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 would think if something was life threatening it wouldn't be a 20 hour wait. I don't understand why people go to A&E when they can't get hold of their GP. I've called 111 twice in the last month and I've managed to get an in person appointment with my son, with only a 10 minute wait on the phone.

Also phone consultations with my GP have always been great. It's rare I've had to go in person even before Covid.

Like everyone has stated above, it’s a perfect storm with many causes. It’s also not going to get sorted any time soon as one of the main issues is a lack of staff - you can chuck as much money as you like at it, you can’t train staff overnight. Quite honestly, it seems totally beyond fixing.

I have not read through the whole thread but I do have 18 years experience of working in A&E. This is the worst I have ever seen it. It's by far the most unsafe environment I have ever worked in.

The reasons are so complex, it's not just GPs so please stop blaming them! There is a massive shortage of GPs which does not help as their role as gatekeeper is vital, they are a very overstretched and under resourced service just like the rest of the NHS.

So yes some people land in A&E as they are struggling to access a GP. Not the GPs fault, it's a broken system!

Yep 111 send a load of patients to A&E who could be seen by a GP or often don't actually need to be seen by anyone!

Yep people rock up to A&E with no real emergency. It's frustrating but tbh understandable right now. They just want to see someone!

Patient flow through A&E is shit as I think has been mentioned by pp. But this happens every winter, not usually as early as October though! Lots of patients in beds waiting for social care etc lots of early unsafe discharges been made as the medical team are under pressure to create beds... usually 24 hours later these patients come back to A&E etc. Consequently people are literally waiting hours upon hours in A&E for a hospital bed. Now in my department as well as running an A&E we are simultaneously running a ward as we have lots of partings bedded down every night.

The biggest difference i am seeing now is how unwell and complex so many patients are. It's the sheer volume of very complicated, very unwell patients that is incredibly overwhelming to A&E and the wards and probably meaning much longer stays in hospital. Why is this? To me this is the collateral damage of the pandemic. People with complex chronic illnesses have often not seen their specialists face to face since before the pandemic, many have missed routine bloods, investigations over such a prolonged time. This is secondary care, not GP and again who is to blame? The whole of the NHS apart from the acute sector pretty much became so much less accessible for months on end. Covid became the focus. What about everyone else?
Yes some of these patients have not been to their GP or have had phone consults only. And the difficulty is accessing primary care is certainly part of the problem but it's not the only cause by any stretch and tbh I have only touched on a few other reasons for the bottle neck that is now A&E. but I really do believe that this lack of access to many aspects of health care has created this crisis to what was an already seriously over stretched system. The pandemic has simply broken it.

When an enquiry is made about how the government handled this pandemic I seriously hope that they look at how health care did not remain accessible to those who did not have Covid and how if it happens again how can we keep the NHS FULLY functioning.

The number of adults who can’t, or won’t, grasp that what happens and what is available in their area isn’t universally what happens and is available everywhere is always quite baffling.

@JustLyra

The number of adults who can’t, or won’t, grasp that what happens and what is available in their area isn’t universally what happens and is available everywhere is always quite baffling.

Yep

Econsult has been suspended in my area, its very difficult to get an appointment and even 111 there is a long wait.
I was lucky I got seen straight away but many don't. We also have no minor injuries unit either.
I don't blame people for going to a and e. The nurse triaging me blamed the GPS and the system..they were absolutely rushed off thier feet. I admired them. So many people were there whoobviously really needed medical treatment and weren't seen for hours. Yes you always get some time wasters but how can you say one person needs treatment and another doesn't just by observing them in the waiting room

@Roystonv

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?

You can't expect to be seen at A&E for a minor injury because you can't be arsed driving to minor injuries

There isn't a minor injuries unit in my county.

Nearest one is a round trip of over 100 miles.

I think minor injuries are great, but not every area has one.

You can't expect to be seen at A&E for a minor injury because you can't be arsed driving to minor injuries

No-one seriously expects people to do a two hour round trip to minor injuries…

Half the people in A and E probably just have mental health issues and they want someone to talk to or other support. When I did a placement there a women tried to kill herself and they said she comes in every weekend. She even said see you next weekend 😯 My friend was up there a few days ago and she said it was mental one women pretended to have a fit so she alerted the receptionist as people were just stepping over her. She said she does it all the time. Another lady wee 'd in the middle of the department and got seen straight away after that. Maybe they need a A and E for mental health department and separate one for medical emergencies.

@Meltinthemiddle

Half the people in A and E probably just have mental health issues and they want someone to talk to or other support. When I did a placement there a women tried to kill herself and they said she comes in every weekend. She even said see you next weekend 😯 My friend was up there a few days ago and she said it was mental one women pretended to have a fit so she alerted the receptionist as people were just stepping over her. She said she does it all the time. Another lady wee 'd in the middle of the department and got seen straight away after that. Maybe they need a A and E for mental health department and separate one for medical emergencies.

‘Just have mental health issues’ jeeeez

You want a simple answer?

Tory govt

They never wanted an nhs and always undermine it when they're in power

With a&e there are always those patients there who don't need to be but that's always been the case.

Longer answer

Austerity so lack of funding all round
Poor handling of COVID generally by this govt

Lack of morale meaning staff leaving in droves
Lack of equipment and supplies (like the recent issue with blood vials for tests) meaning it's harder to assess and treat patients in a correct and timely manner

This is an unpopular opinion but I feel the NHS is broken to the point that people need to go private if they're truly worried about their health.

That would be because it's a callous and ill thought out opinion that shows you're thinking exactly what this govt wants you to

The most ill in society are usually the poorest too (either cos they can't work at all or can't maintain employment) like me - how are they supposed to pay for private treatment?

The nhs ISN'T free it's free at point of use

And even if the GP won't see you there are other options - a minor injuries unit, see a pharmacist. And there's the out of hours doctor for nights and weekends too.

Not everywhere has minor injuries or out of hours cover. We don't here. Our supposed ooh place is 90 mins away now!

I am a great advocate of pharmacists where they can be useful but they can't cover everything

As for "just have mh issues"

Odfod!

Lost me there op!

Mental illnesses can be just as much of an emergency as physical

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

What is an acceptable time limit within which you are considered 'ill enough' to be at A&E?

My mum waited 16 hours several years ago with a severe infection after heart bypass surgery. (She waited 12 hours after her original heart attack, after which she was admitted for 3 weeks to be stabilised before surgery). On both occasions she had called her GP first who told her to hang up and call 999. She subsequently had 6 further surgeries under GA for the (hospital-acquired) infection and was in and out of hospital for six months. She'd have died if she hadn't got treatment. Yet she was borderline-not-sick-enough for A&E?

So can you only go to A&E if you might die within 12 hours, not 24?

The NHS was not fit for purpose 15 years ago when it fobbed off my friend's relative. She sought treatment after a year when visiting her daughter abroad and was diagnosed with late-stage ovarian cancer. She received treatment but died a year later in her 60s.

Thé NHS was not fit for purpose 20 years ago when they first fobbed me off for a condition that affects 1 in 10 women. I moved abroad and had 3 surgeries between 2006 and 2010. I have permanent damage due to the late diagnosis. I never attended A&E.

I am under no illusion that it is fit for purpose now. I have remained abroad and pay a lot for private health insurance, but get my money's worth.

It's all very well people extolling the virtues of going private and how worth it it's been for them. And 'only' £90 per month. Aside from the many many people who could never afford that, what would happen with pre-existing conditions?

I am of course referring to private health insurance

@BingBongToTheMoon

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

Bollocks. People need to stop saying crap like this.

I've broken my foot tonight. I'm not dying or critical but I need to be here in A&E despite the long wait, because I need to have my foot put in a cast.

Trust me I'd rather be anywhere else!!

@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.

GP appointments are like blue moons these days, I really don't blame people for using emergency care if they're in pain and don't want to wait 7 weeks to see their GP

@Glitterybug

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!'.

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.

A woman once posted on that subject and she did turn out to have sepsis. Her life was saved because MNers urged her to go to hospital. It's in classics somewhere.

There is also a woman once who didn't go to A&E because of snarky comments on MN, and she DID have sepsis in the end

Frankly if you're well enough to be asking where the canteen is, or where you can nip out for a fag, your situation is not urgent

Again, bollocks. My foot is broken but I can still speak and the pain is subsiding. Shall I go home and leave it broken because some divs on MN have decided that only those unable to speak and move should be in A&E?

Some of these stories are terrible. My husband had a life changing accident 5 months ago - thank god his care was immediate or he wouldn't be here today. We are so grateful.

It’s not the only solution, but a big part of the solution if GPs would go back to seeing people face to face.

The stories on here of people trying and failing to get GP appts are awful.

We have to wait a week for a phone appt for something that really does need attention now (child). I hope we can last the week. But if we can’t, and with no minor injuries clinic, I’ll try the GP again - and failing that there’s no option around here but A&E.

Pre-pandemic there were same-day appts available for kids needing to be seen, or at worst you could get in within a couple of days. Now it’s all ‘the system’ and phone appt in a week. I don’t doubt they are working hard. But ‘the system’ is not working.

Sleepless I didn't mean it as like that so please don't dissect my words when it was written so late and not how it meant. Mental health is serious I know that but these patients were up there all the time and some of them just for someone to talk to not just for medical emergencies .

@StarCourt

It's all very well people extolling the virtues of going private and how worth it it's been for them. And 'only' £90 per month. Aside from the many many people who could never afford that, what would happen with pre-existing conditions?

£90 per month also doesn’t cover emergency care.

I know people on here keep on saying “There are other options than the US system” but there will be no national conversation about this. All that will happen is that the NHS will be continually starved and people will gradually move to private provision. Within 10 years we will have an insurance-company-led health economy like the USA, with their attendant inequity, astronomical costs, relatively poor outcomes for spend per capita, and bankruptcies.

The Daily Mail-captured commentators need to wake up. Their political actions are delivering the consequences that they are deploring.

@Walkingwounded

It’s not the only solution, but a big part of the solution if GPs would go back to seeing people face to face.

The stories on here of people trying and failing to get GP appts are awful.

We have to wait a week for a phone appt for something that really does need attention now (child). I hope we can last the week. But if we can’t, and with no minor injuries clinic, I’ll try the GP again - and failing that there’s no option around here but A&E.

Pre-pandemic there were same-day appts available for kids needing to be seen, or at worst you could get in within a couple of days. Now it’s all ‘the system’ and phone appt in a week. I don’t doubt they are working hard. But ‘the system’ is not working.

The system is not working. But if the number of FtF appointments increases that will decrease the number of appointments overall. Clearly FtF appointments do need to increase, but just shouting at GPs to do more with less is not the solution.