To think there should be another service for when GP surgery is full?

[CreatingHavoc]

Every time I need to see my gp for an urgent appointment and they can't fit me in, they always tell me to call 111 who always send me to A&E. I've spent 7 hours in A&E today when I probably didn't really need to be there because there's no intermediate assessment service, like a walk in centre, or similar. Is this the same for all areas or am I just unlucky in where I live?

Walk in centres.

I’m from Liverpool and we have about 10, they bridge the gap quite well. I’m a nurse and moved to a town to do my training. I was shocked to find they don’t exist here!! You feel the effects of it too. I remember my first ever patient in A&E was someone who couldn’t get through to his GP to prescribe codeine for back pain.

Where i live the main general hospital and a more local district hospital both have a walk in centre open 8 till 4.

We have a walk in centre in my city, the wait is usually as long, if not longer than A&E.

We have a walk in/ minor injuries unit. My GP can also make appointments with other practices for certain things.

We have urgent care, which is based at our local hospital and is walk in like A&E but for non emergency. I went there when I had really bad tonsillitis and needed antibiotics but couldn't get a gp appointment. Pharmacies are quite good for some ailments too. 111 has always failed us.

We have a walk in centre I'm the nearest city, it's closing at the end of this month's with no replacement. I have no idea what people are supposed to do for non emergencies but can't wait to see a GP

Also more community qualified professionals who can meet the needs of the elderly in their own homes to stop them coming in to hospital.

We have walk in centres here.

We have early intervention teams for the elderly, run by gp, nurses and therapists and a community pharmacist,

We have a central GP service which they refer people to if they need an appointment
You then get a telephone appointment fir triage then an in person appointment if necessary.

Pharmacists should be allowed to prescribe more

Don't have a walk in centre anywhere near me. It's either GP or A&E here.

Walk in / urgent care. The waits are looooong though. I burnt my foot at the weekend. Had private go call who said it needed to be dressed as full thickness burn. Called go to try and get nurse appt, next one in 3 weeks so went to urgent care. Got there at midday, left just after 7pm

We have a minor injuries unit in one hospital site and a Critical care unit based in the main hospital that is triaged through a&e along with an out of hours gp service we can access if you can’t get in at your own you can normally get in there. Feel quite lucky we have access to them if needs be.

Unfortunately there is a shortage of DR's. The walk in centre still need medical staff and often will be staffed by GP's. Unfortunately there are none free to staff such centres in an awful lot of places.

No walk in centred here but there is an out of hours GP service at the hospital - by appointment only and accessed via 111.

We have walk in centres, a nurse triages you first and if necessary you then get to see a GP or the nurse sorts you out and sends you on your way. You do have to wait but at least it isn’t taking time from genuine emergencies. I had an infection and couldn’t get a GP appointment so went there and was seen and given antibiotics. Without that service I could very well have ended up having to use A&E which is ridiculous for an infection. I’m genuinely surprised not everywhere has them.

We have a minor injuries unit, and the doctors that I go to has an e consult service

More money needs to be put into opening more GP surgeries and walk in centres.

The minor injuries and A&E’s are at breaking point because people who should be going to their GP can’t get an appointment.

Who's going to staff them? We've had two GP's retire last year along with two experienced ANP's, another GP going early in six months, a practice nurse next year and myself, another nurse in two.
Struggling to recruit.

Was the A&E department not plastered with images like the one attached OP?

Part of the problem with 111 is it being algorithm-driven & call-handlers having limited options. 111 up in Scotland works very differently - it’s set up as a Health Board (roughly the equivalent to a Trust in England & NI, yes) & seems to work better; perhaps because it was designed to include a demographic (Highlands & Islands) whose access to medical care is more limited. I don’t think NHS England’s planning takes rural England into account in the same way (apparently the Isles of Scilly have a 24/7 minor injuries unit at their 10-bed [yes, 10] hospital though).

Did you try requesting a clinician call you rather than you having to go to the ED? They have GPs on staff who I’ve had my care managed by when I’ve used them. Admittedly I’ve been directed to go to A&E on one of those occasions because, well, I needed treatment there; but I it meant I knew I wasn’t wasting people’s time on a strike weekend 😶 When I got Covid at the start of the month they did my referral to my local Covid Medicine Delivery Unit [to get antivirals] & after failing to persuade me I would like a home GP visit at would end up being around midnight; impressed upon me the need to call back on any deterioration & left me to sleep.

There is a kind of “overflow” GP service run from the OOH GP service’s space for daytime emergencies in my area - it books up incredibly fast though.

The 111 GP service can take quite a long time to do callbacks & sometimes they want you to go down to see them (they rarely go out to patients due to the time it takes); but often they can diagnose & if necessary prescribe over the phone, sending out a prescription to your local pharmacy.

Certain symptoms will trigger a flag whereby they have to advise you go to the ED. If you know they’re part of a chronic condition you can advise the call handler of that.

It’s hard to tell from your OP how often you’re ending up in the ED: weekly, monthly, twice this year? Everyone has a different threshold for what they consider a large amount iyswim? Obviously you ending up there if at all avoidable isn’t good for anyone though 😕

There's no staff

I just moved 2 hours away (by public transport) and my old walk-in is now my second nearest.

I think I’m so fortunate. I have an excellent GP surgery who almost always manage to fit me in if needed on the same day. If I need something out of hours, there’s a really good urgent care centre and I don’t think I’ve ever waited more than an hour.
My GP surgery is full of really good doctors who are thorough and caring and have gone above and beyond for me recently.
if everyone had the care I have received from gps and urgent care, I think a lot of people would be in much better health.

It's rare anything needs to be prescribed in urgent care, most are just wanting to be checked out with normal minor ailments. I ran an urgent clinic today at a gp surgery (I'm a paramedic), saw 22 patients only 1 needed a prescription. The majority are sore throat, cough, ear ache for anything from 4hr history of to 14 days... it's very very rare anyone needs treatment just giving self care advice and sending out the links to patient info website.

Then they need to put more money/time into recruiting new staff or better yet trying to retain current ones.

I couldn’t think of anything worse than working in the NHS so I don’t blame them but shortages in staff is going to cause more stress and more people leaving the profession, so it’s a vicious cycle.