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?

You’re no more there than anyone else is so you’ve no idea why no one is being seen, no matter where you’ve worked. The only one there this evening is OP.

And the productivity stats just don’t stack up.

A colleague fell and cracked her head open last week while at work (bad fall, lots of blood from her head).

An ambulance was called but they said the wait would be 6+ hours so our boss took her to A&E.

She wasn't seen for 4 hours, actively bleeding, then she was stitched up, needed scans and told she had possible concussion.

No beds were available so she was put on a seat in the ward for TWO DAYS. She wasn't given anything to eat or drink, we took it in turns to visit and take food and drink to her. She was in such a state from lack of sleep, concussion etc. Eventually admitted, scanned, and discharged after a third night.

The NHS isn't breaking, it's broken.

My husband had a stroke during Christmas holiday period and got to A&E at about 7am.

Within an hour or so he had been seen by both the A&E doctor, and the on call stroke registrar, had had brain CT and was thrombolysed, the stroke registrar had also consulted two stroke consultants via phone. He was then moved from admissions ward to acute stroke ward within 3 hours.

I was bloody impressed, this is exactly how it should work in a high priority emergency. I had been nervous re: staffing since it was in the period between Christmas & New Year.

I had to go to minor injuries last weekend with a allergic reaction and my face was swelling. I went straight through as high risk and was in an ambulance to the nearest A&E within the hour. Took about 3 hours to see a doctor but I was put in front of the nurses station so they could see if I developed breathing problems.

My mum collapsed on a train in London a few weeks ago banging her head. Someone called for a paramedic but they never came. She got another train, collapsed again. Got home, went to minor injuries, was referred to A&E and was there for 36 hours before she saw a doctor. Really is a postcode lottery.

The IFS? I know they claim to be apolitical, but you shouldn’t need it spelling it for you that they have an enormous [socio-]political bias.

The IFS is decontextualising statistics to make it look as if the NHS is suddenly hugely overstaffed & thus wildly inefficient. Remember Brexit? And its epic embuggerment of the NHS from all angles including workforce (specific data on doctors available here)? That big jump between 2019 & 2023 is completely artificial 🤦‍♀️ Huge numbers of EU/EFTA staff had left; the NHS basically went on shopping spree in the rest of the world. And while the rest of the world has lots of excellent & incredibly dedicated nurses; in addition to the ethical issues involved; many of those nurses (& indeed other clinical staff, in particular) have to [re]learn a lot on arrival in the UK.

An increased number of Consultants is simply partly because time is linear. The increase in Junior Doctors is linked to the increase in medical school places - & again, time being linear. (While those on the 5 year courses won’t have made it into the stats, obviously, those doing a 4-year postgrad will).

While A&E is [relatively] well-staffed overnight there will be difficulty in obtaining input from specialists, which delays care. Patients being treated in resus require a large team, with at least one doctor, which can mean a significant proportion of A&E staff being focused on one patient.

It can be very frightening to have to wait a long time in A&E - & horrendous when you’re in pain. But of course staff aren’t lolling about & taking their sweet time with things. Bloods have to go to the path lab once taken; there are fewer staff in radiology overnight do & read scans; as mentioned above night cover for various specialties is either minimal or non-existent. Then to make space to see new patients they need to be able to admit or discharge; & doing the former is much harder overnight too.

I hope your DD is seen soon OP & that she’s well again soon too.

How on earth would you know what the doctors are doing? There are many areas of A&E like majors, resus and minors you would not have access to, unless you can see through secure doors. They may be tied up with really sick people and so that's why you're waiting.

Overnight staffing in many a&e departments is abysmal.

I have unfortunately had to take my baby to A&E a few times in the past two years (recurring breathing issues) and have to say experienced the same every time. I.e. very few people in the waiting room, and yet huge waits. There are doctors/nurses sat at desks, and some occasionally walking in and out, but patients are called so slowly.

It's like the default position is a minimum 4 hour wait (perhaps to discourage people going to a&e for minor things?) And it's so normalised they don't try to see the patients quicker even when there's capacity.

I accept I will get slated for this observation though.

OP I hope your daughter is getting the care she needs and recovers asap

You don't know what's going on behind the scenes, how many seriously unwell patients are there that actually need 1"1 care or needing a small team of staff looking after them.

You really don't know if all the paramedics are checking patients in at reception. I can guarantee that most the staff on nightshift will probably end up missing their breaks.

For example at my local hospital they handover to a nurse, who can then either complete the checking in on a computer themselves or send the paramedic round to do it at reception. So YOU may have only seen a few checking in but they may have more coming in that you don't know about.

Long waits are frustrating but unfortunately hospitals having large populations that they can't deal with combined with the amount of people that choose to go to A&E with sore throats/ earache etc

There's stuff going on behind the scenes, doctors reviewing test results, medical history etc. We get meal deals and newspapers when we go. The not being able to start a thread if it was serious, is ridiculous. My DP has had heart attacks, pneumonia etc since August and I sit playing on my phone. We all react differently. The corridor beds and people being treated in chairs shouldn't be happening and it isn't down to staff. This is tragic.
https://www.google.com/amp/s/news.sky.com/story/amp/investigation-launched-after-mum-found-under-coat-in-nottingham-a-e-dies-13068017

"combined with the amount of people that choose to go to A&E with sore throats/ earache etc"

They either get discharged at triage or bloods are done for infection markers while they wait in the waiting room. I've been through A&E a lot (I tend to be the carer in the family) and the waits aren't because of misuse.

Recent visit to an and e - I avoided the big local hospital with the normal 12 hour wait and went to an urgent care. Waited 2.5 hours so was thankful - however witnessed Drs seeing a patient and then not calling another one for half an hour. They are likely agency Drs too so paid £££££. You cant question this. I was advised to contact my GP or go to an and e after doing an econsult. Called the gp practice - she said “oh that’s a mistake - the algorithm is wrong and if just just do it again” - they couldn’t offer me an appintment and I would have been triaged. I suggested if there algorithm is wrong they fix it!!!
Sadly this is the way it is. GPS are no longer under pressure. Is this right or not!! Now pressure +++ at A and E.

Was at a kids sporting event yesterday with mine. It’s a contact sport. One child (not mine) suffered what was clearly potentially a severe head injury (we all saw them fall and their head hit the ground with large force) and they had some very obvious & worrying symptoms…. I expected an air ambulance to be sent it was that concerning…..they were however told it was a two hour wait for a normal ambulance or get there yourself. As someone said upthread, it’s not breaking - it’s already broken. And frankly terrifying.

Yes OP there's a tonne of doctors and nurses sat doing fuck all in the staff room or chatting around desks about their weekend whilst people face astronomical waits 🙄

The waits are totally indefensible. It is hardly emergency medicine if someone with potential internal bleeding is left waiting for 7 hours, during which time they are possibly deteriorating. We have already had one person die waiting in A&E; I suspect the first of many.

The problem is that we are in a vicious circle. Even with excellent people, the care is appalling due to lack of staff. The excellent people hate being involved in this and leave to other countries or the private sector, leaving those who have kind of given up their passion for medicine and care, and are just going through the motions.

No easy way out, but we must admit where we are and that we need to replace the NHS with something fit for purpose. Even the brand is toxic now.

OP, keep an eye on your daughter and keep kicking up a fuss. Those who get the best out of the NHS are those who relentlessly advocate for themselves and their loved ones.

Most urgent care settings have one doctor only. This doctor will be seeing patients but also liaising with the nurses who have seen patients who need a prescription, referral or who they need to be escalated up to the doctor. The people you see called in aren't the total sum of their work.

@TouseMrap they were probably having a well deserved lunch break on a potential 12hr shift. That’s what staff rooms are for is it not??

I was being sarcastic, I know there are plenty of ignorant and ridiculous posters on this site but if you thought that was a serious post even with the eye rolling emoji then that's dire.

The waiting room for A&E that you can walk through the front door too is such a small part of A&E. the really sick people don't go through there. Majors, resus and trauma are all elsewhere with different entrances.

OP, do you REALLY think staff are arsing about doing nothing enjoying keeping you waiting? Or do think quite likely they are busy doing something you can't see?

No, you’re not understanding what people are saying. If ambulance crew go straight to rhesus, they do NOT then go check in the patients at reception, it’s done with staff in other areas. It depends on the reason they’re brought in as to whether they’re checked in with reception or direct with nursing staff. There’s all kinds of things being dealt with behind the scenes that you’re not aware of, there certainly aren’t doctors/nurses sitting in their arses or in a “go slow”. How derogatory of you to suggest that.

We have this in our hospital where people complain because they’ve only seen three (or whatever) ambulances come in. It’s not true, the ones you see from the A&E waiting room are those bringing in minors, who maybe didn’t need the ambulance but that’s a different matter. The ones coming in as emergencies, the ones keeping staff busy, are checked in ‘behind the scenes’ and those in the waiting room would have no clue.
That’s not to say that the wait times are in anyway acceptable, just a different issue.

@TouseMrap oooh sorry missed the sarcasm 🙃 to my defence I got up at 3.30am and on my third coffee!

Hope you have been seen and your DD is OK.

As for the figures, 2023 saw doctors and others in the NHS on strike for various periods, so I would not be confident the figures are the best comparison.

The system is absolutely broken, and it’s not just about it not having money.

The vast majority of the individual frontline staff in the NHS do a brilliant job, but the system is just a shambles. OP is, unfortunately, a good example of this. A hospital needs to be a 24hr operation, why is it insufficiently staffed overnight? Everything stops when there’s no need for it to. Patient transport is an example - ever tried to get a patient needing transport discharged at a weekend? They can’t be, because it’s a Mon-Fri 9-5 service. So they can’t be discharged until the Monday, which keeps their bed occupied over the weekend, which leaves people in chairs in A&E. Multiply that by hundreds of similar inefficiencies, add in the issues with seeing GPs and dentists, and you get the backlogs OP is experiencing.

one of my relatives is an A&E nurse, he’d disagree with you there - a lot of the waits are due to misuse and people using it as an alternative GP Surgery because it’s more convenient to go at a weekend or an evening.

I hope your DD has been seen OP and agree the current situation is dire. However, it's dire due to 13 years of underinvestment resulting in staff burnout and mass resignations on a national scale. Additionally, the government reduced medical school placements, abolished the bursary for student nurses. Beds have been closed in favour of increased care in the community and we are now seeing the results of the Tories policies.

When you see a "quiet" waiting room and one person being seen an hour, respectfully, you're merely seeing a snapshot of what is happening. You're not seeing the trauma calls for gunshot wounds/ multiple stabbings/ suicide attempts. Neither are you seeing those arriving via ambulance being actively resuscitated nor the child strangled by their drug induced psychotic parent. You're not exposed to to effects of someone who is so high on drugs and alcohol they're being restrained by multiple police officers in an attempt to keep the patient from harming self and others while the staff prepare medication with which to inject said patient to sedate him/her. Nor are you exposed to patients or family members verbally and physically assaulting staff.

The above is a typical weekend in the quiet waiting room of a busy inner city hospital. This, coupled with the Tory government policy towards healthcare including pay and conditions is the reason I left the UK.

I whole heartedly support the strike actions of my wonderful ex- colleagues. I implore others to remember they are taking this drastic action in an effort to force the government to recognise we can no longer provide safe care under the current conditions.