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.

My GP surgery is on “emergencies only”. No routine appointments available. My GP actually wants to see me - there was a note in my last repeat prescription asking me to make an appointment. I presume it’s about my thyroid condition. But I can’t get an appointment. I’m going away in a couple of weeks and will be away for four weeks - so at this rate I won’t get to see him until the spring.

Yeah, I'm getting a bit frustrated with the, "make an appointment to see me in xx days". Are these the same GPS who come on to say that everything is running fine in their practice? Our gps say that and they must wonder why no-one bothers when in fact, you can't book ahead, to get an appointment at all you have to phone the very minute the phone lines open that day and even then, the chances that you can make an appointment with that specific doctor is running to lottery odds.

There are data, there may not always be the analyses that people would like to see or would find relevant to their own questions.

This makes sense and it indicates that there is a high level of need for many of the attendees. (NB: the dates.)

From 2011-12 to 2019-20, the percentage of A&E attendances who are admitted to hospital rose steadily from 17.1% to 19.3%. This percentage increased to 23.8% for 2020-21. [ https://digital.nhs.uk/news/2021/new-figures-released-for-ae-attendances-in-2020-21 ]

You can get up to date data here (NB: a lot of Excel).

www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/

I know this is probably meant to avoid time wasters, but it's ust another block to accessing medical care. I do worry that things like this will have some very serious repercussions down the line.

Sorry English isn’t my first language and it’s only been a year UK (but have had all the extensive lovely medical experiences throughout) so I’m not sure I’ve understood : I meant that most people will try first 111 ooh first, but 111 by phone can’t really do much most of the time (except if very obviously no risk), so lots of people get recommended A&E.

That's ok, I understood, I was just explaining that locally you can't just turn up at A&E you have to phone, there's no other option as they won't let you in if you haven't.

I barely set foot in a hospital between being born and having my own kids. Lots of medics in the family - everything up to stitching handled at home (and yes, those were different times).

I'm starting to wonder if we are going to be one of the families just turning up next week. My 3 year old son has nail bed infections. We've tried everything to avoid the NHS - seen a pharmacist and HV, 4x daily salt baths, bandages and air exposure...

They are getting worse and our doctor's surgery are now not answering the phone at any time of day. They have become completely non-responsive. The advice of everyone we have tried is that our son needs to be checked over before things escalate further.

We're reaching that balance point between feeling responsible if we do and responsible if we don't - which I imagine is 90% of people trying to get help.

I’ve taken DD to local minor injuries twice, straight after school, and both times (after waiting there more than 1hr) the nurse said I ought to take DD to A&E for an x-ray. Don’t you have an x-ray machine here I asked? “Yes but the x-ray operator goes home at 3pm.” I said that I really don’t think it’s broken, I think we just need antibiotics, can’t I come back here at 8am for the x-ray? “You could do but you really really ought to go to A&E right now.” Nurse then glared at me as if am terrible mother

-> Go to A&E -> keep child up past bedtime to wait 6 hrs with all the covid scarlet fever and drunk people -> be told by grumpy staff is not broken and all we need is antibiotics, just like I told the first nurse.

There is a problem with other parts of the NHS funnelling everyone to A&E. Similarly if you google a problem, the advice will often be go to A&e when what is really needed is a quick phone call with a GP.

Directing sick people to pharmacists is not the answer, my pharmacist is an idiot and all of his advice has been wrong. He just sells me expensive meds that don’t work and doesn’t give basic medical advice which luckily I eventually find on google.

What is needed is quick online access to GP. This already exists for private patients and the NHS should roll it out to the public instead of clogging A&E.

I contacted my local Minor Injuries Unit after an accident a few weeks ago which needed medical attention - I phoned them first as it was around 5.30 pm and I wasn't sure when they closed. Although they were open till 8.30, they told me not to bother to turn up because they were already beyond capacity, so I was left with no choice but to go to A&E, which was absolutely heaving. There I was eventually diverted after triage to their Urgent Treatment unit, which I think is meant to be a sort of fast track for minor injuries but that too was really full and was being manned by one solitary doctor and nurse who were having to do all their own admin etc, and I eventually left at about 11.30 pm. Given the circumstances, I thought that really wasn't too bad.

My overwhelming thought was that no-one would seriously be there unless they needed to be. At times it was difficult even to get a seat, it's just not something you would put yourself through if there was any alternative.

Last month we couldn't get seen by our GP, or by the online NHS GP service, or by the private GP service we have access to, or get through to a doctor on 111 for our child with a 41C temperature and suspected strep A infection. After 36 hours waiting for a doctor from 111 to call back, my DH decided to take him to A&E where, after a five-hour wait, he was given antibiotics. We didn't want to take him to A&E but there was no other care available and he was very ill. 111 finally called back while DH and our child were in with the A&E doctor but it still wasn't a doctor, it was a 111 call operator saying that there still wasn't a doctor available.

People don’t want to be sick. That’s the impression I get from booking in patients. Colds, coughs etc that they have had for a day needs antibiotics now. Some come in and have done nothing at home. No paracetamol, no rest and are simply annoyed that they are unwell and want a quick fix. A few hours of vomiting that is ‘the worst ever’

To an extent this is true. Parents don’t have time for their children to be ill, they want them to be fixed so they bring them to a&e, sometimes without having given them any calpol. Everything has to happen now, these days.

Places like social media and mn don’t help. How many times have you seen ‘a&e now’ for a child with a temperature, or because they’ve had two doses of antibiotics and they haven’t improved ‘you need to take them back!’ Or telling people to ‘demand antibiotics’. None of that is helpful.

A short while ago I woke up with horrific nerve pain in my leg. When I tried to put weight on it , it just wobbled and collapsed. I did everything you are meant to, rang 111 who made me an app at the local minor illness and injuries unit( it was a sunday morning) when i got there the place was completely empty, just me. A nurse came out and said they could make me an app with a doctor at 530, it was 830 in the morning at this point. I stated I was in agony, couldnt walk and wanted to stay. I got a mouthful about how I was wasting everyones time but whatever !

Doctor saw me 5 mins later, diagnosed severe sciatica, gave me strong painkillers and sent me home within 5 mins. Horrible nurse saw me sitting with doctor, and shouted through " I told her to go home !" Doctor went and gave her a stern telling off and apologised to me.

My point is, when GPs wont give you an app, and walk ins/111/minor illness units wont treat you, what else are you supposed to do?

@JennyForeigner do a £50 private online consult with a private GP, get antibiotic prescription then pickup from local pharmacy. At A&E you’ll be in a 6-7 hr queue surrounded by contagious people and wishing you’d paid the £50.

If you can’t afford the private consultation, call 111 and ask them to get you a GP appointment - they have the power to order your GP to see you.

Or walkin to your GP and make an appointment in person if they don’t answer phone.

A lot of people we get through the doors are people directed there by their GP surgery when they've been unable to see a GP the same day. The number of young healthy people we've had in recently with the flu is astounding - they should be tucked up in bed with paracetamol, not coming into hospital, and they're often told as much when they're eventually seen.

There are always ridiculous people in though. In the last week we've had a patient come in because they were struggling to sleep, and another who was in because they hadn't yet opened their bowels that day.

I think it’s a perfect storm of media frenzy and lack of alternatives.

Where I live (as most places) it is incredibly difficult to talk to a GP, let alone book an appointment. Many minor injuries units are no longer open and so people are turning to 111 and A and E. I think it must be a very frightening time, especially for first time parents, as the media are constantly reporting on the next thing that will get your child and with so many of these things having generic symptoms, they are scared and don’t know what to do.

The lack of proper/logical services is forcing people’s hands. For example, last year when I was pregnant I developed a urine infection. They gave me the appropriate course of antibiotics for a pregnant woman and said it may not clear up in one dose and to call back if it didn’t. It didn’t, so I called back and took another urine sample in. The receptionist said a doctor would call that day. I cleared it with my head teacher to have my phone on the desk to answer but they didn’t call when I was at work. I had my
hands free connected so I could answer in the car, they didn’t call when I was driving. Of course, they called in the 60 seconds of the day when I was getting my toddler out of the car and I missed getting to my
phone by seconds. My surgery do not phone back, if you miss your call that’s it. I called the surgery straight back and they said I would have to call back in the morning to get my name of the list again. I explained that I can only call up until 8.30 when I start teaching and in the past two years when I’ve called, I’ve never got connected before 10.30 after being on hold from 8am. They said that was my problem and I’ve have to ask for cover for my classes (this was the weeks leading up to the GCSES) to sit on the phone to try and get though. I didn’t do that as that’s outrageous but I kept trying to get through at various points (before work, break, lunch) but could realistically only stay on the phone long enough after 3pm which was too late. I called my midwife and she said the doctor needed to issue antibiotics. Fair enough. After three days of crying on the phone each time and explaining that I needed the toilet about 3 times per lesson which was less than ideal, the receptionist told me to set an alarm for 1am as that is when the online appointments are released and there would be none left by 7am. So that’s what I did and I managed to get an appointment for 3 days later. I checked at 6am when my alarm went off and all the appointments had gone! . So I spent several days in agony and wasted a face to face appointment just to get a doctor to represcribe antibiotics for an ongoing issue that they had the urine results for! I apologised to the doc for wasting an appointment…she just looked defeated and said I only needed a phone appointment but she bet I couldn’t get one…so clearly not a one off. A short while later I was hospitalised by my midwife for off the scale high blood pressure and I often wonder how much that added to it! Anyway…that’s a long story just to say, I was essentially forced to book a face to face appointment that I didn’t need that then takes that appointment from someone else who might then feel that A and E is their only option.

Once they sort basic issues in GP surgeries out, the pressure will ease elsewhere!

I’m sorry that happened, the nurse sounds totally ignorant. I’ve had a 3rd degree tear in childbirth with no painkillers, and I’ve also had sciatica, and I’d rather go through labour with vaginal tears for an entire week with no painrelief than have sciatica again. I hope you’re ok now.

Thanks, this is really helpful. For some reason I thought they didn't see kids and our son is three. Very happy to pay to avoid the NHS right now - I was thinking this morning about how we have moved everything we used to get such as contraception and a standing prescription for my husband to private providers to try and do our bit.

I do think pharmacist would be used more if there was an automatic private Place to see them not have to ask for a private word. That's what puts me off using a pharmacist for advice

I miraculously avoided a trip to A&E recently with horrific UTI. By sheer good luck I managed to get a GP cancellation and got the antibiotics I needed. Things would have got a whole lot worse had I not seen dr and started the ABs when I did. I would have had no other option but to go to A&E for something that was so easily sorted by ten mins with GP.

Most do, you just have to ask.

I am always baffled by the advice to go to a pharmacy. I have tried this lots of times but the only response is ‘see your gp ’ or ‘we are not insured on advise on that ‘ .

Much of the country can only see a private GP online. I do not see how online a GP could diagnose say a chest infection and prescribe antibiotics. Indeed someone on this thread posted about seeing a private GP online and being sent to A and E to see someone face to face.

Private GPs are fine for the worried well. People seeking reassurance.
But patients do better medically if they see the same long term. All the research shows that. GPs should never be an emergency service.

Thanks, you too. They stick me in SAU which is kind of like an extension of A&E.Surgical assessment unit. It's really busy and hectic.

Out of interest do you have any kind of letter to take in to A&E if you need to attend urgently? I think this could be helpful.

How do these private GPs know your medical history?

I was in A&E five and a half hours last Friday after being knocked down. Triaged in five minutes, three and a quarter hours' wait for x-ray (after which they took me seriously at last) then manipulation, plaster, x-ray, a man from 'therapy' telling me I wouldn't be able to manage at home alone (so what do you expect me to do? It's manage or don't) and I'm out.

GPs and walk-ins dismissed my dd for years when she had an achalasia that was trying to kill her.

Medics seem to be trained to disbelieve.