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 don't know when it changed but I went to A&E alone, I can recall in 1996 as I'd had a termination 3 months before. I was only 17 at the time. I'd had agonising cramps for about 4 days, panicking and nothing had helped (not on period at the time) and no Google to refer to... Receptionist asked had pain started in last 48hrs? No around 4 days and was refused to be booked in. There were signs all over saying would not be seen if symptoms/injury started more than 48hrs before presenting that I had only noticed as I left.

I recently had the pleasure of sitting in an A&E for 6 hours. In that whole time only 1 person who shouldn’t have been there came in and swiftly got sent packing by the awesome triage nurse.

I don’t doubt people are driven to A&E due to lack of other services in particular there were a lot of people having acute mental health crises and A&E was definitely not the right place for them but there was nowhere else and they definitely needed medical help.

This ^.

Drs need to start working earlys/lates/weekend like everyone else.

i think it’s a combination of things

Not getting GP appointments
No GPs available at weekends
GPs refusing to see patients and sending straight to A&E
Lack of minor ailment clinics/walk in centres
Education/knowledge and confidence in trusting instincts- many years ago parents taught common sense and home remedies for treating illnesses. A lot of that is no longer done especially when you have children having children. I remember watching a documentary years ago where some young mothers didn’t even know the basics like cleaning a cut because no one ever taught them.

I have the choice of 2 hospitals, both equal distances away, both have primary care units linked to the A&E so once triaged some patients will be sent to the primary care unit while others wait in A&E. This helps clear the waiting area quickly. One has a dedicated children’s A&E too.

In no way shape or form do I want to get rid of the nhs but it’s interesting talking to US friends that they avoid the doctors and hospital if possible so their wait times are pretty good for most treatments. There has to be a middle ground with the nhs where it can still be accessed by all but people stop and think a bit more (if I had to pay for this would I still be going). I think the urgent care centres / walk in centres should be put back in place where they closed as this could take some if the strain.

At my hospital its a hub now, you have to see a nurse at a desk explain what the problem is and you get told where to go (A&E or walk in which is next door) works well and there's no one going to A&E that don't need to.

I think minor injuries clinics, especially for under 18s that operate 24/7 would alleviate a lot of pressure. I've only ever had to take my kids to A&E for those kinds of injuries that might be a break, might be a bad sparing but you need an X ray to be sure. All 3 visits involved hours long waits with v young children with limited facilities obviously. Not great for them at all and more importantly taking up drs and nurses time. but there are a million things that would improve the situation and just as many practical and financial reasons why it won't happen.

@Ginmonkeyagain I honestly thought that was yet another expression I'd never heard of!

It’s so easy to judge.

the last two times I was in A&E you would have thought me perfectly well. Once with an eye issue that needed a ct scan (having been through 111 and ooh). The other for a knee issue. 111 sent me then the triage at the hospital said I could go home without it being checked. I explained the situation & he reluctantly took a look… and (long story short) I needed to be admitted for iv antibiotics. Both situations were at weekends when gp closed.

People definitely do misuse a&e. I was there with DS on a Monday morning and couldn't help overhearing some of the triage/conversations of a grandmother and her grandchildren who came in after me. The grandchildren both had bad stomachs which were so bad that on Saturday they hadn't eaten at all but now they were a bit better and eating. The crux of the matter (which the grandson kept going on about very loudly) was that he felt he shouldn't be in school but his school had said he should be in.

Let's not forget the gift that keeps on giving: Brexit took 4,000 doctors out of the available pool with no contingency recruitment plan in place. Also, the majority of GPs are women, and the majority of those GPs on part time hours are women. The answer is not to have fewer GPs who are women, but to redress the balance of expectations and general attitudes around primary caring responsibilities for dependents. That's clearly not an overnight fix so this isn't going away any time soon.

I worked for a local authority who took part in a project in conjunction with
clinical commissioning groups in the area to provide a programme called the Better Care Fund which was set around a framework that was funded and supported by Local Government. The policy framework is intended for use by those responsible for delivering the Better Care Fund at a local level.

This programme supports local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.

It provided useful guidance on streamlining emergency patient flow to identify a large cohort of patients who can safely be treated on the same day, reducing admissions and reliance on hospital beds and improving the patient experience and reducing the need for people to attend A&E when it wasn't necessarily in their best interests to do so.

I used to minute take the meetings with this particular LA and they revolved around brainstorming sessions to come up with ingenious ways to reduce or prevent patient backlogs, identifying patients needs, working on ideas to support those needs without huge expense to the Local Authority.

It was fascinating and very eye opening.

I had to take my elderly Dad to A & E a couple of months ago, because the Minor I juries Unit was overwhelmed and they told us to go there. He clearly had a minor injury, but they couldn’t see any more patients that night. The most annoying part was that we called in advance and were initially told to go to the MIU..because the call centre isn’t in direct contact with the MIU apparently and had no idea they were at capacity.

I actually rang back and told them, they were grateful to be informed. 🤷

Our GP fucked up in spectacular fashion and if I'd listened to them and not taken DS to A&E he would have been dead within 24 hours.
With that in mind, I can't say I blame anyone at all for not being willing to take the chance that what might be a minor complaint might not just as easily be something catastrophic.

It's such a shame all this. My DD is now on day 5 of sickness and diarrhoea. Absolutely no idea where she got it from as we genuinely hadn't been anywhere since Xmas eve. She's up and down with it. Everyone's saying I would leave her 5 days with that. However in my head she is drinking very small fluids. If she wasnt drinking then I'd be worried it seems to be the minute any food hits her stomach she throws up. If it continues by end of the week I will call my doctor for advise. I'm just thinking if people who are actually needing appointments and seen by the doctors and nurses xxx

And their computer systems seem to be pretty rubbish too.

I ended taking my 90 YO MIL to A&E as she had severe abdominal pain and diarrhoea pouring out of her like water, so was severely dehydrated. We waited hours whilst numerous tests were run - no problem with that - but nothing specific was diagnosed and she was put on a drip to rehydrate her and sent home with a few sachets of Dioralyte. 48 hours later, exactly the same issue, so back we go. Luckily, I grabbed her (computer produced) notes from the previous visit as they had absolutely no record of her previous visit and were about to waste time and money running through exactly the same tests!

Tbh, having had seen how the system worked with my elderly DM and MIL and the fact they were kept in hospital pointlessly and for far too long because there wasn’t the social care back up, that’s where the money should be directed. Hospitals should be for acute care, not holding pens for either the elderly or those who could recover at home with appropriate follow up visits by what used to be known as a district nurse.

I had to go last year as I couldn’t piss after an op. The place was packed but I did get seen almost immediately. During my short wait I overheard one man saying he’d been there 8 hours waiting for a blood test, & that there was a child whose mom had taken him in to have a splinter out of his finger.

@Yousee that has triggered a memory for me. A couple of years ago, dh was dismissed as having IBS by his GP (despite never having experienced symptoms before). It was back in the day when we had walk in centres. His symptoms became so bad he went there for a second opinion where they promptly told me to rush him to hospital with an obstructed bowel. He was then admitted to hospital for nearly a week with pancreatitis.

Exactly.

I can't think if it's this thread or another where I posted NHS data about A&E attendance and the data shows that in some areas > 1 in 4 attendees to A&E are admitted to hospital and that was before the current surge.

We could do with less emphasis on those other people are describing as 'time wasters' and more on the fact that this admission rate reveals a substantial level of unmet need (amongst other things).

I think a lot of people forget about their local pharmacist. I think it would help if pharmacists in this country were able to advise and sell certain things that are only available on prescription (like in France).

It's full of alcoholics too (including those who don't recognise they are alcohol dependent). And those that society fails (homeless).

What would you do if you can't afford private GP?
My son is sick since 28th December. No appointments available at GP.
28th was a bad cold
3rd January + UTI +foreskin infection
I went to GP yesterday, was waiting 1hr before opening (the only way to get an appointment) - they said my son can wait, no appointments available.
Called 111 - they said come back to GP

Yes, I went to A&E.

Like in Scotland (there are conditions).

I always try this route if it might be a sensible solution (because the GPs at our surgery is the best guarded peoplein the country apparently, and there is no chance of getting anywhere near one of them). Most of the time they say to see a GP. On one occassion they could help tell me what the issue was, but I needed to see the GP to get a prescription for the medication I required, so it was pretty pointless.

We have a service in my area where you can see a doctor privately for £10 and they can give out prescriptions too.

You can also see a PIP at a pharmacy www.pharmacyregulation.org/education/pharmacist-independent-prescriber