Stop telling people to go to A&E!

[Miriad]

I see it on here a lot. Someone is getting fobbed off by their GP and not getting diagnosed. So they get told to go to A&E, where they have the ability to do blood tests and urine tests and scans to figure out what’s going on.

I’ve been sobbing in agony for three weeks and my GP isn’t helping me, and I can’t get another GP appointment for a fortnight, so posters advised me to go to A&E.

I waited six hours only to get yelled at by an angry doctor, saying my condition is neither an accident nor an emergency. According to him I don’t need urgent treatment even if I’m crying with pain - because pain isn’t urgent. If I’m stable and not at risk then I need to go home and see my GP.

A&E can not be used to bypass a useless GP and access tests and scans. They will not diagnose you or refer you. Their job is to give you the minimum care to make you stable so you’re not at risk, then send you home.

So stop telling people to go there. Maybe in the olden days you could go there for help if your GP was rubbish, but not any more.

And sadly, in too many cases, that level of pain appears to be acceptable in the NHS.

There was a clip doing the rounds recently from 2006, a Question Time when someone complained about getting doctors appointments too early! This was in the days when Labour fulfilled their pledge to provide GP appointments within 48 hours.
I am getting frustrated with the lack of ability for many to join the dots when it comes to this stuff. We had it good and messed it up.
For gods sake people, stop obsessing over gender issues and see the bigger picture!

The difficulty with uti's is that the bacteria can hide in biofilm and then tests turn out negative, doesn't mean you don't have a UTI though. This is part of genitourinary syndrome of menopause caused by low estrogen as we age. Replacing the lost estrogen with hormone replacement therapy (HRT) and vagifem which will directly be absorbed by the bladder, is your route out of this issue. You need to see a GP who is up to date on peri/menopause prescribing.

@Longma it can take time to get pain under control. Its not always that simple.

For the umpteenth time, she doesn't have a UTI - antibiotics are useless. She needs specialist care from a urologist and it's stuff you can't do on the fly in E & A. If they have a consultant urologist on call in E& A they will be dealing with emergencies such as where a person cannot urinate and their kidneys are going to be damaged if they don't catheterise. An urgent treatment centre is not going to be doing those sorts of investigations either. What they could do is to prescribe some heavy duty painkillers/ anti inflamatories in the meantime.

Changing my diet was the only thing that worked for me after a lot of investigations including a bladder biopsy which was as unpleasant as it sounds. The urologist was very focused on finding out what was wrong and ruling out even less pleasant conditions. Do you really think OP would be in agony for weeks if a few antibiotics would do the trick? She says she has had antibiotics. Honestly, I still remember the burning feeling and it was awful. It was worse than orthopedic surgery where they took to my bones with saws and drills.

This may be an unpopular opinion but A&E is not the place for chronic pain concerns etc, it is for accident and emergency, as in primary care to stabilise urgent cases so that they can safely be treated going forward by other clinicians. It is also not the only option - there is an out of hours gp service and many minor injuries units that would be the better equipt (and far shorter queues) than waiting in A&E. I really would recommend trying one of these services, you're likely to get seen quicker and get what you need. I hope you get the help thaybyo8 need and feel better soon

It's taken me months to finally get estriol cream for vaginal atrophy. Four telephone consultations. Resulting in different creams which did not work because they were treating eczema type symptoms. Thrush, UTI.

Luckily mumsnetters pointed me in the right direction because of my age, symptoms, so I insisted that the GP let me try it. I'm so much better. Incontinence gone, no more pads, UTI settled down. I'm still using a bit of sudocreme on the very sore bit. But am getting there.

@justasking111 My very good NHS GP recognised I had vaginal atrophy straight away. But some women take ages to get diagnosed. My GP said it is extremely common. I had never heard of it.
I do know some women have to try various HRT pessaries and creams before getting one that sorts out their symptoms.

I can't imagine that, but then, I'm in the US, and our healthcare system is very, very different. In most ways, far worse, but in a few ways, better. Here, had something happened to me after being turned away, the doctors would be open to malpractice lawsuits. That pretty much insures that you'd have gotten at least a screening. On the other hand, it would have cost you several thousand dollars.

I'm also somewhat aghast at their reasoning, as severe pain is quite often the first noticeable symptom that something is badly awry. Had my pain been dismissed in one instance, I'd have had peritonitis and been in danger of dying from a ruptured appendix had I waited until morning, much less days or weeks, to be seen. I was whisked into emergency surgery almost immediately, and it was a near thing.

@Mamanyt she did have a screening.

Again, the difference between systems, and I should have been more specific. A "screening" would include blood tests, often urinalysis, and any scans that might be appropriate, not just a triage screening. Sorry for the confusion.

It’s always been the case that A&E is for an accident or an emergency, currently they can’t cope due to inappropriate attenders for various reasons.

Agree with PP about getting a GP appointment through 111 for pain control and book the 2 week appointment as well, if you haven’t already.

Do you not have an Urgent Treatment Centre? They are brilliant to use in cases like yours. Kind of like the old doctors sit and wait, plus they have access to x rays.. Our GP surgery dont even answer the phone so we always use the UTC. You can also get 111 referals too so you have an appointment time

If a UTC is the same as a Walk-in Centre, mine doesn't do x-rays. When I damaged my ankle and went into mine, they told me to go to A&E to get it X rayed.

Please phone 111. They will usually sort something out the same day.

In many cases a person is unsure if a pain/symptom needs urgent care or not. My husband has today woken with an excruciating pain, swelling & redness in his knee. If this is septic arthritis he will need urgent care, and a stay in hospital. If it is gout (most likely TBH), a trip to GP would suffice.

FYI - against my advice he is doing neither- i suggested GP.

OP - I really hope you get the pain under control soon x

I went to A&E with abdominal pain, was admitted, given pain relief and kept in for two nights. Pain resolved itself, they thought it was probably gynaecological. They contacted my GP and my GP referred me for an ultrasound scan.

In pain on and off though not to the level I'd gone to A&E with. Before the scan appointment even came through pain increased again, so I went back to A&E, they gave pain relief, monitored me, did an x-ray then sent me home telling me to come back the next morning for an ultrasound scan - 5cm dermoid cyst on my ovary.

The next day appointment for the original ultrasound scan arrived, I was advised to still attend, they confirmed the diagnosis and I was referred for urgent surgery. That took nine months, and it was only that short because I said I could attend on short notice if they had a cancellation.

This was in 2015/16.

Sobbing in (unmanaged) pain kind of sounds like an emergency to me.

What is causing it? I assume this known if this doctor feels able to ascertain whether it is an emergency or not?

Let me guess - they ran some tests, couldn’t find what’s wrong, they don’t know what’s wrong, so everything’s fine, go away.

NHS medical professional here.

1. You need to go back to A/E. Advocate for yourself.
2. Make a report to PALS about your earlier visit.

You definitely sound like an A/E patient. Even if you saw the GP they will send you to A/E. Make a PALS complaint, the statistics is needed to how we are not meeting patients' need due to being overworked or underataffed or underfunded etc. Sorry, you had that experience but you need to go back to a/e.

I mean it depends
I have a diagnosis and have unmanaged pain regularly where I am either crying or sound like I'm in labour
But nothing they can do until there's NHS space for me to have surgery so it's not an emergency but I know what's causing it

If I was sobbing in agony and had been in this level of pain for days on end, you bet I would go to the sexual health clinic. It’s insanity to be suffering and then act all high and mighty about it!

We might be lucky with our GP. Yes, you can not get an appointment. I usually complete their online consultation form, it has to be done early morning. They normally respond within 2/3 days, booking you a telephone call. Usually about a week. Only once have they asked me to attend face to face after speaking to them. It sounds long & complicated I know, but I usually get help within about a week which isn't too bad for a GP these days. I must have resolved about 1/2 dozen issues doing this. If your GP has this service it might be worth trying.

Do you know you can change your GP? Look up NHS Choices - you can put your postcode in and find a local GP. You can read reviews to help you decide or calm the surgery and ask what their appointment system is . I don’t know any GP Practice in my area where you would wait 2 weeks for an appointment if I’m pain (I’m Staff in GP Practice) . Hope you get the help you need.

I have severe pain now for nearly 2 years due to UTI. Still not seen a GP, they will not see me, just told me over the phone that they can not see anything wrong with me🙄

Why is your pain unmanaged?