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!

@TSSDNCOP presumably they are doing phone and email appointments, home visits, care home visits, writing prescriptions, doing referral paperwork and that's only the things I can think of and I'm not a GP. Seeing patients isn't their entire job by a long shot.

Redhero peak flows are contraindicated in general practice currently (national guidelines) as it can induce coughing in a confined space. They can be done at home though and discussed. A routine asthma review doesn't sound your chest. BP's can be done at home too and discussed - more accurate anyway.

I realise discussion has moved on but in answer to the questions re my story, he was picked up in an ambulance after GP identified a likely heart attack , was in ambulance around an hour then moved to a trolley which went from corridor after a few hours into a bay. After 26 hours from the start, he went to an assessment ward. Then 6 or so hours later to cardiac ward. Things sped up after that and a stent and home within two days. I went to emergency that night to drop him food and clothes and was really shocked at the number of people sat outside obviously poorly, having been spoken to and presumably triaged.

Gps are working incredibly hard! Ha! Tell us another fairy tale-you've jumped the shark there, @takemetomars If only we all lived in the green and pleasant La La land that you do,

It's easier to spot a giant dodo than a GP at their desk seeing a patient.

Almost every man and his dog have a story to tell about how they can't get to see a GP face to face-the government have even had to tell them, tell them, to get back to work.

This didn't happen before the pandemic, so what changed after it? They saw a chance not to have to have face to face appointments and they took it.

If they are all working so so hard, why is the government telling them to get back to work and everyone-apart from those pushing their own agenda-knows you can't get to see one of the buggers.

Anyway, in response to the original question. People are waiting 20 hours in A& E because many of them can't get to see a GP.

It really isn't rocket science.

Yeah I mean why would you think they are working hard, they only have to manage significantly more patients than elsewhere in Europe, but that should be no problem because us brits are just so much more productive than other humans

@YearsSinceISawYou

It is wrong to use A&E like a doctor's surgery.

But everyone, A&E staff included, are aware that until GPs go back to work, this will continue.

Before anyone with a skin in the game jumps in, GPs are not working hard.

I don't have any skin in the game, I'm a mental health nurse but nothing to do with GPs. I think many GPs are working extremely hard; my GP has certainly provided an excellent service throughout covid, simply changing to phone appointments which is fine for most stuff and seeing people f2f when necessary. I think it's very easy to say that GPs aren't working hard when you don't have a clue what they are actually doing.

@TSSDNCOP

I had cause to go to my GP this morning to collect a blood test referral.

At 11am there was not one single person in the waiting room. It is a big surgery, with probably 6 Gp's. I was there for 20 minutes (much looking for piece of paper that was misfiled). When I left there was not one person waiting and not one person had come out. That appeared very at odds with the items I read that GP's are on their knees.

So, my question is why can I not get an appointment until 19th November to discuss a matter with my GP?

They are just as busy doing phone appointments as they were doing face to face appointments. I'm not sure why people can't understand that they are still doing their jobs, albeit mainly via the phone as opposed to f2f.

My husband made an appointment to see his GP on Friday and he was seen today and he made me an appointment whilst he was there for Friday, both in person.

Some people are going to A&E totally inappropriately. I've been to our minor injury centre and never had to wait more than 20 mins.

I think some gps are a problem at the moment but not the only problem.

Eg my practice- the online consultation is brilliant for routine things but it won’t let you put in things for a child around breathing or other issues that are potentially a hospital visit. In the past I’ve been able to call the GP for an urgent issue and they have seen my children within minutes and been able to make the call whether they need to go to paediatrics and have been able to admit straight to the ward. At the moment it is literally impossible to answer the phone so if in doubt, I’d be off to A&E. This benefits no-one.

I think it's many many things. No beds in the hospitals means 2 things 1) a&e bays are full, no space to assess patients and 2) a&e is full of sick patients requiring a lot of attention. Beds have been gradually reduced in many hospitals across the country for years now

You also have I would say a greater awareness of health problems now. And people like to get checked out to be on the safe side. For example an infection means risk of sepsis means A&E. Without actually thinking 'do I have signs of sepsis'

There is also a difficulty accessing primary care. I myself have been directed 3 times in the last year by my GP to A&E for things I know did not need A&E, because I had a temperature or a cough and it maybe covid. You cannot properly assess over the phone anything but the most basic health problem, maybe things like a UTI, but anything that requires looking or examining needs to be seen in person. Sadly I have seen a couple of cancers missed because of Telephone appointments. You risk missing things, patients aren't always the best at describing their symptoms- the problem is your well spoken, well educated patient will probably be okay, but I think this can disadvantage patients who arent in their category. There are also patients who over egg symptoms and many patients who don't want to make a fuss so under egg. You miss so much over the phone.

I think there is now a fear around difficulty accessing a GP as well. I frequently see patients who have been seen by their GP, but they weren't happy with the outcome so go to A&E because they think they won't be able to get back into the GP. In many cases the patients do need to go back to their GP but a lot of this work is now falling back to hospitals

But then we also have an aging population, and a population of elderly people who have had nearly 2 years of reduced contact, often living alone. Loneliness leads to mental health problems which can worsen things like dementia. They haven't been able to stay active, and keep their mind active as well. They've not had the care maybe they would have had without covid, or the family visits to notice when they start to need a but more help. Plus a real social care crisis leads to a melting pot of falls, and ill elderly people that get stuck in hospital

I think you also have to differentiate between 20 hrs to get assessed, and 20 hrs in a&e which may include investigations, wait to see specialities, waits for a beds, waiting for patients to sober up etc.

I suppose @AwaAnBileYerHeid that "people" by which you mean "patients"are mystified when entering a completely empty surgery mid-morning why there is a room of empty chairs and it is impossible to get through in the phone for an appointment so one has to have a day i off go in person and cannot get one until 19th November.

I obviously cannot speak for every patient in every GP surgery, but surely you can see that's a head scratcher and likely linked to an influx at A&E.

Additionally I should add the blood test letter was only obtained at all because a GP rang me by mistake, so I seized the moment.

@YearsSinceISawYou

Gps are working incredibly hard! Ha! Tell us another fairy tale-you've jumped the shark there, *@takemetomars* If only we all lived in the green and pleasant La La land that you do,

It's easier to spot a giant dodo than a GP at their desk seeing a patient.

Almost every man and his dog have a story to tell about how they can't get to see a GP face to face-the government have even had to tell them, tell them, to get back to work.

This didn't happen before the pandemic, so what changed after it? They saw a chance not to have to have face to face appointments and they took it.

If they are all working so so hard, why is the government telling them to get back to work and everyone-apart from those pushing their own agenda-knows you can't get to see one of the buggers.

Anyway, in response to the original question. People are waiting 20 hours in A& E because many of them can't get to see a GP.

It really isn't rocket science.

There appears to be a government bot on here.

'If they are all working so so hard, why is the government telling them to get back to work and everyone-apart from those pushing their own agenda-knows you can't get to see one of the buggers'

If not, it is extremely ironic that you are more inclined to believe this government's or the mainstream media's version of events than the GPs/ practice nurses/ reception staff actually doing the job. You talk of agendas.....

I'm a GP and I have been at my desk seeing patients today and every day that I have worked during the pandemic. But I guess you know what I have been doing all day than I do myself.

A little bit of intelligent thought would make you realise that successive governments (Tory ones recently) have led to chronic underfunding of the NHS and a severe staff shortage. Many staff feel undervalued and unsupported. The pandemic has exacerbated staff shortages because of high rates of illness and the need to isolate. General Practice has been very much inadequately funded and there is a now huge lack of GPs and those who are able to leave or reduce hours are doing so. The population has increased significantly, the percentage of elderly and those with chronic conditions has increased, the amount of possible interventions of every type and the rates and fears of litigation (transported from the US). The population has also been positively encouraged to expect to turn up to see a Dr our nurse whenever they feel like it and however minor the complaint.
Lots of reasons we find ourselves in this situation but it's not down to the GPs.

@YearsSinceISawYou

Gps are working incredibly hard! Ha! Tell us another fairy tale-you've jumped the shark there, *@takemetomars* If only we all lived in the green and pleasant La La land that you do,

It's easier to spot a giant dodo than a GP at their desk seeing a patient.

Almost every man and his dog have a story to tell about how they can't get to see a GP face to face-the government have even had to tell them, tell them, to get back to work.

This didn't happen before the pandemic, so what changed after it? They saw a chance not to have to have face to face appointments and they took it.

If they are all working so so hard, why is the government telling them to get back to work and everyone-apart from those pushing their own agenda-knows you can't get to see one of the buggers.

Anyway, in response to the original question. People are waiting 20 hours in A& E because many of them can't get to see a GP.

It really isn't rocket science.

Bless you and your complete lack of intelligence. You can't reason with stupid so I won't try

I have been to A&E twice within the last week and both times extremely different experiences. First last Week, I couldn’t even get through to my GP, so I rang our local minor injury unit (it was a minor injury) I was directed to A&E as I would be seen quicker than minor injuries, only myself and one other waiting when I arrived. I was seen within 20mins and had my injury X-rayed (not normal result) got special foot guard and found out today I’ve got a fracture in my foot. DC had chest pains Monday we waited 7hours to be admitted, lots of code blue’s being called so I knew it would be a wait. My child and I spent a lot of time with the nurses (close monitoring) and they were admitting lots of kids were being directed to the wrong places or that pharmacy or GP should see them. There were also lots of seriously Ill babies who GP had refused to see in person citing viral infections-they were clearly seriously unwell and in desperate need of medication; it’s heartbreaking that A&E staff are being bashed and those who are in need of the NHS simply can’t access the right service for them

A&E is busy because demand outstrips supply. Simple as that. It’s the same for GPs too.

Last week someone posted on here that they’d been referred by their GP to an urgent clinic for a breast lump, but the appointment was delayed (by a couple of weeks I believe). People advised A&E. One person even said she could get a scan done if she went to A&E.

That’s your answer OP.

I agree with so much on this thread.

Underfunding has screwed NHS services.
GPs and nursing teams (in my area) are seeing folks f2f, telephone, econsult, depending on issue.
All areas should have minor injuries clinics.
Some people are entitled and expect 'free, free, free' and, definitely, abuse services when they can manage at home [think one day headache due booze and sun in A&E, small superficial cut to finger (GP surgery), 3 day cough (GP surgery)] I speak from firsthand experience.
I don't know what's happened but I feel the NHS (what is left) is being bled dry because they can.
Don't get me started on the amount of people who refuse to change their lifestyle in even though it is affecting their health condition (heart disease, diabetes, asthma) or chronic wounds and yet still expect the NHS to make them better!
Rant over!

I’ll give you another example.
Patient of mine (I’m a GP)had a breast lump. Seen and referred, given a hospital appointment 2 weeks later. Couldn’t cope with the worry so went to A&E. Seen by doctor, examined, advised to wait for hospital appointment. Came home and called GP. Over a 2 week period this lady attended A&E 4 times and saw the GP 3 times and spoke to the GP several more times. Was also given number for counselling and urgent mental health support, who spoke to her but didn’t make her feel any better, hence the repeated GP and A&E attendance.
This is what is happening.
I can assure you that every single doctor and nurse is working flat out. Just because they’re not seeing YOU, doesn’t mean they’re not seeing anyone.

@TSSDNCOP

I suppose *@AwaAnBileYerHeid* that "people" by which you mean "patients"are mystified when entering a completely empty surgery mid-morning why there is a room of empty chairs and it is impossible to get through in the phone for an appointment so one has to have a day i off go in person and cannot get one until 19th November.

I obviously cannot speak for every patient in every GP surgery, but surely you can see that's a head scratcher and likely linked to an influx at A&E.

Additionally I should add the blood test letter was only obtained at all because a GP rang me by mistake, so I seized the moment.

Well no, I don't just mean "patients" when I say "people" - I've heard of "people" complaining that GPs are doing nothing when in reality they haven't even needed to use the services of a GP themselves, they are just parroting the rhetoric of GPs sitting on their arses doing nothing.

Also no, I'm not sure why it's a head scratcher. It's not really that hard to understand that Dr Smith is on the phone to 20 patients that morning as opposed to seeing 20 patients face to face and therefore still needing to do 20 sets of notes, any referrals/prescriptions etc for those 20 patients.

@DamnUserName21

I agree with so much on this thread.

Underfunding has screwed NHS services.
GPs and nursing teams (in my area) are seeing folks f2f, telephone, econsult, depending on issue.
All areas should have minor injuries clinics.
Some people are entitled and expect 'free, free, free' and, definitely, abuse services when they can manage at home [think one day headache due booze and sun in A&E, small superficial cut to finger (GP surgery), 3 day cough (GP surgery)] I speak from firsthand experience.
I don't know what's happened but I feel the NHS (what is left) is being bled dry because they can.
Don't get me started on the amount of people who refuse to change their lifestyle in even though it is affecting their health condition (heart disease, diabetes, asthma) or chronic wounds and yet still expect the NHS to make them better!
Rant over!

Yes! Exactly this.

i until GPs go back to work, this will continue

This is nonsense and GP bashing isn't going to help anyone. If anything, more and more will leave the profession. I know from my own GP how hard things are. I've had really good care from the practice throughout the pandemic and been seen in person when I've needed an examination but telephone appointments otherwise. I can't fault them.

@YearsSinceISawYou

It is wrong to use A&E like a doctor's surgery.

But everyone, A&E staff included, are aware that until GPs go back to work, this will continue.

Before anyone with a skin in the game jumps in, GPs are not working hard.

Spot on, the GPs aren't working as they should, mom sister and I all in different county's with different GPs, none of the 3 seeing people, short of begging and pleading for f2f appointments, My receptionist always says in a snotty way "well what's your problem?" Like she's medically trained....or is in a position to decide who gets put forwards for an appointment,

Hmm let's see, lack of housing,
NHS in crisis long before Covid,
GPs who are oversubscribed,
Govt saying there probably won't be any state mentions in years to come,

Country is full,
There's no Great in Britain anymore, it's broken

I’m sure if someone had to pay £50 to see a GP if they felt it was urgent, I’m sure they would, but the set up the way it is now, that’s not really an option.

No, they wouldn't. Some people will wait years for free treatment rather than pay because they have 'paid their taxes' even if it's to the detriment of their own health. Very common. But they will still pay for holidays, renovations...
I know of a very well-off patient who needs to see a podiatrist--pushed and pushed for NHS referral but waitlist very long. Refuses to go private.

There was a man on National telly last week, tried 3+ times to get a face to face with his Dr, denied twice 3rd time "send a picture"
Which was wrongly diagnosed, and as such is now beyond help and DYING of skin cancer, he's seen several specialists who are all of the opinion of "were this picked up sooner" your prognosis would've been far greater.

Then on the news, baby breathing issues, 3weeks old, health visitor, get him to drs to be sure....mom takes said baby to local DRs 2 hours later,
Receptionist denies them entry, via a locked door, / intercom,....because the 3 week old BABY hadn't been jabbed!

Mom calls ambulance baby is blue lighted to hospital,
That jobsworth stupid cow receptionist caused chaos, but a dr was nowhere to show their face! Turns out there WAS a dr on site!

NHS, "We are working closely with practices on covid procedures"
Not closely enough,
How about some common sense procedures! 😡

'Spot on, the GPs aren't working as they should, mom sister and I all in different county's with different GPs, none of the 3 seeing people, short of begging and pleading for f2f appointments,
My receptionist always says in a snotty way "well what's your problem?"
Like she's medically trained....or is in a position to decide who gets put forwards for an appointment,

Hmm let's see, lack of housing,
NHS in crisis long before Covid,
GPs who are oversubscribed,
Govt saying there probably won't be any state mentions in years to come,

Country is full,
There's no Great in Britain anymore, it's broken'

Are people being directed here from the Daily Mail comments section or something

There's a lot to unpack here but to address two of your points. The receptionist has every right to ask what you want to see the GP for, it is information that allows surgery staff to triage you.

Also why are you all begging and pleading for face to face appointments? Just take a phone appointment like everybody else. If the doctor thinks you need face to face they'll see you.