To think if you can wait for a GP you shouldn't be in A&E

[Alfenstein]

Was in A&E overnight last night and was confused and then a bit annoyed about a situation and wanted to see what others thought

I arrived at A&E for 18:00, was told it was very busy (when is it not) and the waits were 5+ hours. I was triaged and sat in the waiting room

At 02:00 a nurse came in and made an announcement. Saying that waits were still really long because they've got 15 ambulances waiting but there is a GP based at the hospital who will be in from 08:00, if people would prefer to go home and come back they would be seen by the GP.

And half of the waiting room got up and left!

AIBU to think that if you can wait until morning you don't need to be in A&E.

Surely the issue isn't that urgent or an emergency if you can bugger off home and come back in the morning!

I recently finished working in A&E in a largish county hospital. There is no 'urgent care' there and no allocated GP care. Regularly 17/18 ambulances waiting outside. One day a 20 hour wait in waiting room for some patients. Very very few people attended unnecessarily. It was he'll.

Haha it's hilarious
When someone posts with something that clearly does need a&e posters pile on to say that's not an accident nor an emergency stop wasting precious nhs resources ....

Op posts that half the waiting room needed a GP appointment due to it not being an actual emergency and she's being in reasonable 😂😂

OP I agree with you and I would have felt the same.

Crikey OP please don't tell me you're in a caring profession! And if you're not, please don't go into one!

Calling other people 'a bit silly' when you have absolutely no clue about their situation is just plain rude and really quite ignorant.

Some of those people may have been directed to A&E by a medical professional (111, GP etc) and yes some people DO find it difficult to advocate for themselves and make health based decisions; just because they left doesn't mean they should have. You have no right or qualification to judge them.

OP you are making this very simplistic. No not everyone knows every service offered by their local hospital. Many come to ours clueless to the fact that we indeed have a GP. It’s not down to you to decide if someone can wait shouldn’t be there. I’ve met people who have tried to get appointments for weeks and keep being fobbed off - and we know that’s the case because it’s exactly the same surgeries and the same excuses given. People get desperate, they are in pain and they don’t know where to go. I totally get it and it’s sad. People like yourselves judging others isn’t helpful, you aren’t them and you don’t have to live their pain or lives and have no concept of their situation. Focus on yourself and getting well. The state of the system is the main issue not necessarily the people, yes some use it inappropriately but many have no choice.

Well you're a beaut OP! 😁

Haven't got a clue what 'Urgent Care' is even if you say both words slowly. And never heard of a GP at the hospital. And I'm a grown up , looking after kids and everything.

I expect the poor sods who left where amazed at the idea that they could just rock up and see a GP in the morning. They'd shown some commitment to whatever was wrong being there till 2am. Either that or by your assessment they were all wasters.

From your general tone and bolshiness I think you probably often think other people have got it wrong or that you know better. And in my experience people like that often get it wrong themselves.

Some of those people who left were probably idiots but some would have had lot more nuanced and complicated situations than you could tell from your seat in the room. Despite you 'knowing' that it's always easy to get a GPs appointment where you live ( you've not had a problem) .

Hope your issues have been resolved.

I took my 6 year old into A&E for an actual emergency but he also needed antibiotics so the nurse said I would have to come back for the GP the next day. When I called the hospital up for the GP they had no idea what I was talking about so we went to A&E again.

My baseline is that you shouldn't be in A&E unless:

1. You have an accident or injury that without immediate medical attention will likely be exacerbated and worsen (e.g. if you have a compound fracture and you will be disfigured with long term damage).
2. You are likely to die imminently. That includes strokes, heart complaints, diabetic ketoacidosis, significant head injuries etc.

The title of A&E says it all... ACCIDENT or EMERGENCY. If you can wait 6-12 hours to be seen it isn't either of those. People need to get items removed from their bottoms by other methods. Those who want to check a boil on their knob need not attend. Pulled muscles, aches etc also don't warrant the A&E treatment.

That said, I do think that there needs to be a massive roll out of certain services if we are to stop people attending A&E. Mental Health Services need to have a designated "Mental Health A&E" that is staffed solely by psychiatrists and psych nurses. MH patients clog up A&Es constantly in my area and aren't appropriately supported in A&Es. We also need a massive roll out of non-surgery GPs, surely the standard model of GPs (attending a surgery, waiting etc) is nowhere near as innovative as it needs to be? I'm thinking 18 hour services across the board, GPs based at pharmacies as walk-in clinics etc. Surely this can be done?

I have two HCP family members - a nurse and AN ACTUAL A&E DOCTOR- and they have both ended up in A&E in their own healthcare trusts with minor issues because there was no where else to go 🤷🏻‍♀️I got sent to A&E by a walk in clinic once 🤷🏻‍♀️ Also some people don’t have much experience with healthcare services - I had literally only ever been in a hospital twice for visits (in completely different parts of the country) before I got sent to this A&E and didn’t even know where the hospital was. unless you when a reason to know about random OOH health services it is actually quite mysterious.

I know my local services by looking them up online though it's not always accurate. In discussions with locals, it generally ends up discussing how poor services are and how frequently they change what's available where. If I went based on signs, I'd be fucked - we still have signs for a hospital that was knocked down years ago.

Sure, there are people who get overly worried or overplay it that could have waited though with how services are right now, it's hard to fault them. There are equally people who are sent to A&E from other placing having not taken things seriously enough who likely could have gone home to their detriment.

My family tends to be on the latter part -- my husband once had what he said was a bad sore throat that he went to the walk-in clinic with as he couldn't get into GP for it. It ended up that his throat was closing, he was having a strong allergic reaction after having given our daughter antibiotics, and they had to convince him to wait for an ambulance rather than take a couple buses to the hospital. He's also been sent to A&E from the GP for shoulder pain as they were concerned it might be related to his spinal injuries. He still thinks he should have just gone to the chemist.

So yeah, sure some should have waited most likely, but I can fully believe people who really should have stayed left, and that I probably would have been one of them. I've outright had HCP say while doing test that they weren't sure how I was conscious. We can't know how many of either were among those who left, or which of those knew the services available to them or if they were sent by other services.

Locally you can't go to A&E without phoning first, so nobody can just turn up - and I've seen them turn people away and tell them to phone first.

I was there last year with chest pain. After about 4 hours, a nurse came out, and basically said the wait was 8 hours and anyone who wasn't at risk of losing a limb or dying might want to go home. A number of people left, including the young man sat next to me who had been Googling private health care options.

Everyone there would have been told they needed to be seen in A&E. Not saying there were no time wasters or people exaggerating, but they'd all have had a fairly extensive conversation about their symptoms before being advised on whether they needed out of hours GP, GP in the morning, minor injuries in the morning or A&E that evening.

@PurpleDaisies i also don’t know and have never known what/where my local urgent care unit is 😂 and I’ve lived in 4 major UK cities so… maybe I am too unobservant to deserve treatment?

You cannot blame people for going to a and e when seeing the GP is often not an option. Rather than judging, just think of how many of those folks obviously preferred the GP option and would probably have taken it before going to a and e had it been made available by their practice.

Burgoo

Members of the public often don't know if what they have meets your criteria because they're not qualified to diagnose themselves.

I suspect some who left really shouldn't have, whilst of course there are time wasters there aren't masses of people who sit in A&E for a laugh. People in pain, those who have plucked up the courage to seek help despite that being a real challenge for them, those who have caring responsibilities and on hearing the wait time put the person they care for above their health- plenty of reasons people would leave upon hearing that.

I understand GPs are under pressure (it's the family business so I do understand) but the trigger happy way they are firing people off to a and e is irresponsible in my view. They clock off knowing there are oodles of people needing to be seen by a GP and are, it seems, becoming increasingly flippant about suggesting they mosey round to a and e.

It's been suggested to me a couple of times for issues that were not appropriate for a and e (eg possibly infected umbilical cyst). It's almost like they're not invested in what's going on in a and e - seems like they're lone agents and they've got compassion fatigue for their colleagues at the hospital.

I mean accident encompasses a wide range of things. People often don't know whether their injury will be exasperated or not if they leave it. Many cottage hospitals have had their X Ray facilities removed and/or close overnight. Whilst i agree there should be more innovative ways to allow people to access care, there's a shortage of MH staff and of GPs so not sure where you're planning on conjuring them from.

Technically they don't have colleagues at the hospital but I know what you're saying. The issue is a referral from a GP for something simple but that they aren't qualified to/don't have the equipment to perform or carry out can take ridiculous amounts of time. Sadly the best way for many people is to access it by going into A&E. Should it be this way? No. But it is.

There’s no point going to A+E if it’s an emergency.
You won’t be seen for hours.
You could be dead before they get round to seeing you.
Might as well stay at home and die in comfort.

I need antibiotics when I get a chest infection. Yet my GP won't prescribe them over the phone and I have phoned for days trying to get seen. I've been unnecessarily to A&E around four times. I would have taken up the offer. I've spent three days trying to get my GP to check my changing mole. I've known people who've ended up with surgery, for things like cysts, when if there was earlier intervention, like seeing a GP, they wouldn't have needed it.
A&E isn't just for accident and emergency anymore. It bridges a gap in care services. Our walk in centers often don't have prescribers on and they are useless with complex health issues such as mine and children.

i once had to take a person to A&E who was trying to walk into the traffic, not suicidal but suffering from dementia, and determined to just get away from the people trying to care for him.
triaged and told to wait.
after sitting in a different area to us in A&E, otherwise he'd be off again, for several hours, a nurse made a similar announcement.
at that point he happened to see a person from the day centre who greeted him and his mood changed. he then permitted one of us to take him home.
while still looking askance at the other.
this is just one example. you cannot know what why people were there, or what they were trying to cope with.
people's needs are complex.

*1) You have an accident or injury that without immediate medical attention will likely be exacerbated and worsen (e.g. if you have a compound fracture and you will be disfigured with long term damage).
2) You are likely to die imminently. That includes strokes, heart complaints, diabetic ketoacidosis, significant head injuries etc.

The title of A&E says it all... ACCIDENT or EMERGENCY. If you can wait 6-12 hours to be seen it isn't either of those. People need to get items removed from their bottoms by other methods. Those who want to check a boil on their knob need not attend. Pulled muscles, aches etc also don't warrant the A&E*

Nah, sometimes you don't know how much of an 'emergency' something is.

You speak as if everyone should know about possible long term disfigurement or likelihood of death or if it can wait till later. That's what triage is for.

If one of my kids had a bad boil on their knob is it for me to decide it doesn't warrant treatment? I'm sure it would cause a lot of pain and worry.

In my part of London urgent care is A&E. There is no separate service.

The way people talk a lot hers attending A&E you would think it was a theme park giving away free gifts all day. Nobody wants to sit in an A&E waiting room for hours, going to A&E instead of your GP or even a walk in clinic is not some kind of treat. They’re always busy and noisy, the chairs are uncomfortable, there are long waits and no updates to inform you how long you might be, hospital parking is expensive, any available food and drink from vending machines etc is overpriced and there won’t be much on offer, there isn’t even phone signal in my local one. There really is no reason anybody would go who didn’t feel like they needed to be there.

If somebody is going to try their luck sitting for hours in A&E instead of booking a GP appointment there will be a reason. It might be a reason others would see as invalid such as a poor understanding of what kind of ailments should be treated where, misinformation around which services exist locally or something like not being able to get a same day GP appointment or one that fits around working hours but in that case it shows there are real issues with the system if somebody would choose waiting an undetermined number of hours to be seen in A&E as the best solution. It doesn’t help that there is very little consistency with regards to services; my local hospital has an A&E but no minor injuries or urgent care/ treatment centre and so it is the place you need to go following things like falls, cuts and burns needing treatment, breaks and sprains etc that might be treated elsewhere in another town. The next hospital over has a walk in GP clinic, minor injuries unit and urgent care unit so the A&E there really is only for accidents and emergencies.

That said, for those saying people with mental health issues ‘clog’ up the system, it clearly says on the NHS website that feelings of self harm or suicide are an emergency and a reason to go to A&E over any other kind of service. When I lived in a different area I went to the walk in centre for stitches following self harm and was sent over to the A&E department as they weren’t willing to deal with me, even though had the injury been caused in any other way that would have been the correct service to go and get the wound stitched.

Proper mega

People aren’t that good at diagnosing themselves. You have chest pain, it could be something, it could be nothing but people already delaying going to A&E with heart attack symptoms. Better to go and get checked out. You have an accident, you don’t know whether your broken ribs will pierce your lung, so you go and get checked out. It’s nonsense to suggest that people are meant to know how serious their condition is. I once spent most of the night in A&E and was left lying in a cubicle for 7 hours without seeing anyone so went home. 2 days later I was having emergency surgery. I didn’t know what I had was potentially life threatening, I thought if it were then I would have been seen sooner. I was very young and thought I might have been wasting their time.