To say every hospital should have a children’s A&E

[Wouldloveanother]

I know, it’s pie in the sky and won’t happen.
the state of A&E scares me at the moment. It’s one thing adults waiting 12+ hours alongside people high on drugs or in mental distress (our A&E seems to have a lot of both), it’s another thing for a small child to have to wait in such circumstances. I also feel in general children should take priority over adults (perhaps that’s controversial) and they shouldn’t have to queue with us.
Where we lived before had a dedicated children’s A&E and it was fantastic. AIBU?

🤦🏼‍♀️ this is already the case in many hospitals so it’s obviously not as ludicrous as you’re enjoying making it out to be

and did you read my OP where I said it was pie in the sky?

I did just say that 🤨 it’s you and other posters that have conjured up a load of nonsense that I never said then started criticising it

"Also yes children can also suffer a MH crisis but a child having a crisis and shouting/acting erratically while scary, isn't as scary as a 6ft tall man doing the same thing. That's not fair but it is true."

There would still be 6ft teenagers there.

It’s one thing adults waiting 12+ hours alongside people high on drugs or in mental distress

You'd probably get that in even in a kids A&E, if the child is accompanied by a parent and/or other adult. And, as others have said, child patients themselves who're in mental distress or have taken drugs.

I also feel in general children should take priority over adults

Lol. Nah.

@Wouldloveanother You said that, and also that children should be prioritised over adults. I assumed, reasonably, that they were separate points, because having a childrens' A&E is not prioritising children over adults. You haven't been able to explain what you mean by priority and so of course posters are going to demonstrate how ridiculous it is to prioritise children over adults for reasons other than clinical need.

Our hospital has a separate children a&e which works very well. I was there with DS when he was a toddler (not for a sore finger in case anyone is worried but for a terrifying life threatening situation) and having a calmer separate area was a godsend.

Our local hospital does have a paediatric A&E and as a general rule wait times are shorter than in adult A&E (depending on how busy it is obviously). I genuinely didn’t realise it wasn’t standard.

Yes, in an ideal world there would be a separate children's A and E, and it would probably be clogged up with 20% genuine emergencies and 80% hysterical mothers and those too lazy to book and wait for a GP appointment.

Not the experience I've had with our dedicated paediatric A&E at all. The triage system tends to work well, people get redirected to OOH GP (on site at the hospital) or minor injuries (relatively new, but have a separate children's waiting area), and I've never seen the smallish waiting room of the paeds A&E overflowing and every kid there was there because they needed to be.

I've not been with Covid (thank you, children, for giving up luxuries such as concussions, suspected meningitis, severe croup, and DS2's insistence on leading with his face when falling against hard surfaces and objects) but the systems they had in place to manage intake worked very well.

@Wouldloveanother you can still have thought about it rationally even if you know it won't happen...

I never suggested it's a ludicrous idea. It'd be great to have two completely separate areas - mostly because then you could have specialised paediatrics but ultimately I don't see how it's feasible. As it's your proposal, I'd assumed you'd considered feasibility.

Given how differently children can present with some emergencies compared to adults, and how difficult they can be to treat, I'm eternally grateful that our hospital has one with specialist medical staff who are brilliant and experienced with ill or broken children.

Given lots of hospitals have one, I'm not sure on what basis you're saying you don't see how it's feasible?

I can see for smaller hospitals they may not have the population to sustain the two separate services, but for larger hospitals having separate emergency departments for adults and children is far from unheard of.

@JassyRadlett it's not financially feasible currently - hence why I asked how they'd be funded.

What about the elderly particularly those with dementia attending A and E for something unrelated e.g. a cut following a fall. A and E is a terrifying place for them removed from an environment they are familiar with, being treated by people who they dont know and who often don't understand their needs and also witnessing people with significant MH concerns, drunks shouting, people in pain again things they cannot necessarily understand. Shouldn't they also get priority?
Ultimately it's not possible to prioritse in A and E due to age you could make a strong case for other age groups.

How do you think the hospitals that currently have them, fund them? They are clearly feasible in a large number of hospitals and the number that have them appears to be increasing.

Norwich and Norfolk have recently done something interesting - not only expanding its dedicated paediatric A&E, but also a dedicated A&E for older patients. Greater specialisation is likely to bring efficiences, not the other way around. That certainly seems to be part of the rationale for opening the A&E department for older patients.

I'd assume that some of these factors would form part of triage decisions on clinical need (I'm not an expert on this but I'd hope so).

It's an interesting point, though. I don't know how many geriatricians there are compared to paediatricians but if we're creating separate A&Es according to the specific doctors who train to treat distinct age groups then perhaps we should be looking at this too.

There’s nothing reasonable about your assumption. I never said a mildly ill child should be prioritised over a very unwell adult, I never said children’s A&Es should replace regular ones (I mean, seriously?!) yet these are all bizarre extrapolations of what I have said which I am now being criticised for 🤨

I didn't realise that a separate children's A&E was not standard, OP.

Blimey - i feel very lucky now.

Our hospital has adults and a separate children's area.

Both are overflowing with terrible wait times.

The staff are bloody heroes but the service is just broken.

I wonder if there are any more in the pipeline apart from the new one at Norfolk and Norwich? It seems to be a much more effective and efficient system to make sure that the care pathway for over 80s works properly.

@Wouldloveanother And yet you're still unable to explain what you meant, then, by prioritising...

We have a kids A&E at the children's hospital. All under 2s have to go there. There's one other hospital that can take under 5s, but when my DS had an obviously broken finger on a Saturday night I went to the children's A&E rather than the city centre A&E...

Would have preferred minor injuries but our minor injuries can't see under 5s and it's not like a fracture can wait until Monday for an X-ray. Had to wait 5 hours which was fair enough as he wasn't ill, but pretty tiring. He wasn't the only child with a likely fracture to the hand/wrist, we were all seen at around 2.30am when everything else was quieter...

It's where the NHS seems to struggle the most - not life threatening now but can't wait until in hours.

I meant, having their own facility. It isn’t hard rainbowmilk.

I didn't know that Childrens A&E wasn't standard

I don't think that kids should necessarily take priority and I trust the professionals to triage people accordingly.

As I've said about five times now, having their own facility in addition to the general A&E isn't prioritising them over adults. Adults don't need paediatricians. I am going to stop engaging with this now as I actually think you're determined not to understand that words mean things.

My local hospital asks for the child's date if birth and I think under 16's go straight through the the childrens a&e bit. They still have to wait but just not asking. It's completely separate from normal a&e. Thought all hospitals was like this.

Are children who are drunk or have taken drugs not asked to wait in adult A&E? Where do children who are highly distressed and possibly acting violently waiting ?

I've only been up kids A&E a handful of times and the most distressing thing I've seen is a child have a seizure while waiting.