Ambulance and A&E performance drop to lowest levels on record

[JC544D]

Ambulance and A&E performance drop to lowest levels on record

Are I being unreasonable in saying that this is the worst that we can ever remember it?

I used to think that if you called an ambulance in an emergency, that they would come rushing. That's what the emergency services are for.

Sadly, I don't think that this is any longer the case. It feels that today, you are just going to have to wait, if they even turn up at all. The same applies to the other emergency services.

What happened?

We also have an ageing population, lots of advances in medicine, people living much longer, often past the useful life of their body, faculties and enjoyment, also some culture of fear when it comes to comprehensive DNACPR/Respect forms being completed, not prescriptive enough so the patient ends up back in hospital again as a default when nobody knows how best to interpret it, or patients/families who won’t allow the forms, despite there being no realistic prospect of recovery from a cardiac arrest/CPR.

The other night an 8 bedded resus had 17 trolleys in it with patients in them requiring advanced care. 14 of them over the age of 87, multiple co-morbidities and essentially taking it in turns to die throughout the shift. Every time one went to the mortuary the next one took their go, I’ve never seen anything like it in my life, some of them made it to the medical ward, thankfully. I’m sure that at least some of them would have preferred to be home in their own beds, some good pain relief on board, surrounded by family.

I hope when it’s my time that my family love me enough to let me go, that they don’t choose to delay their grieving at the expense of my peace and rest. And that doctors are kind enough to put my best interests over unfounded fears about their GMC numbers, or simply that they properly consider how the purple form might be interpreted in the middle of the night by an 18 year old care home carer who’s never met me before and a newly qualified paramedic doing their best to put the jigsaw puzzle of my entire past medical history together, and make an on the spot decision about whether my rapid deterioration that night falls within the “for admission only for reversible causes”.

Don't worry, the government's sorting it by sending refugees to Rwanda.

If it's like this now how on earth will it be in 10 years time with the ageing population?

Definitely the worst its been, the CQC are currently carrying out a national review of all ED's nationwide. We used get VERY rarely get a 12 hour trolley breach (a patient waiting in ED after they have been referred to a speciality) and in March our trust alone had over 250. We had a patient awaiting a mental health bed for 5!!!! days recently in A&E. we frequently carry more than 35 patients at a time who should be on a ward with the same amount of staff. Its really bad

15 hour wait for my mum last weekend.
Admitted with sepsis. Very very ill.
3 day wait for bed on ward.
Lots of demented patients with nowhere to go as no care package/care home available.
It's bad. It's really really bad

and the new health & social care levy isn't going to fix the problem.

Oh, and I had yo beg the ED staff for pain relief for her
She was also not given fluids despite being very dehydrated
Vile receptionist. Just nasty.
Vending machines empty.
No cleaner seen in 15 hours...toilets disgusting...had to throw my shoes away after wading through all the urine and blood

Sadly, my local trust and ambulance service are the worst performing in the country but its bad everywhere

I'd also like to point out that not everywhere had OOH urgent care centres

The average call back told from 111 is now 8 hours here

@portionplate

and the new health & social care levy isn't going to fix the problem.

Nope

And our GP has disabled the online appointment request service

You have phone

Except you can't get through and you aren't allowed in unless you have an appointment 🤷‍♀️

I think part of the problem is that there is a severe shortage of beds especially ITU beds. Some people can only be admitted if there is an intensive care bed for them. So they might have to go to a different hospital. The longest waits are often in majors because they need a lot more to see doctors, a bed, monitoring etc.

Cuts every year by the Tories to the NHS and social care have obviously had an impact, surely even a Tory voter can see that, or is it easier to fall back on the people need to help themselves argument? There is enough public money swilling around in millionaires bank accounts for PPE scams and tax evasion to boost social care, which has to be given priority as our population is large and ageing

Years of Tory cuts affecting the entire healthcare system

I think the problem is that UK residents expect a Rolls Royce Health Service but are not willing to pay for it.

Lets not forget all the skilled EU medics who left after brexshit

It's like the racist xenophobic elephant in the room

I waited almost six hours for an ambulance for my mum in the summer. It was unreal.

It's not necessarily new though. My friend rang 999 pre covid for her husband and was put on hold- there were no ambulances available.

I worked for an ambulance service last year. You get dickheads ringing with pathetic shit like toothache, exaggerating minor illness and saying they have chest pain when they don't. You would actually be astounded at the level of crap they have to deal with on a daily basis! I regularly had abuse screamed at me and was threatened with physical violence. The amount of people who think its just a taxi to A&E is unreal.

The whole system is overloaded. I still triage people over the phone on a daily basis who are surprised that they feel rubbish with covid. “Terrible high temperature, all shivery, I’m achey all over, so sore”. “Have you taken any paracetamol?”, “No, don’t like taking tablets/thought I’d check with you first/haven’t got any in”. We’re actually years into the pandemic now, how does it still surprise people that they feel terrible and it causes fevers and aches?

To be fair there are two prevailing narratives about Covid that most people have absorbed:

1. It is incredibly serious and might well kill you even if you're a healthy youngish adult
2. It is as mild as a cold and you might well have no symptoms at all, especially if you're youngish and vaccinated

2 has largely taken over from 1 as the prevailing narrative, but most people still have 1 somewhere in the back of their heads so they freak out when it doesn't turn out like 2 and think they must have a terribly serious case.

The Tories have for the last 12 years steadily under funded it. 12 years!

They’ve also cut local authorities funding so they can’t afford to pay for adult social care. This is closely linked to the nhs so also crumbled.

Then came Brexit. Which meant a significant loss of work force.

Then came covid which was the shit on top.

@HardbackWriter

Actually plenty of people have had covid and it was neither 1 or 2. Plenty of people who’ve been laid out for a couple of weeks absolutely exhausted! Unable to work.

Expecting someone to turn up to an emergency call, is not a 'Rolls Royce Service' as some on this thread say.

People are ill for hours, not even knowing if anyone will turn up at all.

Have just spent a week as an inpatient with Daughter and been appalled. 2 drug cock ups, 28 hours of not seeing anyone because of some error on her admission notes and no one coming on 3 occasions when she went grey and had severe chest pains despite me pressing the bell...and then going out to TELL them what was happening. I had to go to the pharmacy to buy some of the drugs needed because surgeons had taken over 24 hours and still not prescribed them. They even gave up doing obs over the last day. I asked where I could fill her water jug and was told I couldn't, only staff could but they never came back when asked.
They were not busy. They even told me they were not busy-she was the only one on the ward on one of the days! Just an absolute lack of organisation, common sense, urgency and, heartbreakingly, care. I almost cried when we got two kind nurses on the last shift change because it was such a relief!
The whole system needs to be completely rethought.

There are so many factors at play but imo the number one issue is the continued misuse and abuse of services and we need to start getting tougher in tackling this. People know they are completely taking the piss but they don't care because they know they won't be turned away.

Numerous causes I think
Tory cuts is number one
Unhealthy population is number two - obesity, smoking, crap food, lack of exercise
Very elderly people refusing to live in suitable accommodation and having constant falls

If the Emergency services are not the 'Emergency Services', what are they?

Buffer services?

Yes
Let's not pretend all HCPs are angels
I wouldn't let some of them look after a dog