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.

I totally get what you’re saying but trust me - from my previous career working in A and E and the overflow wards at the local hospital as a HCA and my own admissions, it’s rare that a sports related injury comes in. However, guaranteed every single day - and especially at the weekends - there are many many drunks and people on drugs.

There needs to be more support put in place for those with addiction issues - but those who break bones falling down stairs whilst pissed or whatever on a random night out shouldn’t automatically qualify for a bed. Last time I was in there was also a 75 year old man sat in a chair who’d had a stroke. He couldn’t Even sit in the chair properly, was on oxygen and was in a pretty bad way. No bed for him either but the pisshead 5 metres away? Snoring away happily until a nurse banged into their bed whilst doing something which woke them up and therefore meant the nurse got called a “stupid cunt” before he went back off to sleep. Was ejected an hour later.

I had an allergic reaction to my guinea pigs and this time it wasn't only my eye that was swollen it was the right side of my face. I rang the pharmacy and they were actually helpful and advised prescription level anti-hestimine , when they saw me I thought they may say go to A&E or ring GP. In the summer I visited my Mum in Shropshire and had a ear infection that was agony, worse than childbirth, I was in the phone waiting in line for hours, after all that nobody would see me as I was out of area. 12hrs waiting to be told they can't see me. Advice to go to the shockingly dismal hospital but there was no way so I used a private GP service, DH still had to drive me 45 minutes to see GP but all sorted in space of 2 hrs.

GP OOH exists and is a better system than it used to be. It used to be your regular Gp covering their own patients and then at work the next day. So no sleep and dangerous, now it’s shifts.
ive seen people ask for home visits as they’ve got other children or no transport, but no clinical need for a home visit. One home visit you could see 10 other people. I had a friend complain ab no home visit when she had a car and the child was well, just didn’t want to wake up her other child!!

Reading all the above the majority seem to feel that people are going to A+E because they can’t get a GP appointment.

But there are more GP appointments taking place than before too. So although demand for appointments is outstripping supply (you have to start saying no to note appointments at some point eg when you’re already seeing 60 patients a day and it’s just not safe) the problem isn’t that GPs are doing nothing, it’s that the demand for appointments is too great to be safely met. Whether that’s because of people seeing their GP when they don’t need to or because of a greater need is a different debate.

I do think most people have a far lower tolerance for any sort of risk than they used to - eg any infection must be seen because it could become sepsis etc.

When I mentioned the pharmacists couldn’t advise on certain conditions, I only started using pharmacies as we have been encouraged to go to them before a gp. Some of the conditions are on a big list on display in the gp surgery telling patients what pharmacists can treat. In reality they are not doctors so won’t diagnose, maybe just help patients manage existing conditions.

@Bunchamunchacarrots it's really shocking isn't it in 2023 Britain jumping through hoops especially for children who can't advocate for themselves. My friends abroad as soon as one has D&V temp they are put on a drip to restore everything with antibiotics determined by a quick test, in my case my poor son had to go through with this for a week. He has never had a huge appetite but to see him severely underweight, unable to walk and talk and barely open his eyes is soul crushing that you can't get help for him.

The pharmacist here are like "go to the GP, I can't say anything, um I don't know can't say" most likely due to liability issues but who do you turn to if your kid is kicking and screaming from an infected ear which requires a basic level of attention and no GP appointments and the only GP appointment available is like fighting for the hunger games in reverse, not the survival of the fittest but the patient that is at deaths door. I don't know but it is a shit show and I'm absolutely embarrassed of our healthcare system and what it has become.

I've never had to attend A&E for myself and up until this year had only had to go a couple of times for my DC (10 and 13). Unluckily, I've had to take both of them up there three times in the last few months (twice sent by GP, once for a fracture). I haven't seen anyone in there on these occasions over many hours of waiting with what seemed like "trivial" issues. Lots of kids with high fevers though which could presumably have been dealt with by GPs if people could have got an appointment. Also lots of very young children with respiratory issues. I also heard a couple of people talking who had been to the minor injuries clinic in the first instance but then sent to A&E after that.

The big issues seem to be around lack of access to primary care and lack of access to social care.

What your mum says is true. But GPs and nurses in surgeries used to come out of their surgery and treat minor injuries, including out of hours. Watch Doc Martin for how it used to be. Come now Doc an elderly lady has fallen over on the high street and gashed all her leg. Doc grabs a bag and rushes out to treat her.
Services have changed. My parents got the GP to visit me at home in the evening as a child when they were really worried about my illness. Now parents would take their child to A and E in the exact same circumstances.

I wanted a pharmacist to check a rash today on one of my DC but they were too busy so even that option isn't always viable.

I ended up in A&E twice in the space of a week because DS (10 months) was having breathing difficulties each time 111 sent me as we got refused GP appointments. The first time we were able to see the hospital GP service and were in and out quickly but the second time it was absolutely crazy. DS needed a xray second time which showed a serious lung infection. But unless you were counting his breathing rate he was still a smiley baby despite a high fever and fast respiratory level.

They were having to triage kids on the floor. There were a few parents who got annoyed that we "skipped a few hours" but reality was medically he was far sicker he just remains smiley!

I agree, this is my experience. If you have constipation or nits they can advise you what to buy. But they only really help with very basic ailments. Whenever I have asked for anything beyond this level they always say go to the GP.

I think the system also encourages it now. Very difficult to get a GP appointment so people phone 111. 111 has a flowchart that looks for key words and as soon as you say things like 'child' 'over 50' 'chest pains' etc the advice is invariably 'gonto A&E as they have to err on side of caution as are diagnosing remotely over the phone.

They need to fix access to GO surgeries and bring back walk in centres and minor injuries units that can see kids IMO to start taking pressure off A&E. Very few people want to hang around hospitals for hours but it's often the only way to get things that they know aren't emergencies sorted - antibiotics for an infection, x-rays to confirm a break etc.

Will they though? Surely they wouldn't make it through triage. I got sent to A&E by 111 and got sent home again by the triage nurse. Which was a relief to be honest as I didn't want to stay all night for something that was probably ok, but worrying at the same time in case things weren't ok.

I worked in the ED in the 80s,and 10 years ago. In the 80s, people came in with a single facial spot, one woman,by ambulance with a small cut on her thumb,it wasn't difficult to get a gp appointment in those days. You're correct now, I had worrying symptoms for 2 weeks,in terrible pain,rang my surgery who told me to ring 111, was put on hold 5 hours. I gave up. Had a nurse practitioner appointment,by phone which took a 5 week wait. Then emergency cancer pathway, found out by accident, after seeing consultant what the original problem was. DH taken to the ED in October, central chest pain, discharged "to the care of the GP", he had a phone appointment today, that was the first available appointment 7 weeks wait!

That doesn't make any sense though, more appointments - what kind, on the phone? The quality is not good enough and actually there was a government health committee back in 2015 demanding the GP crisis be looked at recommendations need to be back to 'personal lists' as research shows that GP /patient relationship significantly reduces emergency admissions. The home visits my DH'S uncle did definitely reduced admissions of his elderly patients. My neighbour was taken in ambulance to hospital a few weeks ago he is late 80s but couldn't be seen by GP, didn't have anyone advocating for him as he has no DC or nephews nieces, so he gave up, condition worsened and the next thing I see is an ambulance. How's that a working, effective GP system with mor appointments than ever. The accessibility and quality of appointments is shit. I don't know anyone that would visit the GP let along A&E unless necessary as absolute hell hole. Amongst my friends, peers we are all attracted to jobs now offering private health care or already in it not that solves dire A and E.

Does anyone know (I don’t, I’m just an international student who had to wait 1.5 hours for an ambulance for the highest category emergency transfer to ICU, unconscious, breathing stopped) :

Have ambulances always been so so long !! Or have they been reduced in amount ? I was in city center as well

Does anyone wonder if 111 staff would be more efficient dispatched to A&E or minor injuries hospitals (the ones that haven’t closed…) since there is rarely anything they can do without a physical check-up ? (Not a blame on them, just wondering about the system)

I am lucky I can get a same day GP appointment.

It used to be years ago you could not ring for an ambulance. Your GP had to ring for an ambulance. That would cut down ambulance use, although it would also lead to a lot more people dying.

I have been about 7 weeks ago. Terrible continuous back of head headaches with dizziness plus one leg went very very heavy and buzzing and chronic pins and needles. All out the blue and started about 3 months ago. Couldn't get a gp appointment for 3 days and general advise is to go to A&E . I hadn't seen a doctor for years and am 61 and overweight by about 3 stone. A&E were lovely , established quickly that my BP was off the scale and dr on duty (lovely older woman) checked my neuro responses thoroughly , calmed me down and assured me that stupidly high BP can indeed cause these kind of reactions , prescribed me beta blockers and statins (she had access to my recent blood tests) and explained too that these often cause pins and needles as well . I couldn't fault them. Told me to get a GP appointment asap, get bloods retested etc and advised me to pay for a neurologist if I could, if only to rule out certain things underlying.

I honestly don't think that's the case. Would people really sit around in A&E for 14 hours if they didn't need to?

Adult Ds phoned me to tell me he'd tripped badly and tried to break his fall with his hands, and for some reason his elbow now didn't work and hurt like hell. Described several things that meant I put a side bet on him having broken his elbow. He'd been hoping I was going to tell him that landing on his hands couln't do to much to his elbow.

He needed to carry on doing the (physical) job he was on. My advice was get a sling and work one armed carefully, and organise help to strip the stuff he was working on down later, then get dinner inside him and go to a&e a few hours later taking any computor work he could with him as it would be a long old wait. He wasn't face timing etc, but clearly wouldn't have looked like he was at deaths door, and was at times on SM.
A needed Xray showed he had indeed broken his elbow and badly, as well as displacing it and the shoulder, and needed treatment to start that evening before things swelled any further and made it all worse. Being able to update SM or not with the other hand, wasn't relevant.

If you need an urgent x-ray there isn't a choice here, it's a&e, and when we did still have separate minor injuries, they'd get annoyed by people who were clearly going to need an x-ray turning up there.

I think it's absolutely rediculous that GPs aren't open over the weekend. I think this would dramatically improve the people going to a&e who don't really need it.

In theory...

I spent a night in A&E last year and it must have been a popular night for playing football, as after a certain time there was a steady stream of young men coming in wearing football kit for about an hour.

The second time I was in A&E that didn't happen.

I think they were the two longest nights of my life though, and nothing ever seemed to change, just sat looking at the same people all night.

The arrival of American private firm run GP mega practices worries me. We have one near us and I hear only complaints about. Serious ones such as a friend with cancer symptoms repeatedly being refused a referral. Sees a different GP every single time, no continuity of care. She went to A and E in the end and had cancer that was thankfully quickly treated and is in remission.

My independent GP practice is the old fashioned kind and is brilliant. They advocate for patients and I can still get seen fairly easily.

But the American mega practices seem awful.

111 have to err on the side of precaution : they’re in awful position in my eyes : it’s either take the guess by phone or recommend A&E to be safe. And once people hear A&E they’ll just end up going naturally