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.

What good is making a 7 day GP service a legal requirement if there aren't enough GPs and nurses to staff it? Who/how will enforce it?

The problem is really not the fault of rhe patients!

I'm ashamed to say it but when I was 17 (39 now) I went to A&E for an infected ingrowing toenail 🤦🏻‍♀️. I wouldn't dream of doing that now though.

Our population has gone up by nearly 3 million over the last three years, which could easily out demand the rise in appointments. Which is why councils are using the law to reject migration/asylum population because the local services won't cope.
All of the consultants, the BMA etc agree that the main issue is a lack of investment. Suddenly we ignore the experts on this and blame the people who have the temerity to use services.

My DH's Grandad, uncle and Aunt were all GPs so my MIL knows quite a bit about medical conditions. She has a kidney issue recently, knew that it could be treated with a prescription from GP but she needed a physical check first and phone call would not suffice. They refused told my 75 year old mil to go to A&E but instead she went along to the surgery which is locked, she waited and entered when someone left, she waited in the waiting room, was seen by a GP, for her prescription and went home - one less person in A&E and also stopped the condition worsening to create more issues and potential hospital visit. DH's uncle was working up until a couple of years ago and would do out of hours visits for patients that rang him at home,old patients that he'd known for years. That kind of relationship stopped the admissions in the past. You need personal lists, attractive funding for medical students to commit to GP on leaving.

It seems a big coincidence that GP/patient appointments stopped in person in COVID, now we have an NHS crisis.

I wonder whether we ought to go back to the days of having cottage hospitals in every district.

It would ease the burden on general hospitals and be an extended support for GP practices that are , clearly, no longer coping with the volume of appointments needed.

People use a&e when gps won't see or refer them. My dad and grandparents have had to go to a&e for something urgent that a gp practise nurse should have been able to sort out, but couldn't get an appointment. A good friend kept getting fobbed off by her gp who wouldn't refer her for cancer tests, and she sat in a&e until someone saw her, luckily they caught the cancer in time. GPs aren't on bad money by all accounts, but trying to get an appointment with one is like trying to get an audience with the pope!

In the last year I've been in A&E for ?broken elbow (wasn't broken just very badly sprained), the worst headaches of my life, and being unable to stop vomiting (not pregnant, just puked 20x in 6 hours).

2/3 needed medical attention that warranted a trip to A&E.

The headaches could have been sorted at my GP practice, but I couldn't get an appointment at all, and on the e-consult I couldnt quite convey just how much my head felt like it was splitting open. Going to A&E got me the pain relief I so desperately needed for some much needed respite and made my GP take me seriously. I was finally diagnosed with a serious endocrine disorder and need to take 14 pills a day to feel normal.

Repeat this scenario for the population and one factor for the choas we see is apparent.

What do you expect people to do if they can't see a GP?
Pharmacists can't deal with many things. I've never had good answers from them. It's always 'ask your doctor' and they're not open much outside office hours.

I was in A&E recently (as an emergency)

While I waited to be seen there were people there laughing, FaceTiming about the next days dinner and posting selfies. I obviously don't know why they were there so it may have been appropriate, but I suspect that if you're in a state where you can update social media then you probably don't need A&E.

I definitely think there should be a regular GP service in the evening and at weekends. Children always seem to be more unwell at night with fevers etc (well mine do) and sometimes you don’t know how long to wait before you get medical attention. The U.K. has had eight days of weekends and bank holidays in the last fortnight with no access to a gp.

I believe it is even worse than we see on TV. My cousin had a suspected stroke a few weeks back, luckily neighbours raised the alarm when her blinds were not open. She waited an age for an ambulance but was left in the corridor in a wheelchair for 30 hrs with a 59 hr wait for a doctor. Her dd kept a record, photos/videos of what actually was occurring that day. She also foolishly became involved in a row with a drunken family who were seen as a priority because of potential head injuries. I have seen pics and they are deeply disturbing.

I had a minor op this time last year and staff were great but fiercely critical of local GPs who do tell patients to go to A and E and simply wash their hands. The receptionists are only doing what they are told. Hospital staff felt GPs did not want to return to pre pandemic levels of service and had got used to working remotely. Make your own minds up. Whatever, it is worse than we realise. I can say my own DH was treated very poorly by own GP surgery which resulted in an investigation.

Agreed, in a medical field also, and you can’t do the most basic checks by phone ; I don’t think you can really blame GPs and 111 for referring in doubt, they have a responsibility to, it’s a lot to ask them to guess based on what someone panicked is describing on the phone

I have a few chronic conditions and one of them creates a pain that mimics a heart attack and it can go on for days ( I know it’s not a heart attack so I will stay at home for as long as I can in agony in case it eases off - sometimes it does so of it’s own accord but it’s very unpredictable)

I have a pain protocol put in place by my pain consultant a few years ago and have had to enact it probably 3/4 times a year. This means when it’s clear it’s not subsiding, I need acute care in the form of IV pain management plus an oxycodone injection - all of which helps me to cope until the pain drops to a level I can manage at home, where I remain on bed rest for however many days.

Now here’s the stickler - IV pain relief and the oxy injection can ONLY be done by A and E. I’ve rang the MIU places nearby and both have said nope, you must attend A and E as they aren’t equipped. Our local A and E is hell on Earth currently - as an ex NHS HCA I know well what that means…. I do not want to add to the problem so I sit at home in full flare and in agonising pain for days because that’s still better than waiting in A and E but sometimes I give in to the pain and get my treatment as prescribed.

I hate going over there, I hate being a burden BUT the last two times I’ve been in I’ve been on a hard chair or the floor for hours yet there’s been drunks laying on beds sleeping happily!!!! Makes me fucking rage!!! It shouldn’t be allowed. It’s not fair that I have a condition through no fault of my own - one that’s ruined my career, my mental health and my life - yet put off going for the treatment I need at A and E because I know what he’ll awaits me and the stress of seeing people there lounging around, snapping at the amazing staff and being generally cuntish and abusive to them when they’ve got too pissed or too high and can’t handle themselves…. Where’s the fucking personal responsibility here?!?

I have had to completely change my life to lessen the risk of serious flares, and my co diction has now led to several others being discovered last year. Yet I feel guilty as hell when I DO access the service and now I’m thinking, “why the hell should I feel bad when there’s utterly irresponsible arseholes out there who take ZERO responsibility for their own health?!”

And to be fair, that’s not just drunks and people on drugs - there’s a fair few out there who really should be taking their health seriously and don’t and then expect the NHS to pick up the pieces time and time again - it’s bloody wrong.

Sorry for the rant but I’m flaring at the moment - luckily a low level one with pain of 6/7 which is just above my daily level… but I worry it’ll escalate as it sometimes does and how the hell I going to access the medication I need and is onl6 available at one place which currently has 18 ambulances outside plus all the other people inside?! Scary, upsetting but also ridiculous that a GP or OOH Dr can’t give me an injection elsewhere!

Allowing pharmacists to prescribe would be a good start. For example with hormonal contraception I see no reason why pharmacists couldn't handle the weight and blood pressure checks needed twice a year. There is not real reason why it has to stay the preserve of doctors.

"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."

Yes. They won't (quite rightly I suppose) give advice outside their competence.

"For example with hormonal contraception I see no reason why pharmacists couldn't handle the weight and blood pressure checks needed twice a year."

If they have a separate room, yes. Some people wouldn't want to be weighed in public in front of all the other customers and answer personal questions.
Repeat prescriptions though, yes.

Stew - if you're going to rant at people who drink, will you also rant at people who do even more risky things, but that can also be healthy like skiing? We start on a slippery slope when we start to say that we won't treat people for anything that may be self-inflicted or partially self-inflicted.

Community midwives, too. I had stitches for a 2nd degree tear which became infected. The midwife directed me to the GP & thankfully they did see me, but unbeknownst to me prescribed a suboptimal antibiotic.

Reexamined a few days later & GP told me to go to A&E. I said I didn't think that was appropriate; several phonecalls & I was advised to go to the gynae department where I waited for several hours with my newborn before being prescribed a more appropriate antibiotic. Midwife was puzzled as to why that one wasn't prescribed in the first place.

Yes, at the end of the day they’re allowed to not wish to be sued, all of them, aside from medical responsibility and legal rights to deciding.
A lot of GPs are just hired by surgeries, they don’t really have a say. Some are dreadfully awful sure, but I’d guess half are stumbling along with what they’re being told

"Agreed, in a medical field also, and you can’t do the most basic checks by phone ; I don’t think you can really blame GPs and 111 for referring in doubt, they have a responsibility to, it’s a lot to ask them to guess based on what someone panicked is describing on the phone"

But then they should see the patient in person!
And of course there are loads of things that can't be diagnosed over the phone/online. You can't be examined physically for one thing.

Are they opting for phone calls out of convenience or by choice, I don’t know (ex: 111 they’re obliged to, GPs some surgeries are just dreadful yes

I went to A&E and was seen quickly by triage and immediately admitted. Couldn't fault the care. Later I found out that a friend also visited A&E for stomach pains. Had triage and scans/blood tests and then left to wait for 9 hours. She eventually went home and saw GP the next day.

From what she said it seems that A&E staff had determined from investigations it wasn't urgent but no consultant was available to formally review and feedback to her (because there were dealing with critical cases). She was upset by her treatment and the wait but I think they had determined she was ok by the tests they ran.

Her expectations were higher and because she doesn't use A&E often she felt she should have had better care. The fact A&E staff had run extensive tests quickly didn't seem to be appreciated.

We have lost basic medical knowledge in families and there is a sense of entitlement so people seem to over react to medical situations.

It depends on your area we used to have it but since covid it has been cut and not restarted. If you get given an ooh appointment its now a 100mile round trip to the city rather then being seen locally

@Gwenhwyfar yes of course - a lot of pharmacies do have private rooms as they already administer flu and Covid jabs.

Ironically since Covid my GP has basically handled my contraception check ups by getting me to do my own reading in a machine in reception and handing the resulting print out to the receptionist to pin on the the prescription request. I would have more privacy on Boots!