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.

@Orangesandlemons77 They don't.
They used to be viewed as a possible route to legal highs for drug seekers.

Definitely think people are using A&E for minor issues at the moment.

People often can't get an appointment with the doctor, so are sometimes then being directed to A&E.

My Ds was ill over Christmas and given medication for tonsillitis which didn't seem to be working. We spoke to 111 who said he needed to be seen and we should go to A&E if couldn't get an appointment.... we didn't go to A&E and did manage to sort things out ourselves.

I think 111 are covering themselves by directing people to A&E and people then think they need to go to A&E.

A senior paediatric nurse I know told me they normally see 50 children a day in A&E, but it was up to 150 due to panic over strep A. Many of the people she has seen in A&E haven't needed to be there.

I remember when there were minor injuries units and walk in centres though, which would have eased the pressure on A&E hugely, they should make a comeback - these were specifically for where neither a GP or A&E were appropriate (or you couldn't access a GP)

I have turned up on Boxing Day before as I knew my son needed antibiotics for a chest infection and it was the only way of getting them quickly. He wasn’t that I’ll but he might have been if we had waited for the goa to open.

I was in A and E last month, 11 hours for an infected gallbladder. Over that time I saw plenty of people give up and walk out which to me, indicated it was not an A and E scenerio.

A bloke walked in because he said he had been using a screwdriver that morning and now his thumb hurt.

There was a bloke who must have taken 15 fag breaks while there for a chest issue, he went in before me and half an hour later a member of staff was walking him back out explaining he had to see his GP, not them, and he was going bananas and stropped off.

Obviously, people are showing up because they cannot get GP appointments.

Secondly, more needs to be done at triage to make an fair assessment if its an A and E situation that can be treated by them. Sore thumbs need to be redirected.

Yes. I worked in A&E for over 10 years. We would get whole families turn up, flasks of tea, full picnic hampers more or less prepared for a weekend camp out in waiting room turn up at 5pm and not be seen until 7am the next morning and sent home with a box of co-codomol for the back pain they'd had for the last ten years, happy that they'd had a good night's entertainment seeing reception staff shouted and screamed at, nurses and doctors spat at, verbally, racially and sometimes physically abused, drunk man passed out in wheelchair piss himself four times, the bride to be on her hen in town crying and screaming to be seen immediately because she snapped her acrylic nails after falling off a table top dancing and needs to get back to her friends, the little old lady that came in after getting three busses with an arm like a black banana after falling 3 days ago and didn't want to bother anybody and they saved a whole £2.80 as they could have quite simply gone to chemist and bought them over the counter. Hey-ho though, owt for nowt as they say. 🤷‍♀️

How much does an NHS GP know?
Ive been with my practice for 12 years and in that time never seen the same doctor twice. There's nothing in my notes that I can't tell them in an appointment

I had the "pleasure" of sitting with dd for 3 hours in a&e last month. Half of those waiting were older adults (over 75 at least) with a younger person (age their child would be) with suspected knee, hip or other fractures or delirium. Several obviously had advanced dementia. Of the remaining 40 or so people, a large number were drunk with cuts etc, several handcuffed to police.

No children as they have a separate entrance.

Exactly, I've had to request that my notes are changed four times in the last two years because they keep putting things down wrong. At one point I was constantly contacted for an urgent asthma appointment (I don't have asthma) and to see the smoking cessation nurse (I don't smoke).

The last time I was in A&E was September 2021 when I fell off my bike and broke my shoulder in 3 places, which ended up needing pins and a plate put in. However, I was shocked to hear the other day that hospitals in Manchester (I think) were advising people to only attend in life and death situations, which I assume are heart attacks, strokes etc. A broken bone is not a life or death matter, but is clearly a significant injury requiring urgent medical attention. OK there's minor injuries but they'll get bogged down with injuries that aren't exactly minor!

I have a chronic health condition and nearly always see the same GP. My DH nearly always sees his preferred GP as well.
All the research shows that continuity of care leads to better health outcomes. And I certainly couldn't tell a GP what medication I was prescribed for a flare up and whnen.

I agree.
Just a small example.My husband has a nasty flare up of his gall bladder. Was in agony and being sick a lot. We drove down to a walk in centre that was packed.
He was sitting in the waiting room with a sick bowl just in case. There was a teenager sitting next to him. She had come in because her nail had split slightly vertically only a small amount, but she was refusing to cut it as it would spoil the look
Lots of eye rolling i'm afraid.
Eventually we were seen. The doctor phoned an ambulance and he was kept in for 2 days to get on top of the infection 6 months later he had his gall bladder out.

That sounds great. Never move house.

I think different people have different thresholds for A&E and perhaps once they’ve been once are more liable to go back? On the odd occasion I’ve been there with my children I have been surprised at the reasons others come in with and would not have thought of attending for that reason myself. Eg toddler bumped themselves to wanted to get them checked out when they are bouncing happily round the waiting room clearly fine! Or child with a fever - A & E administered calpol and waited to see if it went down - it did (Disclaimer: I realise this is only a casual onlookers view and I don’t know all the facts but that was my impression)

@User0610134057 I admit I am surprised what some parents will take their children to A and E with or even the GP.

Another part of the problem is that loads of things cannot be diagnosed outside of a hospital - I.e there are no radiography labs « in town » as we have in France, which your GP can refer you to if they suspect you might have broken something, but you’re overall OK.

A fair few moons ago, I hurt my foot playing rugby. I could kind of walk on my tip toes straight after, so thought I’d give it some time. It wasn’t much better a couple of weeks later, so I went to the GP who (correctly) suspected a metatarsal break. In the absence of any other options, he sent me to A&E yo get an X-ray with the advice to lie and say it had just happened… Cue much confusion as my X-rays showed a break that looked old, had started healing but had broken over and over again… I ended up telling them the truth and the GP’s advice, but it’s not great to have to lie to medical professionals! I came in walking, walked out on crutches, could have perfectly waited a couple of days for an X ray outside of A&E at that stage…

Really? Not where I live 🙄
It’s a 6 week wait for a GP appointment here, you’re told to phone 111 if you need something more urgently. 111 advise you to go to A&E so my guess is that’s what’s happening here. One GP automatically sends you to Ambulaatory Care to ‘be sure’, clogging up another service for little reason 90% of the time.
It’s a farcical situation here (West Country)

Can anyone explain why i dont just have ONE NHS file that my GP and hospital can see?
I am under a consultant at my local hospital for gallbladder removal and while visiting my mum was ill and taken to her local hospital where I stayed for three days and had scans etc. They were not able to see my notes, my current treatment plan, surgery date etc or my last scan to compare growths, and when I returned home my local hospital had no access to my notes from my hospitalisation. Do each trusts use different systems and cannot access each others?

Before Christmas my DS had tonsillitis, a temp of 40 and (due to his additional needs) we couldn’t get antibiotics or paracetamol into him. I called NHS24 for advice who’s response was to get him to A&E.

I took him to A&E and the children’s section was full of children with the same issue, running a fever, all been sent there by NHS24. The doctor who assessed him advised me not to call the NHS again, DS wasn’t at risk and the only time I need to take him down is if he becomes drowsy enough he can’t wake to alert, if he has a seizure or if his temp is continuously at 40 degrees for longer than a day. He was sat extremely poorly in a waiting room for 8+ hrs because of NHS24 when he didn’t need to be. If I’d known he was ok to stay home and be cared for at home I’d never have taken him and nor would any of the parents in the waiting room.

It’s not a case of people popping in to A&E because they feel like it as far as I’ve seen, it’s being told by a helpline full of untrained non medical personnel that you need to get to A&E or your child could die from a fever. I’ll never call them again!

@Seasonofthewitch83 This was all over the news at one point. The conservative government spent a fortune trying to create an IT system to do this and failed. So they decided to ask a private company to do this in return for access to our private data. So many people objected they had to drop the plan.

This, exactly. I took my ds to the city A&E just before covid for an injury that needed stitches, every seat was full, and many were sat happily chatting away with adult family members who were also taking up the seats around them as well as stood around in groups, many of them smiling and laughing! Some sat silently staring at the wall, but yes, lots also had other adults with them obviously from the same family. DS was crying when I carried him in and they all turned to stare silently...didn't care about that, but did think at the time, "wow, lot's of seemingly ok adults who are quite silent, this is so different from when I was in A&E many moons ago" myself - I remember people moaning, some crying, some on the floor in obvious agony, but it was so weird how....normal everyone seemed! It was really bizarre.

Years ago up my way there was west doc which was an out of hours doctor. Surgeries were able to cope with the demand. I stay in a wee village and we had a small surgery. 2 doctors each day, midwife and a nurse and some days it was but others it was fairly quiet. The surgery closes and now we have to go to the next town. If your elderly and can barely walk your fucked. This surgery is massive but awful. Trying to get a phone appointment is like blood from a stone. A&E is always busy when I've been there I've only been up when my daughter broke her leg, fingers tore ligaments in her foot, when she was really unwell, swallowed a 5p oh and got her earring stuck in her ear lobe (surprised they haven't called the social on me) one time she hurt her arm last year after being out n her friends bike and she couldn't move her arm bend it for hours even after ice so we went up. It was a long slog and even after she started being able to very very mildly bend it i told receptionist she was fine and we would go but they really insisted we stayed as they wanted to check via X-ray then had to wait longer as the X-ray showed damage but not broken xxx

That people are attending A&E when they don't need to is beyond doubt. The question we should instead be asking is why are they? Have we suddenly turned into a nation of snowflakes who get a cold and think they're dying of Ebola? Or has it been a gradual decline over the past 12 years or so, as a result of a succession of bad management and policy decisions? I give you:

• Brexit exacerbating pre-existing staffing problems;
• inability to attract staff due to appalling pay and conditions;
• Inability to attract and retain GPs;
• Inability to utilise better technology (AI and automation) to take pressure off GPs and other stretched areas;
• Closure of walk in centres and minor injury units;
• Ineffective, risk averse 111 service (lots of people get sent to A&E just to be on the safe side as 111 operatives terrified of making the wrong call)

Add to this a global pandemic delaying treatment for chronic conditions that subsequently turn acute, media coverage of Strep A and our failing immunity etc and it's a perfect storm.

There's a severe lack of out of hour services in our country so people end up in A&E. I'm asthmatic and last time I needed steroids for a chest infection it was a weekend and ended up having to sit in Urgent Care at the local hospital which was really just a section of A&E for about 5hrs when all i really needed was an out of hours doctors appointment but they don't seem to exist where I live anymore! Massive waste of A&E staff time and my time.

You've taken up time in a walk in and an ambulance that wasn't needed. You needed to drive straight to A&E. But like everyone else, neither of you are medically qualified to know that.

When people were asked not to go to A&E at the start of Covid, people died unnecessarily. People's conditions weren't picked up on etc. We can't rule make for the level of silliness or anxiety that some people operate at, we have to accept that there will always be people using the services who don't need to.