To think this is a fucking joke - A@E wait?

[CanNeverThinkOfAName]

So our local hospital serves 350,000 residents from a large area.

Arrived at A&E at 11pm. Expected it to be packed and to have a long wait. There were around 15 patients waiting. At 3am there were 4 still in the waiting area plus us.

From that time only one person has been called to see a doctor and at least 10 people have gone out after being seen.

Ambulance staff check patients in near where we are sitting and only 3 have checked in since we got here.

Obviously not a busy night.

AIBU to think this is totally piss take and the staff must be on a bloody go slow or something?

A few months ago I took GS to A&E and we waited hours. Under 18s were being seen first even if it didn't look serious and children who were being carried in unable to walk were skipping out very quickly. Then it was triage order and we weren't high on the list.

Eventually we were called. There was one nurse practitioner on duty, I assume there were others dealing with emergency admissions as they were using a different entrance. The nurse was dealing with all the kids and the higher priority triaged patients before she saw us. I couldn't believe it to be honest but that was the situation. I assume they are having trouble staffing all the shifts but that is where we are.

Hi @CanNeverThinkOfAName, I will assume that by the lack of your responses you're being seen to and wish your DD all the best.

I agree with PP that you are severely ill-informed.
I don't know which A&E you are in, but there are several around the country that have only 2 junior doctors working overnight (and now, there are some places that have only 1 actual doctor and another that is an allied role like a physician associate etc).

No matter what you think, you are not seeing all the paramedics "handing over". Some incases essentially don't have a handover when they come in - they are pre-alerted and the team prepare a space in anticipation of their arrival and soon as the patient comes in in an "arrest" or equally life-threatening situation all staff are essentially hands on deck, with the monitoring at the ready, medications etc.

Overnight there are often no middle grade or senior doctors (who want's to continue working nights at 50/60 etc? Many physically cant). So from about 2am-6am especially it was very likely that every "doctor" is just a couple years out of medical school.

After dealing with the "arrest", they will have other patients they have seen before you came in - who have no bed in the main hospital yet - so still in A&E and technically udner their care, they will have started them on medications, monitoring, blood tests, radiology imaging which they have to sporadically review what the bloods/imaging showed to alter management along the way if needed.

The first review of patient takes a long time, so not surprised 1/hour is being called through - this is actually a good speed. They are talking, assessing, writing, thinking, diagnosing and managing in this time. These are undifferentiated patients (i.e not like you do the same thing for each patient as they all have different problems). Everyone's brain functions slower at 3am. This doctor almost definitely has not slept well - the vast majority don't. Theyre under a lot of pressure.

The other patients that you don't see are often a lot sicker, some are dying/ already dead. A doctor needs to go and review them as needed and also certify death. The next second they may be seeing a newborn who isnt breathing. The system is broken. While your DD may be very unwell - she won't be the sickest. Doctors are leaving to go work elsewhere for better conditions, the few that remain have it tougher. It is constantly demoralising and this is a good "quiet" shift as you put it. Its basically on a spectrum from bad to terrible all the time.

There is also almost no training - when and how could a senior doctor stop and train properly? there are always endless patients to be seen in A&E around the clock. There just isnt the staffing and these doctors need to go home and sleep so they're back the next night. It's relentless. Nobody signed up thinking it would be like this (because it wasn't years ago when they decided to take this career path and started training).

I suggest you raise your issues with the local MP, thats the only way to influence change.

I've worked 35 years in the NHS, it's never been this bad and it's getting worse. All I know is that I (and my colleagues,) couldn't work any harder. I am totally burned out, after catching COVID in it's early days and having an MI, but it's home that suffers, not my work. My work is always the priority. Most nights, I get home and can't even speak, I just go to bed. I'm the one who gets accused of sending people home who in the relatives opinion aren't fit to go home, but if they stay the whole system clogs up and there isn't a bed for the next acutely unwell person who needs one. I got called a fucking bitch last week and I've recently been kicked by a patients son who didn't like the wheelchair that she had been given.
Last week my DS worked for an extra 5 hours after his shift finished as he couldn't leave patients unattended and no cover was available to take over from him. He gets paid £14 an hour as an RN. In ICU. He used to get £13.50 in a bar plus tips. No wonder others in his year group quit the NHS to do aesthetics on £150 per hour 😞.
I don't know what the answer is for the NHS but I do know the staff would probably be financially better off in any other European system.

Hopefully because the tories definitely won't improve things. The NHS definitely faired better under previous labour governments as did schools and our more vulnerable people

Is that true? I was 11/12 circa 2000/2001-ish when it seemed like every single day the news headlines was 24 hour+ waits in A&E, people stuck on trolleys in the corridors... I fully admit though that I was not of an age to pay much attention.

@penjil I know ! This was children's a&e as well.

My son has significant scars on his face which if he had been seen more promptly might have healed better. (Not life threatening but still not great)

This.
Sorry you have to wait OP but you have no idea what's going on in the rest of the department.

Staffing is fucking scary. I worked somewhere where the A&E had only 2 doctors overnight, both only a few years into being a doctor. No registrar or consultant on site. This a an A&E that took majors/heart attacks/Rta’s.

Well said. Then produce statistics that suggest the “NHS has more funding than ever before” and see how many sheep soak that up. It’s the depletion of all grass roots services for over ten years that are increasing the demands on our NHS.

This is the sort of attitude people have because the NHS is free at the point of care; so demanding and entitled. It is free at the point of care but it is funded the square root of fuck all per patient, so of course there are not a zillion staff at your beck and call as soon as you walk in. Please be aware that the vast majority of staff in the NHS worked fucking hard and many additional unpaid overtime hours just to try and keep it safe and have done for years. Doing this in a failing system is bad enough and stressful enough but when you get ungrateful members of the public treating you like shit it makes it even worse.

I hope your daughter OK now @CanNeverThinkOfAName Sorry you had to wait so long. That does seem quite a while - 4 to 5 hours and no-one has seen you yet, when there is only 15 people there. But as some posters have said, there are very likely not many staff on. Still, only 3 people seen in 4-5 hours is bizarre.

Sending good wishes! ❤

No it wasnt as bad. Im currently doing research on A&E wait times for my MSc,

2012-2013, 21,738,637 visited NHS England A&E departments, of those 152,584 breached the 4 hour waits after the decision to admit was made, 170 breached 12 hours.

2022-2023, 25,348,842 visited NHS England A&E departments, this excludes walk in clinics, just main hospital A&E's. 1,662,862 breached 4 hours, 410,092 were waiting over 12 hours after a DTA.

170 12 hour breaches to 410,092 in 10 years. I imagine these last years it was even higher but that data isnt public yet. This is from the NHS England website. I dont have the data for 2000/2001 however it has rapidly grown in the past 10 years, there was actually only a drop in 2020/21 because fewer people visited A&E. But i would confidently say that whilst there were perhaps occasional patients in corridors in those times, compared to now where corridors spaces are actually on computer systems as legitimate bed spaces up and down the country, it wasnt as bad back then.

I know that the default answer when people criticise NHS staff (also school staff) but there are lazy people in every workplaces, why would the public service be exempt? Or not even lazy but just people who are not giving it 100%.

I have seen hospital staff chatting for quite some time when there were people waiting - the same way I have witnessed it with supermarket staff, post office staff and my colleagues (corporate office).

The issue is that as much as we should be grateful to the individuals going above and beyond / working more than their hours, etc, globally we shouldn’t have to be grateful for a system we pay for!

(never ok to treat people like shit though!)

Thank you for actual statistics. It is mind blowing.

NHS is so rotten, it stinks.

A&E departments are a horror show of complacency, driven by lack of accountability rather than lack of funding. The same as seen on Maternity wards.

I still can't get a GP appointment at my shite GP surgery, even though a legislation was issued that appointments should be made available to those who request one. Today, tomorrow or next week, but it should be available. Instead, a doctor apparently will call me back at a random time of his/her choosing in 5(!) days time. 5 days for a phone call... Cunts. But then again why bother, when surgery is paid per patient on the books, not per patient seen.

European mixed-financing model is long overdue. I don't want to be a patient anymore, to be tortured "for free". I want to be a customer and have rights as a customer.

One of my kids is a nurse. They were told that visitors were disturbed to see them sitting at a desk drinking coffee, eating a sandwich and chatting and it had to stop forthwith. The response was we couldn't get off the ward for a break, we can't work 13 hours without a drink or food so we will be taking our breaks in future regardless.

Funnily enough the instruction was removed, they continued to go without breaks from the ward but were allowed to have food and drinks. How generous.

you are being very unreasonable. You have no idea what is happening in Resusc and Majors. They may have very unstable patients there already who are taking a lot of time and resource.

It may appear that way but sometimes these Drs and Nurses will get called away to other parts of the hospital.

I was a Radiographer and even I experinced this as a Patient in A&E at the hospital I worked at. No special treatment. Waited over 5 hours with suspected appendicitis
Short staffed 100% less people on nights. It is worse on holidays when they have "skeleton" staff.

Patients are often expected to go for hours - days in one case on this thread - without food or drinks.

It’s not shit. It’s actually a bloody good thing that we have in this country.

Everyone expects everything to be done immediately. Unfortunately, that’s not realistic in any stretch of the imagination. We cannot compare the NhS to any other healthcare system in the world, especially not the US 🇺🇸 where you don’t get treated if you don’t have money.

Patience is so important. Yes it’s changed in the last 40 years but that’s because with the aging and fatter population, more people are trying to use it.

As for the intestinal bleed - what sort of suspected bleed was it? Piles? U GI? Ulcerative colitis? Pretty sure the triage nurse knows their job.

At our local hospital they have 72 hours to discharge you from A and E. So when our elderly relative went in with a serious medical need, and there were no wards in the hospital to admit her too, she spent 72 hours in A and E in a corridor. So even though the waiting room might seem quiet, there will be lots going on in behind the scenes and in different areas. Or doctors will be deployed to serious things going on in the wider hospital.

There will never ever be such a thing as change if people don’t start having the conversation about the healthcare system like adults.

The NHS and its staff are immune to criticism, no matter how piss poor your care is. Throwing money at it doesn’t work, shouting at people who can’t get a GP appointment so end up more poorly and present at A&E doesn’t work.
It’s about time the UK actually accepted this

I hope she's now been treated OP. Irrespective of whether what's happened to you is understandable or not given the state if the health service it is terrifying and horrible to have to wait with a potentially seriously ill loved one.

Depends on the department, but yes children’s A&E is often staffed by general paediatricians, especially out of hours, who will also have responsibilities on the wards.