception for a simple infection that just needed antibiotics. She said they had no appointments, 111 was overloaded, the local urgent care was at capacity, so I should go to A&E (I had been told by pharmacist that I needed an urgent GP appointment). I explained this at A&E, and was told it didn't need A&E, but it did need treating urgently. On that evening, they were literally the only place seeing patients that hadn't made an appointment early in the day. They treated me, as they accepted I did need antibiotics ASAP, but we all knew they shouldn't have been the people treating me.

'You have no concept. That poster could have died.'

I do have concept thanks.

I'm not suggesting anyone with any symptoms should sit at home and die. There is a system you see, you ring your gp they will see you if needed. If not you ring 111. Or, attend one of the many UTC or minor injury units.

A&Es tend to be in larger towns and cities so these people who use A&E as a gp surgery are able to travel.

Just go the UTC. A&E is for accidents and emergencies.

A relative of mine was on a trolley for 26 hours 2 weeks ago after being ambulanced in after a heart attack. Treated and home now after an op but it was a worrying start. Not true that if you have to wait that long you don't need to be there at all.

I was seen about 5 weeks ago. I had fallen off my bike on my way to work and injured my arm.

The only issue was ambulance....i was on the ground and couldn't get up because of my arm. Waiting time was 2.5 hours. I don't blame ambulance for this, when it was clear I was conscious, not bleeding etc. The issue is shortages. Fortunately I got my husband Dow and with the help of some very kind passers by managed to get to a standing position and to the hospital. By the time I got there I was in a terrible state, severe pain and crying +++. Within 15 mins I was xrayed and diagnosed with a complex fracture of mu humerus, near my s houldr r. I have since Bern operated on and have plates and screws in place.

So I think yes if you're genuinely in need of urgent care, waiting times are usually ok but of course it depends on how many are in the department. 9am on a Thursday morning, when i was seen, is probably a lot quieter than 1am on a Saturday night!

@PinkyU

I recently waited nearly 7 hours with what ended up being severe hypoglycaemia. I, at times, was passing out, incoherent unable to stand or walk. When triaged I had tachycardia (a very high heart rate) but they never took a BM (test to check blood sugar)and I was sent back out to the waiting area.

I was left for nearly 7 hours in need of urgent care because they thought I was drunk. I couldn’t advocate for myself (my oh was allowed to stay with me as I was semi conscious, when he tried to get me help he was told it wasn’t my turn yet), I had already had a seizure.

(Not even mentioning the fact that when my oh found me on the bathroom floor having a seizure, dialled 999 was told I was low priority, unconscious and seizing, and we would wait 4+ hours for them to attend).

A very broken NHS.

That's terrifying

Sorry for typos, still typing with non dominant hand

@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 problem isn’t really the triage system.

Yes, there are people who turn up to ED when they don’t need to and yes that’s almost certainly got worse since covid. But the problem existed before that and while the government like to plant the narrative that most of it is caused by people using ED irresponsibly, it isn’t quite true.

The people waiting outside in ambulances aren’t stuck there because of the people who turned up with dry skin on their scalp. If you can’t move patients out of ED and into a bed elsewhere, you can’t get more patients into ED. And the people who need to be admitted are not ‘timewasters’.

Well that is completely different @Equimum if you were allegedly told to go there by hcps. 111 being 'overloaded' sounds odd, no matter how busy they are people will get back to you depending on priority after being triaged following the initial call.

My (well, my child's) appointment with a private gp has been just cancelled, after us travelling for an hour to see them. Accidentally double booked, haha sorry. Call to rebook.

The NHS GP does not have slots for the next 6 weeks, and their system does not allowed to book ahead of that. I was advised to call in daily to check if there are any cancellations. When I call in the morning, the automated line does not even add you to the queue, it is full.

Yes, it is for a chronic condition that had worsened. Not catastrophically worsened, but I really want someone to take a look at it earlier rather than later.

I mean, what should I do now?

When DH turned bright yellow, was triaged by the GP receptionist who told him he could wait 10 days for an appointment so was directed to A&E by the British Liver Trust (who also turned him away) should he have just laid down like a good boy? Turned out it was the first signs of cholangiocarcinoma, by the time it was diagnosed it was too late as it had already spread. He has been failed and it has cost him his life.

My daughter has a couple of health issues and has had a few serious flare ups of symptoms lately.

I’ve been unable to get hold of my GP - no answer on the phone, no reply to emails and no response to e-consults. We’ve phoned 111 and been sent to either A&E or the Urgent Treatment Centre at the hospital.

She just needs medication, but due to the type of medication and her age, our GP won’t prescribe it so we have some just in case - every time she has a flare up, we have to ring up

The longest wait at A&E we’ve had was 5 hours, if we get sent to the urgent treatment centre it’s usually really quick.

'A relative of mine was on a trolley for 26 hours 2 weeks ago after being ambulanced in after a heart attack. '

Oh do please complain being left on a trolley in a corridor following a heart attack would seem totally negligent. Or do you mean they were being monitored whilst awaiting a bed on a ward?