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 got to see a qualified person to fix your car, gas appliances, electric etc, but when it comes to our bodies and those of our children, we have to be on the level of someone who has done a degree. Of course people go to A&E that could be dealt with elsewhere because they aren't qualified to make that decision.
@Liz1tummypain your Mum needs to be reminded of available GP appointments, home visits and different clinics that were available. In the 80/90's we had drop in baby clinics, they'd gone by the time my GC were born. My DD used to go to the weigh in clinic (which wasn't busy) and was told not to come as often, but she needed that reassurance as a bf first time Mum. I need antibiotics everytime I get a heavy cold etc. I get directed to A&E because I've had an embolism. It's a waste of resources. The little girl (3) who has just died after being sent away from A&E would be classed as a time waster on that night's statistics.
All of the austerity measures link to were we are today. Including the bedroom tax, which split communities and families, meant that people wasn't living close to family and didn't have a spare bedroom for a older relative to recover in.

Every single person I know would literally not go to A&E unless they were carried in on a stretcher. I don’t buy all this people are going in for minor things when it’s a 15 hour wait. I think, in fact I’m certain, that it’s just the usual government deflecting blame for the state of health services. I’m amazed that people believe it to be honest. People seem to turn their brains off with this stuff, like I wouldn’t go to A&E for a cut finger because it’s not warranted and you’re probably gonna wait 15 hours and that would be both pointless and stupid, but the newspaper/Mumsnet/the government are telling me lots of other people do it, so it must be tru.

They do BUT no one can get gp appts so they go to a&E as they get worried. You see on here ‘I had a suspected heart attack and waited 9 hours the nhs is broken’ but they key word is suspected, they didn’t have a heart attack, they had chest pain on and off for days which they should have got an appt at gp for to diagnose something like costochrondritis or chest infection but they googled and it said maybe heart attack so it’s panic stations and go to a&E where the wait is way too long. It shouldn’t be this way I’m not saying people do it on purpose but if there were better primary care options then a&E would work for true emergencies. We have an excellent walk in in our area, a true ‘minor injuries’ type thing where you go if you can’t get a gp appt. I’ve been for things like a nasty ingrown toenail, ruptured ear drum with infection, sprained ankle with bruising. All treated and sorted fairly quickly. All of these I’ve also known people to go to a&E with.

This. and I can totally see why. My DD19 has been suffering with a horrid cold, 2 nights ago she sneezed and felt a sudden sharp pain in her ear. All night it was very painful. Yesterday morning I took her to the pharmacist to see what he recommended, he said she needs to see a GP or an Audiologist as he thinks she may have perforated her ear drum.
I tried our GP surgery, was on hold for over 2 hours before we were told no more appointments that day. So I called private audiologists in the area, as I was happy to pay for the appointment. Upon speaking with them they said that they could see her, but if it was perforated and she needed antibiotics they wouldn't be able to prescribe so she would have to still see her GP.
This morning after an hour and a half I did manage to get her a GP appointment for this afternoon, but I could easily have missed out.
I tried ALL other avenues before trying to get a GP appointment that were recommended, but if she couldn't have got a GP appointment today who knows where we would have ended up as she's in a lot of pain and mostly deaf in that ear.
So yes, people go there who shouldn't, but if they've tried every other option what do you suggest? The NHS is on its knees thanks to the Government, and I don't think it's going to change anytime soon.

I find what a pharmacist can do is very limited despite the list of conditions they can supposedly treat or advise on.

Whenever I have asked a pharmacist to look at a condition they have always advised a GP appointment eg sore toe, ear ache, sore throat that won’t go away, swollen eye.

The sore toe was an ingrowing toenail that needed a referral to podiatry and a minor op, ear ache was a referral to audiology and ears syringed, the sore throat developed into a chest infection which needed antibiotics and the swollen eye was shingles which needed antivirals. (Shingles was me, the rest was dc.)

Fortunately, my gp has seen dc for urgent conditions on the day but getting through on the phone is a nightmare and I have been told on several occasions when I have rung first thing in the morning that there are no appointments left. I always say, it’s urgent and then I get an appointment. Other patients might leave it then the condition can get worse.

When my dc had tonsillitis they became seriously ill in one day and ended up in A&E.

It is pretty clear that it is the lack of GPs, the lack of appointments, I read an article where it highlighted the fact that GP as a profession is denigrated by hospital Doctors so medical students don't want to enter the profession. The PR issues around becoming a GP are a major problem and we need that personal connection again this is proven to reduce hospital admissions. Phone call appointments make it akin to service like a taxi or a takeaway.

TugboatAnnie
Absolutely. I'm a veteran of children's head injuries- counting it up, my 2 have had to have medical attention 6 times between them for either massive bleeding head wounds or signs of concussion. I've always taken them to MIU, who have either glued them back together or kept them under observation for the time required.

This time, DS2 fell over in the playground at school, bled profusely and showed signs of confusion, and they called a bloody ambulance, who insisted on whisking us off to A&E at the County hospital, where he underwent the same period of observation, except rather than having a bed in a bay to recover, he had to sit in the waiting room, because of course they're much busier there.

It was only afterwards that I found out that the local MIU is only open part time now ☹

Telephone GP/111 calls are part of the problem. You can’t do the most basic examinations. So to be sure, it ends up being A&E. Or worse, calling an ambulance to get to A&E, which delays them for absolute emergencies (I was in a rather big city center, needed an emergency ICU transfer = absolute top of the emergency list (had stopped breathing literally), and it still took 1.5 hours for the ambulance : then stayed after reanimated for evaluation of potential hypoxia damage due to this delay. Then had to be discharged because no place in regular wards (so, the lack of social care issue also) because you obviously can’t keep an ICU bed. Was shattered, they gave me food for days and all meds, I never could have managed otherwise if alone at home.

I think it's a minority of people who go to A&E off their own back for something minor and haven't tried other options first.

The majority of "unnecessary" cases are sent there by the doctor or 111 or go because it's their last resort.

During covid my friend tried to get a GP appointment for her sick child. She was refused because she had to take her other children with her as she had no childcare options since we weren't allowed to see other people. They told her to take all of the children to A&E instead and get the sick one seen there. So basically spend hours waiting in a waiting room full of sick people Vs 10 minutes in the other with barely any people in because it was strict appointment only. It just seemed absolute madness but our doctors is still very reluctant to see people and the place is still like fort Knox.

It's not so much the patients that cause the issue but the system itself.

I'll admit I once walked in to A&E and would have looked like a timewaster as it was for a gum infection.

HOWEVER - I had seen my dentist earlier that week about a mildly infected gum around a wisdom tooth. He advised rinsing it out with Corsdyl or salt water and coming back if it got worse.

It got a worse and by the weekend (when my dentist is closed) to the point at 3am on the Saturday I woke up drenched in sweat, shivering and with a very high temperature. My gums were inflamed red, painful and hot to touch. Mindful of the link between infected teeth/gums and sepsis I went to A&E (at the time I lived a 10 min walk from a major London A&E unit). I basically waited three hours and argued with the triage nurse until I was sent away with a small handful of penicillin.

When I saw my dentist on Monday I was diagnosed with acute necrotising gingivitis and my dentist said it could have easily and quickly turned in to sepsis had I not got hold of antibiotics.

There are some idiots out there, but the big problem is we don't have enough GPs.

GPs are actually seeing more people than ever, but can't keep up with demand. Like every other area of the NHS, it's understaffing, high levels of stress - not worth it for the money.

You can't get through to 111 a lot of the time. Patchy access to OOH GPs.

Along with the Tories closing lots of urgent care, minor injuries and A&Es, it means intolerable pressure on the services that are left.

You may get a very tiny minority of people who have hypochondriac tendencies going there, but as others have pointed out the wait time is so long that the vast majority will only be there if they really have to be.

NHS services are so strained and stretched people aren’t getting the treatment or care they need, or put off trying to get a GP appt as they know it’ll be a nightmare and then by the time they relent they’re much sicker than they were and A+E is the only option. A few years ago our local minor injuries clinic was very well staffed and treated people who were in need but it wasn’t an emergency, often things like mild falls, burns etc. It took a lot of strain off the local A+E but it’s now closed - so people who would’ve gone there have no choice but to go to A+E and add to the pile.

Mastitis can be life threatening so its understandably getting sent to A&E

We used to have a couple of walk in GP hubs. They are no longer walk ins and you have to get an appointment through 111. I think introducing walk in GP clinics again might take some of the pressure off A & E. Getting an urgent GP appointment is very difficult.

A septic finger needs prompt antibiotics ,or ir x5an lead to sepsis.How could you diagnose the footballers knee accident?

I work with young people (16-25) and the amount of things that 'guidance' tells us that we need to recommend they attend a&e for us absurd.

Things that if they were my own children I'd be giving them a paracetamol and just keeping an eye on it. It's all arse covering and it's just adding to the chaos. Guidelines for things like this need reassessing and putting into context.

@Ginmonkeyagain your case basically sums up the situation in a lot of people, to not end up waiting around for sepsis to take over your body when you have no access to a gp or walk in clinic. These things tend to happen at night and weekends and you don't want to risk waiting for the next day or Monday in case the situation takes a dark turn and it's too late. We read about these stories every once in a while don't we, hell even people who have turned up to the a&e and was sent home that had died at home.

I wasn’t sent to A&E because it can be life threatening, if my GP was worried about it being life threatening I’m sure they could have offered me an appointment sooner than 2 weeks.
Then the OOH doctor refused to see me too.
A&E did a basic exam and prescribed a standard course of antibiotics - there was no need for me to clog up A&E.

I used to work on the same reception as A&E, I've seen people come with an ingrown toenail, people coming because their baby has a slight temp or has D&V, I've seen lots come because they've had a slight bump in their car and need to see a dr to enhance the likelihood of a future car insurance payout (no injuries recorded); women who pretend to fall so they can get an early scan (this was a pretty regular thing to do for ladies from a particular country - I'm not racist, it just is what it is), I could go on a while..

Forgot to mention, as I had a long severe pneumonia consequently, I was sensitive (still am) to any respiratory infection for a while, and so any symptoms related I was always directed to A&E : they can’t examine anything by phone, and good luck getting a GP appointment. I did go, although I figured it would be nothing, it’s hard to be told go and think no I won’t (after a réanimation stay especially, but really the stuff was minor risk, it’s just that by phone they can’t check the most basic stuff)

For most it’s probably an issue with getting a GP appointment, although for our surgery this has never been an issue even throughout the pandemic so we are clearly in the minority.

The health service also needs a major overall which also in turn means becoming a 7-day service, because people don’t just get sick conveniently Mon-Fri 9-5pm. GP surgeries should be required by law to be open 7 days, with at least one doctor and nurse available to deal with those who ‘inconveniently’ get ill on the weekend.

We have just spent 3 hours in our local Paediatric A&E after being told to go by the out of ours GP (child was admitted to hospital so not a fob off from this GP), and the small waiting room was full of young children stripped down to underwear and clearing running fevers, coughing and spluttering, and vomiting. If there was a 7-day GP service then I would suspect many of these children could have been seen without an A&E visit (obviously not all).

The A&E doctor also Strep A has always been around and the media are really ramping up the panic which then has the flow-on effect of people arriving at A&E worried sick. If they could see a GP then again this volume of people could potentially be reduced significantly.

Yes definitely but that's because we have no bloody GPs so no one can get appointments.

@NYNewYou Indeed and that would have happened to me as I was basically told to go away as I think they suspected I was after a freebie from the emergency dentist. I was just very insistent and very middle class and demanded at least a couple of days of penicillin in case the infection took a turn for the worse and became sepsis.

As it tuned out I ended up on a two week course of metranidazole (which is VILE)

Agreed. I have found the lack of access to urgent medical advice for my toddler truly terrifying in the past year.

Friends in other countries have same day access to paediatrician community care for things like suspected ear infections. Meanwhile, I have taken DD to A&E with suspected sepsis and faced scorn from the triage nurse because she doesn't look at deaths door.

I ended up in A&E unnecessarily over Christmas. 111 told me to go there as GP was closed and medication more effective within a certain amount of hours so couldn't wait for it to reopen. 111 were pretty sure of the diagnosis, as was the triage nurse. But had to wait to see a doctor as I needed a prescription. 5.5 hours later (which I consider good!), prescription received. Doctor said if it doesn't resolve to come back to A&E despite NHS pages on the condition saying GP should be the first point of call.