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!

@BingBongToTheMoon

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

Maybe yes, maybe no.

I think many people are there because of failures in the system leading up to that point.

Our ‘local’ (23 miles away) walk-in centre is only open 7am-9pm and is quite difficult to get an appointment with. We don’t appear to have a Minor Injuries Unit, at least not one that shows up within the 50 mile radius you can search on the NHS website. Last time I tried to get an appointment at the walk in for DS I was told they didn’t have an X-ray machine so it was best to go straight to A&E if there was any possibility of a break.

111 and out of hours tend to default to ‘go to A&E’ due to a lack of alternative services.

I went to A&E on a Friday evening some years ago at the request of my GP with a breast abscess and suspected blood poisoning. It had been a growing problem all week (no pun intended!) but my GP had not managed to get me referred onto anyone else.

DH waited over a year for lifesaving surgery on his oesophagus. He became dangerously underweight and eventually collapsed and was taken to A&E where the surgery was performed the next day as an emergency case. He still had another 3 months to go before the scheduled date for the surgery.

I suspect poor mental health provision plays a big part in A&E attendance. Both directly (MH crisis) and indirectly (poor self-care)

Just today my husband tried to call his GP surgery for a problem that is getting rapidly worse and could be blood clots. He was unable to get through so called 111, who told him that he needs an appointment with his GP but could only have a telephone appointment. How is a GP supposed to effectively diagnose quite a physical problem over the phone? Take blood pressure etc?
I’ve been really let down by my GP recently - they didn’t give a shit about the fact that my eldest daughter needed to be seen after a recent hospital stay or that I was concerned about how my c section scar was healing. I’ve since moved practice and had face to face appointments in a week…turns out my eldest daughter really did need to be seen by a doctor and I actually needed to have an 8 week check…
So anecdotally, there are three cases there of people who could have ended up in a&e because of the failure of their GP practice (husbands case pending.)

You only need to read a few threads on Mumsnet to see how many people use A&E inappropriately. Of course there are huge waits when people are going in with breast lumps, headaches, light bleeding in early pregnancy etc etc etc

Our UTC and A&E are at the same place, you get triaged at the door by a nurse and sent to book in either of them or she can prescribe if needed.

We were there on Friday after school as my daughter hurt her ankle in PE and it needed an x ray. We were in and out in 2 hours but when we came back from x ray there wasn't a spare seat in the waiting room.

@JaniieJones

'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?

She didn’t say they were in a corridor - she said on a trolley. A cubicle wait of 26 hours for a bed is pretty appalling.

However this is what the public voted for when they voted Tory again. All parts of the NHS have been run down, and the public has somehow been duped into blaming the GPs, the hospitals and other patients for the state we’re in.

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

I'm not sure that is true. What about people who need stitches? I had an accident recently and was seen and treated in under an hour at my local minor injuries unit. Had my accident happened just 20 minutes later I'd have been turned away from there and sent to A&E. I would have been physically able to wait 20 hours, but I did need to be treated as the deep cut would not stay closed if I released pressure on it.

Also, people who have broken bones. It is entirely possible to sit for 20 hours with a fractured arm or ankle, but still need to be treated.

I went to A&E 4 weeks ago, wait time was 12 hours. I was triaged and being treated within 30 minutes.

The wait time seems to be the maximum that someone will wait if they are very categorised as not an emergency.

@BingBongToTheMoon

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

Alternatively you might drop down dead in the car park just outside the doors while waiting as happened to one person at my local a&e the other week.

'She didn’t say they were in a corridor - she said on a trolley. A cubicle wait of 26 hours for a bed is pretty appalling.'

It really isn't. She implied the ambulance had dropped them off and they then waited 26hrs.

If they were seen, examined, treatment initiated, they were fed and monitored then no it isn't 'appalling'. It is not ideal but depending when this allegedly happened I would expect the hospital probably had significant bed pressures anyway due to covid.

Waiting for a bed is not the same as waiting to be seen and treated is it?

C*ouldhavebeenme3 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.
*
But I was responding to a poster (echoed by many other posters) who said if you can wait 20 hours to be seen you shouldn't be at an A&E. Which is clearly bollocks, because all those people I mentioned could wait 20 hours - with distress, definitely, but no medical problems from the delay itself

Saying people go to A&E only to walk out with paracetamol and Elastoplast just drastically misrepresents the problem, imo. You suggested those waits would have been shorter if others had been more sensible and not gone to A&E. I didn't see any time wasters there on any of those four occasions, I saw a lot of tired, ill, scared and in-pain people who would rather have been anywhere other than a plastic chair or leaning against a wall in a loud and busy hospital. These threads always blame "time wasters"; we should instead be asking why the government doesn't put in the funding, staff, preventative services, alternative routes, etc, so A&E services can meet need

There are so many problems causing a&e lng waits. I’ve recently had surgery and now have a post op infection. Most recently spent hours in a unit next to a&e having tests because of the infection.

Closure of walk in centres near us, lack of gp appointments, rise in acute treatment because waiting lists for surgery are long turning some people into emergencies, rise in acute mental health as services have been dire for years now made worse by the pandemic - all of these increase the number coming in
Staff shortages - every department I went to was short staffed - funding/illness
Diagnostic test delays - caused by lack of staff and need more equipment - eg only 2 ct scanners in our large hospital - all waiting had either come from a&e or my ward. If this was sorted patients would be diagnosed quicker and either admitted or sent home with treatment quicker.

Proper funding would sort out most of this. Also Allowing covid cases and covid hospital admissions to increase as they are currently is just madness. From what I saw this week I have no idea how our nhs workers are going to get through the winter and I worry that patients will die because of it.

@JaniieJones

It is because people treat A&E like a walk in gp surgery. Look at mn for a snapshot 'I have severe period pain and heavy bleeding should I go A&E?' 'Yes it would be sepsis, or a life threatening hemorrhage, go NOW!'.

All practices offer econsults and phone consults and will then see those who require examining.

No all practices don't

You cannot speak for services you don't know about

Just to add onto this
My daughter is poorly. She's got a chesty cough, she's wheezing and she is not well. I took her to the pharmacy originally who suggested I try my gp. I called 111 last night who said someone would call up to 4 hours. Nobody phoned me. I tried my gp this morning who have no appointments. The receptionist advised me to go to a and e with her.
So I have a wheezing 1 year old who with a high temperature and is coughing up green stuff.
We are going to a and e
We don't need to be there
We need a gp appointment

And yes she is negative for covid

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)

Yes I was in the early stages of a natural MC and my (private) consultant actually told me to go to A&E if the bleeding becomes too heavy. DH used to work as a paramedic and he remembers one ambulance callout for a woman miscarrying. Sadly that's one situation which has a tiny chance of being very serious (ectopic, infection) but in the vast majority of cases turn out fine even if the bleeding is horrendous.

However unlike a twisted ankle, miscarriages are very emotionally charged so people are more likely to want "help" of some kind or are generally in far more distress.

I've just gone to look and see if there are plans to reopen the walk-in clinics - I didn't realise they'd also closed the one 30 mins down the road last March and redirected all the users of that one to the same A&E as we've been redirected to.

Apparently they don't think they're going to reopen them either (they are "currently assessing"). This seems so short-sighted to me but I guess they have the overall view of patient numbers and types?

@User134342134 that would be fair enough if we didn't also have to contribute so much tax to this broken system. I pay for private and contribute. It's not good is it. I can't really afford to pay but I've had to because my GP wouldn't see me face to face and my health was deteriorating. I agree we should pay something but it should be a better system like France or Germany has. Not 'free' healthcare vs pay a ton of money for anything!

I also had to wait 6 hours in a&e with my dc with her broken arm before she was seen last year so it really isn't working. My dd was 6 it was really unpleasant.

It's all well and good saying that A+E is not appropriate.
But my local (well, fairly local) MIU closed down in 2019. They have recently built upwards of 70,000 new homes/apartment buildings in my area, with more to come, and not increased the GP services in any meaningful way.
And people don't have medical degrees. They do not realise what is and what is not urgent, only what is abnormal for them.
(obviously not talking about someone with things like a paper cut here, for clarity)

The NHS has been chronically underfunded for the past several years. It's the Conservatives' way of running down the system so that they can justify privatisation. Simples.

Don't blame people going to A and E unnecessarily, don't blame Covid or GPs. It's the government, pure and simple.

What are people meant to do who literally cannot get access to a GP or afford a private one?

It is all v well saying A&E is for accidents and emergencies, but are we going back to the early 20th century where medical care was only available to the rich or dying?

Alot of these posts are missing the bigger picture.

My A&E department has 29 adult beds, plus 6 resus.
So if you need to be admitted you first need to get one of these A&E beds.

Yesterday we had over 120 patients in the department. Alot of those were minor who would need a bed. But a significant figure do

Now these beds only become free when people are admitted up to a ward.
The wards have no beds free as they cannot discharge patients, the lack of resources of physio, OT, home help, care packages etc.

It's not just an A&E problem, it's a government problem. Lack of funding, shit pay, lack of training opportunities leads to no retention of staff and no one to do the vital work at both ends!!

stop voting Conservative

I often read threads like this and this has honestly not been my experience with the GP or A and E, both of which I've unfortunately had to access recently. If any of you work for Gateshead NHS- thank you. My GP has been fully accessible throughout Covid and just yesterday I had an appointment and antibiotics for my child an hour after calling. I honestly don't know how they've done it but they are doing an amazing job.

@BingBongToTheMoon

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

Yep. I took my friend in with a burst appendix, she was taken straight away. Whilst waiting i got chatting to a young lad approx 20 ish, he was complaining about waiting for 7 to 8 hours, he had a 1cm cut on his finger, wasn't bleeding and the plaster his mum applied at home had done its job.

My oh has private care through his work, I have axa insurance, its about £90pm, its brilliant. Only thing they don't do is a and e , otherwise great. 24hr doctor available, plenty of private hospitals if you need them, included diagnostics as they call it (mri, ct scans etc) and you can still use nhs if you chose.
Highly recommend private insurance , as you never have to wait to be seen or treated for anything. Also saves burdening the nhs which is on its knees

I've been to A&E twice in my adult life, both were hand injuries: a broken finger, and a suspected wrist fracture, and I was sent there after going to MIUs first and being told to go to A&E for x-ray. Both times I got there by bus, as was in little pain, but there were no other services that could get the hand looked at. It does feel like another service should exist, so that things that can't wait as such can be dealt with, but aren't exactly crisis.

Until I had cause to use them, I thought MIUs filled that space, but the ones I went to were staffed by nurses with no doctors, and said suspected fractures were beyond what they could deal with. Anyway, the Minor Injuries Units in our area close in winter - they have done for the last few years, so that staff can be re-deployed to the hospitals, so people have to go to A&E for anything that a GP or pharmacist can't help you with.

Long waits in A&E are nothing new. Twenty years ago my DH broke his elbow. I drove him to our nearest hospital. Triaged, X rayed and then a long wait. We arrived at 7pm. At 3am we were exhausted and went home for a few hours sleep. We went back in the morning. Nobody had noticed and the teenager with a broken ankle who had arrived the night before just ahead of DH, was still waiting. About half an hour later my DH was treated. Sorry for the wait they said. We laughed to ourselves as we had had four hours in bed asleep.