To be really worried about the poor, disabled and elderly this winter?

[Namechangenhsworried]

I’ve just got in after spending nearly 14 hours in urgent care at my local hospital. During this time they didn’t even have the capacity to X-ray me. In the end I had to leave and fortunately what is a suspected broken hand and infection (the injury resulted in broken skin which has got infected) is manageable and I will be able to pay to have private treatment tomorrow after work.

I know much of the NHS isn’t in a good place but was shocked by just how bad it was. I have spent two days trying to get a response from a dr at 111 , my GP is off sick and it’s virtually impossible to see the locum. The queue for urgent care was out of the door and down the street (took an hour just to wait to get registered). The centre was standing room only with people saying they had been waiting for over 12 hours. Most of the staff looked exhausted , were running between patients and many irritable (one was angrily shouting at someone who was clearly unwell but it looked as though they had just snapped under the pressure). Staff complained of staff shortages, a lot of the equipment didn’t seem to work and on top of that they were having to try out a new records system which just seemed to be causing more problems.

I felt so sorry for everyone. I know things have been bad before but this just seemed so much worse than I’ve seen it before. It was like people had just given up /staff and patients were broken. And to make matters worse we are not even at peak flu/covid etc time. I should be able to get help from elsewhere but what about those who can’t? It’s so scary.

in the circumstances it doesn’t feel right that this lame government should be allowed to carry on whilst it is causing so much harm. But even if there is a change in leadership.- what then? Can this still be improved? We need change/to intervene before even more people suffer. It’s disgraceful that so many senior managers, private companies , the pharmaceutical industry, recruitment agencies and IT companies are making huge profits out of the NHS whilst so many of our most vulnerable can’t even get a basic service. It’s so sad and I just don’t know if it can be turned around.

@Namechangenhsworried So now we're getting the full story.

"The queue for urgent care was out of the door and down the street " so you were aware of any delay from the onset and could have gone home and come back another time, but you chose not to?

When you walked into the department the display on the wall would tell you what the waiting time would be. At that point you could have left and gone back the next day, you chose to wait.

You were seen by a nurse and triaged. You were told you needed an x-ray and had to wait for that. You were told clearly how long the wait would be. At that point you could have asked if you could come back the next day, instead you chose to wait.

Your comment "During this time they didn’t even have the capacity to X-ray me" was uncalled for and maligning an overworked department. They had plenty of capacity but just could go at the speed you wanted.

A fracture of a bone in the hand alone isn't a medical emergency unless-

a) it's a crush injury and/or circulation is compromised
b) it's been pushed into a circular saw (or other industrial machinery) and a digit is severed and/or extensive bleeding is present
c) there is extreme deformity caused by the facture (usually caused by a heavy fall) in which case other injuries would be present.

Any of the above ^ would be classed as serious trauma and would have moved you to the front of the queue.

BTW I take strong exception to your comments about the X-ray department. Radiographers will always be working to full capacity, not sitting around drinking tea/doing their nails.
Bashing the government won't help either.

@Kendodd I feel like you and I have had this conversation before! Relatives and patients themselves need to be given the frank and honest truth, all too many time relatives and will guilt trip their loved one into cancelling or not having a DNACPR. Many patients themselves in their 80s and 90s still want resus, they have no clue and think it’s like causality. Families still want every treatment for their 90 year old relative and don’t understand things won’t work how they did when they were younger, repeated blood tests etc which I always question appropriateness before doing

the truth is things will change when the reality of a top heavy elderly population comes to fruition, I’m not there yet some way off in fact but i do count myself in that. Thankfully I’ve seen the realities every day

It is clear the OP was blaming the system, not the staff nor the department.

Patients shouldn’t be blamed for the system. There is no other mechanism to get an X-ray for an acute injury.

@Teder You talk as if the OP has no agency.

They were given information to make informed choices about waiting and they chose to wait.

It also isn't clear what time they actually attended the clinic/dept.

Fri & Sat nights are peak times. After 11.00.pm on a Friday/Saturday a casualty dept looks like the 7th Circle of Hell, so is best avoided if possible.

It’s not about “having agency”. It’s simply that services are pushed to the limit and a wait like that is ridiculous.
We should all be wanting better services, not blaming patients (or the workers).

Much of what you have said in your post is simply untrue. You clearly have some sort of agenda and problem. This is the last response I am going to post to you.

I was in pain and my hand was infected. As a diabetic I was advised to go and get it seen to , hopefully getting antibiotics to stop the spread of infection.

On arrival at Urgent Care there was no ‘display on the wall ‘ telling us how long the wait was. I had waited nearly 14 hours before being told that I needed to get an X-ray. In the X-ray department I was then told there was another 7 hour wait. As it was the early hours of the morning I then decided to leave and get treatment elsewhere. To suggest that I have in any way ‘maligned’ NHS staff is ridiculous. Where did I suggest that radiographers were ‘sitting around drinking tea/doing their nails’? My post was actually suggesting they were run off their feet and expressing sympathy.

You making things up simply undermines your argument. You clearly have a political agenda and I won’t be responding to you again.

Pigeonqueen, have you seen this?

https://www.england.nhs.uk/atlas_case_study/adrenal-insufficiency-improving-safety-and-experience-at-royal-bournemouth-and-christchurch-hospitals-nhs-foundation-trust/

It's aimed at getting better treatment on wards with Addisons. I appreciate it doesn't necessarily help with ED recognising & treating, let alone 999.

I spoke with my endocrine nurse, she spoke to the consultant & then with patient safety about my recent near miss with my meds. My hospital are now setting up something like that mentioned in the above link. Maybe your trust could implement something similar?

I'm sorry to derail.

@Namechangenhsworried
Whether or not you engage with me is entirely your choice.

However, if you feel strongly about your experience, may I suggest you put in a written complaint as follows;

If you are unhappy with an NHS service, it is worthwhile discussing your concerns early on with the service, as they may be able to sort the issue out quickly. Most problems can be dealt with at this stage but, in some cases, you may feel more comfortable speaking to someone not directly involved in your care.

How to complain;
When making a complaint, you can choose to complain to either of the following:
The healthcare provider
This is the organisation where you received the NHS service, for example your hospital, GP surgery or dental surgery.
The commissioner
This is the organisation that pays for the service or care you received. This will vary depending on the NHS service you are complaining about.

If your complaint is about:

• primary care services such as GPs, dentists, opticians or pharmacy services
• hospital care, mental health services, out of hours services, NHS 111 and community services such as district nursing
• Contact your local Integrated Care Board

@pumpkinpiesarefab you are missing the point. @Namechangenhsworried doesn’t want to complain about her “service”. She is clearly expressing a concern about the wider structural issues within the NHS. She is concerned about a very vulnerable group of people who may not be able to help themselves and may suffer unnecessarily. Some people don’t have a voice and those of us who do should be speaking up. We need to be looking much higher than individual complaints to our local hospital. In cases like this, they cannot do anything. The government need to take action because the NHS is not sustainable in its current format for neither patients nor staff.

@Teder I disagree that I am 'missing the point'.

Apart from the title, OP spends 3 paragraphs describing how awful her experience/treatment was then slips in one line in her last paragraph about 'vulnerable people'.
So not much concern there IMO.

Unless people report examples of what they feel to be poor care then administrators will be unaware of shortcomings.

Here are other agencies that monitor healthcare standards.

https://assets.publishing.service.gov.uk/media/5a7db846ed915d2ac884d241/About_Monitor___July_2014.pdf

https://www.cqc.org.uk/

Well she wasn’t blaming the staff nor the department for her care, was she? In fact, she commented that the staff were busy!

I agree people should always report poor care or significant concerns. These are structural and organisational issues though. The CQC will not investigate a hugely overstretched department. The government need to restructure the NHS and make it work for patients and staff. If anything @Namechangenhsworried would be best writing to her MP.

OP is entitled to complain online about her experience. Last year I had a terrible experience in A&E while waiting to be admitted to a ward d because they were so busy. I didn’t complain because the staff were doing their best. However, I did wonder how we had reached a point where a sick person was sitting on a hard chair for 14 hours. I was lucky I had my phone and my partner visited to bring me drinks
and snacks. I worried about people who didn’t have that. I did not want to formally complain that the department was overcrowded and they were understaffed, I didn’t receive a poor service due to a badly managed department. I wrote to my MP who ignored me but I tried. 🙄

@Teder "OP is entitled to complain online about her experience"

I agree. People can complain about whatever they want on-line (within reason).

However, that wasn't the thrust of the post.

The title was "AIBU To be really worried about the poor, disabled and elderly this winter?" Then the 'poor, disabled and elderly' didn't get a mention again until the 2nd to last sentence.

IMO that's just government-bashing dressed up as faux concern.

If OP is really concerned about the "poor, disabled and elderly this winter" maybe she could give a couple of hours a week helping a charity, a foodbank, organisations that provide 'warm spaces', give concerts at care/nursing homes, volunteer for hospital transport services, give up a hour or so on Christmas Day to help serve a meal to the homeless (or help wash up afterwards), support a Armed Forces & Veterans' Breakfast Club, support a disable persons' swimming club, fund-raising for local hospice, help with a toddler group etc etc.

There are lots of opportunities for those who are really concerned about the poor, disabled and elderly to do their bit.

@pumpkinpiesarefab
Yes of course, those of us who can should do our bit. Neither of us have any idea if the OP does or not volunteer or donate. Regardless, as a tax payer and a concerned member of society, I would expect government run services to be safe and effective. No amount of donating to a food bank will actually solve the crisis health and social care is experiencing. Yes, it’s nice if you can visit an older person as a befriender in a voluntary role. It’s no bloody good if they’re stuck in hospital because there’s a shortage of social care staff to help them have a wash. We need to be able to provide the basics.

@Teder "Regardless, as a tax payer and a concerned member of society, I would expect government run services to be safe and effective. "

That's not unreasonable on the face of it. However, Urgent Care/A & E both operate a 'walk-in service', so there is no way of knowing who will be arriving.

An A & E /UC Dept Manager will be sorting out the rosters the week before and deciding if they have enough staff to cover all specialities or whether locums are required. They will be juggling staff absences due to sickness/holidays/training/secondments/vacancies etc etc.

Don't forget the Depts have budgets to work to and extra expenditure such as locums (that are very expensive) have to be justified. So staff can't be stood around doing nothing, and there are also minimum treatment times to work to. So managers, who don't have the advantage of a crystal ball, are involved in an unenviable balancing act. They are squashed between senior management and staff/patients and trying to please everyone.
It's not job I would want.
,
At w/e's there is usually an influx of people who have been 'pubbing and clubbing' and got into fights, fallen over, etc so extra staff and extra security are needed.

I agree that Delayed Discharges are a continual headache for hospitals but that wasn't what OP was complaining about.
The nub of her complaint was that she had to wait too long. Any concerns about Care in the Community were conspicuous by their absence

Oh yes, lets, because all will be perfect, just as it has been under all other Labour administrations!

Oh my God, life was so much better in this country when Labour were in charge. Even after the global financial crisis Labour had managed to get the economy back growing again, if only that trajectory had continued and the Tories hadn't been voted in with their programme of austerity placing a massive drag on the economy. That's without even mentioning the wreaking of public services under the Tories.

OK, let's talk about this wonderful Labour Government(1997-2010, which, in 2003 under Tony Blair, took us into an illegal war with Iraq (based on non-existent Weapons of Mass Destruction) and cost UK £8.2 billion.

The human cost to Iraq was the deaths of 209,982 civilians.

Some people have short memories.

Back to the NHS

Also remember that Tony Blair wanted to sell off the NHS?
1997 Tony Blair (New Labour) dumped Labour’s tradition of support for public service and opts for privatisation and deregulation, funding 100 new NHS hospitals with PFIs. (Private Finance Initiatives) In total, approximately £12.7 billion was borrowed, with repayments reaching over £80 billion. Even when fully repaid, the public won’t own the hospitals! PFIs enable a covert bed closure program to shrink NHS capacity, and a future land grab. As the costs of paying off debts rise, NHS trusts will be forced to sell assets.

2000 New Labour’s NHS Plan introduces private provision of medical services into the NHS for the first time to ‘modernise’ and ‘reform’ its practices. Routine planned surgery, diagnostic tests and procedures are contracted out to private sector treatment centres at greater cost than the same care on the NHS.

In 2021 NHS Trusts spent close to 1/2 £billion in interest payments.

2004 New Labour brings in Payment by Results. Providers are paid a fixed price per unit of completed health care. This helps the private sector to cherry-pick the easiest, most profitable treatments.

2009 Gordon Brown (New Labour) brings in the Unsustainable Provider Regime, the framework for using the PFI hospital debt burden to close and sell off publicly-owned NHS land and property.

I wish the next government (Whoever they will be) joy in sorting this lot out.🙄

I went on the Iraq march. It is clearly irrelevant to a discussion about UK domestic policy.

In 2009, I could get a GP appointment. I could get a cancer referral. I would wait less than 4 hours in A&E.

I could get a passport. I could get a driving licence. Schools were being rebuilt. I could get a police officer to visit me if I was a victim of crime.

We only have to look outside to see howuch the Tories have wrecked things for all of us.

In that case A&E should have triaged and sent you elsewhere. They do at my A&E - you can't get in without telling them the problem first at the front door.

@MidnightOnceMore
Since 2009, the number of NHS FTE staff has increased by more than 25 per cent. However, this growth has not been evenly spread across the years or staff groups. Changes to the workforce are set against the backdrop of several events, each associated with different trends. The 2008 economic crash saw a reduction in health workers, as NHS staff make up a large proportion of the NHS budget. The NHS reorganisation around 2010/11 led to high staff turnover with pay freezes and fewer managers, and most recently Covid-19 saw a sharper rise in workforce in response to the demands of the pandemic.

"In 2009, I could get a GP appointment. I could get a cancer referral. I would wait less than 4 hours in A&E.

I could get a passport. I could get a driving licence. Schools were being rebuilt. I could get a police officer to visit me if I was a victim of crime."

I don't doubt that's ^ true.

However, we are comparing apples & pears here.

Between 1997 and 2010, net annual immigration quadrupled, and the UK population was boosted by more than 2.2 million immigrants, more than twice the population of Birmingham. In Labour’s last term in government, 2005-2010, net migration reached on average 247,000 a year.

UK population 2009 was 62.28 million.
UK population 2022 was 67.508 million.

So how do you think that Labour's 'open door' immigration policy and mismanagement of the NHS should be rectified, so the 'poor. disabled, and elderly' get a better deal?

When you walked into the department the display on the wall would tell you what the waiting time would be. At that point you could have left and gone back the next day, you chose to wait.

What is this display on the wall, that tells us the waiting time?

We have been regular visitors to A & E (6 different hospitals iirc) for the last 14 years and never seen one? Even if our local A & E had one, which it doesn’t; it wouldn’t help if patients are allocated to different streams, would it?

@Quisquam Locally, you can look at the hospital's website and one of the live indicators shows how long estimated wait time will be. It's not on the wall, it's on the internet so you should be able to check using your phone.

https://kingstonhospital.nhs.uk/live-waiting-times-now-available-in-the-emergency-department/

If not on the wall, info on the internet;

https://aeinfo.nhs.wales/

https://nhsquicker.co.uk/

https://www.uhcw.nhs.uk/patients-and-visitors/live-waiting-times/

https://www.macklinstreetsurgery.co.uk/practice_news/live-wait-times-for-ae-urgent-care/

https://www.bbc.co.uk/news/health-59549800

https://www.ncic.nhs.uk/services/accident-emergency

From the above (North Cumbria) site

"The time displayed in the waiting room is an estimate of the time it will take for you to be seen after your initial assessment. This can change quickly depending on the number of patients in the department and how unwell they are. We always see those who need us most, first. We'll do everything we can to keep you comfortable while you wait. "

@pumpkinpiesarefab

I don’t live in any of those places. Last time I looked for a NHS website to find the waiting times, it only covered the SW.

I can assure you there has never been a display on the wall with waiting times at our local A & E - we are usually there at least 8 hours, so we would have plenty of time to see it.

Anyway, like I said how does one display work for people in different streams? For instance, there may be one stream for people with minor injuries and other one, for people with the same injuries but there is a more complicated cause.

My local urgent treatment centre does x-rays between certain hours, even on Saturdays and Sundays (well, it did a couple of years ago, when I took my friend there when she'd fallen and twisted her ankle so badly they thought it might be broken).

It eases pressure on the x-ray units at the two hospitals in the trust area, and they can plaster straightforward fractures as well. It serves quite a big area, three towns each of 15-20k population and a large rural area.

It's really convenient, if the GP refers you for an x-ray, they give you the form and you can drop in there and have the x-ray done without an appointment or anything.