Lots of people go to A&E when they shouldn't

[Liz1tummypain]

To be clear- I couldn't think of a way or wording this so I just came up with something that might attract some opinions. It isn't something I can spout about with any authority.

But is it true? My kids are older so I haven't had to go to A&E for ages. Very little experience. On the radio I heard they are trying to re-direct potential patients to pharmacies etc . So what is your view on it?

My mum worked in A&E , a long time ago and she says she thinks people wouldn't have dared to turn up with some minor injuries that she thinks people go in with now. She thinks people just tried home remedies and only went in with broken bones, trauma, sick children. But I think maybe she was just getting a bit worked up after seeing something on TV. She also hasn't been to A&E for a long time.

You've posted links to useful leaflets and I hope that some people will find them helpful and reassuring.

One of my favourite public health people always says, "Don't bring a fact to a narrative fight."

Along with many references to playing chess with a pigeon.

A&E is essentially a mix of 3 things:

1. Actual critical injuries/ medical emergencies (definitely the majority).

1. People who are unable to access medical care elsewhere and are desperate (easily the majority).

1. People who have minor ailments that likely don't even require a GP appointment but as we live in such dire high anxiety times they are convinced if they don't seek medical attention, the worst case scenario will come true. (This is more than 1. But far fewer than 2.).

Sorry, 1. Was suppose to be definitely the minority, not majority.

I have MS, I'm supposed to have an MS nurse who I can call when I need help/tablets, but she was fired in 2020 and never replaced. My GP refuses to help and the chemist isn't allowed to issue anything without consent from my consultant, so everytime I need something I have to go sit in A&E and wait for someone from the neuro wing to come see me. It's a huge waste of everyone's time, and could be easily fixed by just letting me book a neuro appointment myself or by hiring a new nurse

Well I do because I was also on that night shift.

I’ve had to go to A&E recently 3 times for extreme pain management.

I’ve now been referred for further testing and waiting for my appointment, but I’ve been told by the staff at A&E, to go back whenever I get into the state I was.

Im talking abdominal pain where I struggle to walk. Literally rocking in my chair, crying in pain

And did the child have MCCaD or LCCaD?

Just read a story about someone turning up for ear wax despite the hospital having declared a critical incident.

I saw that story and the Twitter thread it's based on. Predictably enough, there were people arguing that ear was might mean the person had pain. I'd hope that if the person had been in pain, the nurse would have mentioned it.

afaik, ear wax removal hasn't been an NHS core service since late 2020.

Since then, patients in most areas have been told that they need to book themselves in with BUPA, SpecSavers, Hidden Hearing, Clearer Ears etc. if self-management techniques don't work. (NB: self-management does not include cotton buds any further than the outer part of the ear.)

It’s literally posted about 20 posts up.

@AdobeWanKenobi I don't have time to read multiple posts at the moment 🤷🏻‍♀️. Just saw an article online and thought I would mention it.

There's no need to be rude. I only mentioned it because people don't realise there are alternatives. I've never used it but its good to know its there if you need it.

I just checked my local hospital A&E waiting times out of curiosity. It says they are very busy but only have 27 patients waiting. It says 7 hours until consultation and 11 until discharge. Is this due to staff levels as it seems an awful long time for hardly any patients?

I don’t have any reliable data so only going on personal experience. It seems to depend area to area what service you receive. I recently moved 50 miles away and when I broke my arm, I was seen in 30 mins in the walk in centre and was out in plaster in 90 mins. I was told by the reception at A&E that I wouldn’t be treated as a priority and that the wait could be up to 17 hours!! Whereas now, I’ve moved there’s only one walk in centre and it doesn’t have an x-ray machine so let’s hope I don’t break anything again.

When I broke my arm in my previous city I got the quick service (just to be clear)!!

You are rude if you are trying to blame me that I wanted help for my son!
Can you understand that these services ARE NOT AVAILABLE everywhere in UK!
Try to book even private appointment at London, you have no clue.

I couldn't get a GP appointment in the summer for my DS. I was fairly sure he has a chest infection. He also asthmatic. I needed antibiotics asap. The GP surgery told me A & E in the hospital 30 minutes away. He was seen (by a nurse), diagnosed with chest infection and prescribed antibiotics. A lot of countries have pharmacies which can sell more medication over the counter. We're stuck in the middle here.

It depends what’s wrong with those patients, a couple of patients in resus or a death causes a backlog. Or yes, staffing.

I had to take ds to A&E a few months ago for an asthma attack - they had started a system where 3 nurses triage each patient then send them either to OOH GP, minor injuries (so nurses could patch up wounds or check potential breaks), or back to wait to see a dr. It seemed to work well, and despite projected 5 hr wait ds was seen by a GP within a couple of hours.

One man was in with a scratch on his leg - literally a scratch that had bled a bit - he was triaged and sent home, he wasn’t happy about it at all, but why on earth would you go for a few hours wait for a scratch?

I was in A&E recently. Aside from having a patient in the waiting room who had been there over 28 hours when I arrived. They had a system of coming out every 90 minutes and calling out a list of names usually 10+ long and telling them to leave and seek help from the Urgent Care or Walk In Centre. It really showed how many people didn't actually need A&E. One homeless man had been in everyday that week so he could try and get free food from the vending machine when it was refilled. There were plenty of very obvious issues that were blocking access to the service.

This is a great resource, thanks for sharing!

Gosh chill out. I wasn't try to blame you for anything. I just made a comment that we had a pharmacy by us that offered appointments for £10 and also that certain pharmacies can dole out certain antibiotics if they are PIP. It wasn't having a go at anyone, I think you are a feeling a bit sensitive at the moment due to be worried, which is understandable. I hope your son is better soon x

In an attempt to give patients more choice and actually divert people away from overstretched services we have made access medical care for acute issues very complex to navigate. Do I go to the GP, ring 111, see a pharmacist, go to a walk in centre or go to A&E for a particular condition? It seems that there are lots of rules and guidance about which service is the right one now and that suggests they are services that rely on people being well informed and not under stress to access appropriately which seems like very poor design. Combine that with patchy provision and people struggling to access certain services in certain areas and this is why we have people accessing the wrong service for their needs. People will just default to what they are familiar with or go to the highest level to ensure they are treated appropriately (i.e. going to A&E when they don't really need to possibly because they have not been able to be seen by their doctor in the past or had a bad experience with 111 or are just not aware of the existence of a walk in centre in their area).

My view is that we need a significant rethink about how we access primary care in the UK and I suggest that consolidation and simplifying routes of access are what would help here.

When I went in a few weeks ago, sat there in the waiting room I might have looked perfectly fit and healthy to the casual observer - until I got up to try and walk to the examination area; I had a torn meniscus

My dh might have looked fine when he attended 3 months ago, but in fact he had developed complex fistula disease due to complications of an abcess. Unless he dropped his trousers you wouldn't know

Dd went in August - she probably looked okay to anyone's passing scrutiny, but in fact had a Kidney infection which couldn't wait for the GP on Monday

A&E is not for the faint hearted (lengthy, lengthy waits) so I suspect most people who attend need to be there

@swg
My middle aged husbands abcess which has developed into complex fistula disease (he now has an open wound held open by a seton and is waiting for surgery in a London teaching hospital because local hospital can't do it) was originally misdiagnosed as piles in A&E. He had to attend a second time before they worked it out!