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!

Yay! Another GP bashing thread! We haven’t had one of those today.

@Slowfoxfast

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.

This must be so area specific because where I live (and work) the GPs are working their asses off--seeing patients F2f, over telephone, and responding to econsults.

I think people need to understand that all areas do not have enough GPs. And some areas have too few GPs.
I work in a practice that serves 23,000---we have 11 GPs. Do the maths. Start emailing your MP rather than moaning on Mumsnet,

Lack of appropriate care elsewhere certainly doesn't help the situation. My DD was recently very unwell in her University town, couldn't access GP appointment so eventually ended up at walk in centre...waited 5 hours and when seen was sent directly to A&E with suspected sepsis (had to make their own way there mind) and was admitted to hospital. If she had been able to see a GP a couple of days earlier (when she first tried to get medical help) I am sure things wouldnt have got so far and wouldnt have cost the NHS a 3 night stay. To be fair she was seen quickly at A&E, initial triage within about 15 mins....I would imagine anything non urgent would be then sent back to waiting room for however long it takes but what are people supposed to do if no other care available?

@SmellyOldOwls

'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.

Yes to a point they can/should ask but when they want more details it's intrusive, moreover she's known to be a gossip, and as such I don't want her knowing too much about me, moreover I'm well aware she's in a position of trust, and can see my records at a keystroke anyway, my complaint was lack of sensation in my legs increasing, in turn worsened my loss of bladder control to varying degrees, turns out a disc had ruptured in my back over the next week resulting in emergency spinal surgeries plural, had I have seen/spoken to a dr there may have been preventative measures in order to have stopped it going so far, how can I send a picture of that! As it wasn't deemed "important enough" to see a dr I continued to mobilise and get on which has left me ongoing disabled, 111 didn't want to know, to my mind it was incompetence because the receptionist WOULD not triage me, despite several calls across a week, a dr would have known bladder and bowel issues are "Red flags"

My sisters baby, had a rash that didn't pass the rash test, in the end went with her gut took baby to A&E where upon waiting his tongue swelled up and he couldn't breathe! Ended up in intensive care, couldn't get past her receptionist either,

• would not pass the glass test

GP’s need to get back to proper working and we need a complete overhaul of the NHS with people co paying. No other country has the same model as us (and no, it’s not the US system, there is something in between)

Obviously, there is a serious lack of medical staff in all settings for a number of reasons but the main reason that A&E is overrun is that people have no common sense or idea of how to self triage simple issues.
Over the summer I worked in a community pharmacy and I was shocked at the number of people who had no idea how to deal with the most simple conditions. They would come in for medications for a cold, but rather than just wanting to know what was best to take, they wanted the strongest of everything, upon questioning they had mostly woken that morning with the sniffles!
They would be on holiday and had forgot to bring medication, this means that they either needed to contact their GP surgery to send us a prescription or to ring 111 and get them to send one, they kicked off and screamed at us for ruining their holiday because they didn't want to spend 5 minutes to right their own wrong!
We were told daily that the GPs were not answering the phone to arrange repeat prescriptions etc and yet we were speaking to the same surgeries multiple times a day on the exact same phone numbers!
We were constantly told that GPs were not doing appointments even by phone and yet funnily enough we were receiving thousands of prescriptions a week from these same doctors!
No one seems to want to take any kind of responsibility for sorting anything out anymore and then think that A&E is a magic gateway to getting everything there and then, which it absolutely isn't.
I know work in a hospital pharmacy and we are dispensing thousands of medications every day, the doctors, nurses, clinical staff, pharmacy staff, porters, cleaners etc are working so so hard, just like GPs and its awful that people are laying the blame at the NHS when it is the government and their cuts that to blame, but then again the tories have been trying to find a way to get rid of the NHS since its conception and by causing this blame they are slowly winning!

Just want to leave this here to counter some of the uneducated comments.
www.nationalhealthexecutive.com/articles/record-numbers-doctors-nhs
The biggest issues in my view are time wasters, self-inflicted health issues (alcohol, drugs, obesity, smoking etc), an aging population and a lack of family support for the sick/elderly that puts pressure on care home spaces.

@thebestnamesweregone

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! 😡

If that man so worried about his skin, why didn't he pay to see a dermatologist? I am, by no means, rich but if I was worried about skin cancer, I'd pay the 100-200 quid on my credit card to see a specialist. As for the baby, if I'd been the mother, after not being able to see the GP, I would have contacted my HV to intervene or gone straight to A&E (in those circumstances). People need to be proactive to their care, IMO. As for the GP issue, just because some patients are having bad experiences, doesn't mean everyone is.

To be honest, that one about the baby sounds total bollocks.

The Daily Mail has really done a marvellous job on a lot of posters on this thread who think they can lay the problems of ED waiting times at the door of primary care. Well done for swallowing this line hook line and sinker. You do understand the agenda behind this blame game don’t you?

The shameful catastrophe that is ever increasing ED and ambulance waiting times is complex, however the principle issue which only a few posters have commented on is due to flow through ED.
Huge bottle necks occur behind the scenes in ED because they cannot transfer patients who need admitting to the wards. The staff in ED can only safely manage and care for a certain amount of patients. When ED hits its own limits then things grind to a halt.
Patients can’t be transferred to the wards because the wards are already full.
Many wards are full of stranded patients who are medically optimised for discharge (they no longer require acute inpatient care) but they can’t be discharged. And what are these patients waiting for? Packages of care in the community, or placement in residential or nursing care.
And why are there no packages of care available?
Because social care has been totally and utterly neglected by this government. Health care and social care go hand in hand. If you shaft one you impact the other.

It’s a problem with flow. And flow of patients is FUBAR because social care has been neglected, under resourced and ignored for years and years. This problem should be placed at the door of Johnson et al, but instead people are furious with primary care, because it’s easier to be cross with GPs and phone appointments than it is with a complex system of funding for this nation’s ageing social care needs.

I also forgot to say that in the last year I have had to contact my GP a couple of times, every time I was given a call back the same day, I was seen when needed including a blood test with a nurse and a prescription sent to my nominated pharmacy. My DH has also had to speak with the doc and was treated the same.
I also managed to damage the ligaments in my ankle, I went to A&E and was triaged within 10 minutes and then sent to x-ray and then the minor injuries unit. I was out in just over an hour sporting a lovely walking boot and everyone I dealt with was professional and lovely and our trust. The system is broken in places but it is not due to the staff it is due to the lack of funding

@TheShadoutCrepes

The Daily Mail has really done a marvellous job on a lot of posters on this thread who think they can lay the problems of ED waiting times at the door of primary care. Well done for swallowing this line hook line and sinker. You do understand the agenda behind this blame game don’t you?

The shameful catastrophe that is ever increasing ED and ambulance waiting times is complex, however the principle issue which only a few posters have commented on is due to flow through ED.
Huge bottle necks occur behind the scenes in ED because they cannot transfer patients who need admitting to the wards. The staff in ED can only safely manage and care for a certain amount of patients. When ED hits its own limits then things grind to a halt.
Patients can’t be transferred to the wards because the wards are already full.
Many wards are full of stranded patients who are medically optimised for discharge (they no longer require acute inpatient care) but they can’t be discharged. And what are these patients waiting for? Packages of care in the community, or placement in residential or nursing care.
And why are there no packages of care available?
Because social care has been totally and utterly neglected by this government. Health care and social care go hand in hand. If you shaft one you impact the other.

It’s a problem with flow. And flow of patients is FUBAR because social care has been neglected, under resourced and ignored for years and years. This problem should be placed at the door of Johnson et al, but instead people are furious with primary care, because it’s easier to be cross with GPs and phone appointments than it is with a complex system of funding for this nation’s ageing social care needs.

Very relevant.^

@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.

Are you a GP? Want to tell us what you're doing instead of working hard?

There is limited flow through hospital too so a lot of sick people are staying in a&e over 24 hours at times over 48 hours waiting on a base ward. So Staff are looking after these people and trying to see people who arrive in the dept including the people who come for no reason

Ok @thebestnamesweregone sorry you ended up being so unwell but it's not clear, did you actually tell the receptionist what the issue was?

I work in a practice that serves 23,000---we have 11 GPs. Do the maths. Start emailing your MP rather than moaning on Mumsnet,

WTAF? How does that work? Okay, I suck at maths, but I simply cannot compute in such a way that this works out!

@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.

It’s simply not true to say that all practices offer that.

Here you have to have to get through on the phone at a certain time to get a phone consult appointment and they don’t do econsults.

I had to resort recently to going into the surgery and making a very embarrassing demand to speak to someone after trying daily for 6 weeks to speak to a Dr about a breast lump with other symptoms.

And that was despite explaining to the receptionists numerous times why I wanted an appointment and being told simply to try the next day. Emails to the practice manager also didn’t get anywhere as she’s off sick and no-one was picking them up.

Had I not managed to embarrass them into shoving me into a room to see someone just to shut me up my next step was going to have to be A&E as I had no other way of getting seen (and it turns out I very much did need to be seen - luckily the delay hasn’t caused significant impact to prognosis).

Yes, there are a lot of people who misuse services, but there are a lot of areas where services are failing patients and that leads to necessary misuse

If that man so worried about his skin, why didn't he pay to see a dermatologist?

Dreadful thing to say

Posters talk about minor injury units but our main hospital doesn't have one (nearest one maybe an hour away) which means you really fall between a and e and your gp. One should not be bothered and one no longer deals with. Does anyone know how it is decided where they sited?

If you have to wait 20 hours to be seen in an A&E then you don’t need to be there
I suspect this refers to people waiting on a trolley for a bed. I was taken to A&E in August and needed admitting. I was on a trolley 11 hours until a bed was available. I was seen by doctors and treated while waiting though it was uncomfortable and I was pretty ill.
I don't know what the answer is. So many people going to hospital who really just need a GP or practice nurse.
111 doesn't help, run on algorithms rather than medical expertise so many people again get directed to A&E who don't need it.

It really isn't rocket science.

Ot may not be rocket science but it is far more complex than your 2+2=5 calculation. As @TheShadoutCrepes has noted the problem is flow. Partly because of the lack of social care, but also because wards that might have been available for people to be admitted to have been repurposed for treating all the Covid patients we have. People need to understand when they say we “just have to live with” Covid and “only a small percentage of people get really ill with it” that means that health services will be stretched and your hugely important F2F appointment tomorrow might not be possible. That’s what isn’t rocket science.

@User134342134

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 went to a&e with a miscarriage following the advice on the sheet from the epac. I haemorrhaged at a weekend pending a d&c, soaking through maternity towels in 5 minutes and passing out. This was precovid but I was seen quickly, treated with tranexamic acid, fluids and transferred to gynae. They said I definitely needed to be there as I apologised for taking up their time, making a mess and having no veins.

These are the things that the nhs exist to treat, we have to be really careful not to make patients feel so guilty for using services that they stay away. This was certainly a concern during the first lockdown… elderly people avoiding hospital with signs of stroke or dysuria for example.

**13Glitterybug

'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'

Actually I went to hospital with severe vaginally bleeding 2 weeks ago AFTER ringing my gp (couldn't get through) AND 111 who advised me to go straight to a and e.
I collapsed in the waiting room, went straight in and was admitted. Turns out I had an unusual reaction to sertraline and it was a good job I went.

What a stupid Post.

It’s a whole mess of things, lack of GP appointments, irresponsible usage, systematic underfunding meaning there aren’t enough nurses and doctors to get through patients ‘quickly’ (I went to a and e for an appendicitis and I was waiting 6 hours, there were 2 Doctors and 2 nurses covering a&e) and an ineffective 111 and out of hours service.

I disagree with the comment that said if you have to wait 20 hours you don’t need to be in a&e, sometimes you bloody well do. May bank holiday weekend Bham children’s hospital had a 15 hr wait. We were directed there by 111 for a 40degree fever on our 18 months old that we couldn’t get down. There was a 4 week old baby that wasn’t feeding, passing urine and had rapid breathing- the baby had been there 6 hours and hadn’t been triaged. That child needed to be seen, the only option was to wait. Out of hours and 111 seem to just direct all children under 5 to a&e.