To wonder why A&E seems to be designed to be the worst possible place you could possibly be when ill?

[CassandraWebb]

My GP asked me to go to A&E and while I was waiting I was just struck by how it was a pretty unpleasant environment to wait in for the family members of the ill and injured but utterly irrationally poorly designed for people who are ill or injured.

Firstly you were expected to stand and wait to check in, I explained I couldn't and they grumbled but accepted my explanation but a lot of people with obvious leg injuries or desperately ill were being made to stand and wait and then stand to check in and then move and stand in another line to speak to an initial clinician.

Then there were people clearly in huge physical discomfort sat on the world's most painful chairs with no way to get comfortable for a long stretch.

Plus people were explaining why they were ill and giving their symptoms and contact details and the receptionist was literally announcing them back loudly to the whole room, I think there was some sort of microphone so her voice could be heard through the glass. And no microphone going the other way so she was getting irritated with me because I was hard to understand (my condition gives me dysarthria when I am having a flare).

It just seemed mind bizarrely poorly designed for a place where unwell people go.

I realise cost is a real factor, but some simple changes like chairs while you wait and a privacy screen so the whole room doesn't hear your symptoms and address /living situation would seem like a good start.

Maybe it's just our local a&e but I was totally puzzled by it.

I would love to hear if other places have really good tweaks to make it more bearable though.

(And I would add that the clinical staff were absolutely brilliant and very knowledgeable and switched on about my rare condition and also very kind and compassionate despite an obviously busy evening)

It frustrated me just seeing people suffer but it also frustrated me because the process of waiting and dealing with that made me more unwell

Totally agree. Same in my chemist, no seat fit when you're waiting to collect a prescription. Just expected to stand or hobble up and down the street for 20mins.

I now also know a random stranger's full name address and date of birth. Just as well I'm not an identity thief!

I can only imagine it’s because they were designed with zero input from the users (the sick people), and lots of input from hospital facilities staff, healthcare staff etc.

There should have been more consultation with Users when it was designed. Even with a limited budget you can do more.

They are mostly horrible spaces, that make a difficult time, even more difficult.

Yes, and the doctors surgery, you are meant to stand and wait in a line, and I can see I am not the only one struggling!

Yes, you’re totally right. It’s the worst place to be genuinely seriously ill isn’t it? The chairs are awful and there’s little privacy when giving details. Even when in cubicles you’re only separated from your neighbour with a curtain so can usually hear all their personal information too.

not Helped by gps fobbing people off to urgent care/a and e. Next time I have to go I am taking camp chairs.

The only possible reason is to deter people from using it. I've had to go twice this year with severe bleeding and it's nightmarish.

If it's too comfy more will attend ...

Yes possibly. For the avoidance of doubt in my case though the tests that needed doing could only have been done in hospital

they have to consider cost, infection control and ensuring staff and patient safety (so nothing which could be weaponised or conceal abusive behaviour)

Yeah I said to my husband s it to deter people from attending /to ensure half of them are dead before they even see a doctor!

But I could see people who were already very unwell struggling more and more as they stood in line /waited on horribly uncomfortable seats .

I do think it's to try and deter what they deem 'timewasters'. The seating is unbearably uncomfy, no decent food or drink anywhere near, and obviously chaotic as there's no control over how many people can enter at any given time.
I lay on the floor for 24 hours with a broken hip and shoulder BC I was too scared to go through the agony of waiting in a&e. The ambulance techs had to beg me. Thankfully once I was there I was on a trolley and dosed with morphine almost immediately but I thought they might make me sit on a horrible chair for 12 hours plus.

I used to design hospitals. You would not believe the level of design and clinical input that goes into these places. Everything is designed down to the last inch for a reason.

And yes the outcome is clinical and uncomfortable. But I can’t see another way tbh.

What would be a good design?
What changes could be made?

Oh my goodness, that must have been horrible.

I really didn't want to go to a&e as I knew it would make me more unwell but my GP was very clear (and correct) that I needed these tests urgently as my condition can rapidly become life threatening

To put you off going I reckon. I was pretty unwell over a weekend a couple of months ago and probably should have gone, I spent the weekend crying in severe pain and unable to walk in preference to going

I have recently spent 3 spells of over 12 hours in A&E (heart problem) and it truly is hell. The basic problem is that the place was designed for about a quarter of the patients who are there. All the cubicles have been divided in two with screens to provide more space; the corridors are full of trolleys and people sleeping on the floor; there is no privacy - I knew all about the bowel movements and sex lives of several people around me; and I waited hours before seeing a doctor in spite of the fact that I was in the throes of a heart attack.

My experience is that clinical staff are not consulted either. I got banned from planning meetings for pointing out major issues with proposed plans. I'm a hospital consultant.

It might be more spacious with more free seating if five relatives didn't also attend, with one sick relative, all taking seats, while sick people stand, or sit on the floor.
Also, with regard seating and leg injuries, my local A&E had some wheelchairs you can use parked at the entrance.

I think, as a minimum, a seated "queuing and check in" option for People who are unwell.

But otherwise I am not sure, that's why I am curious to hear if there are good examples out there. Then maybe I can make some constructive suggestions or even do some fundraising for my local hospital a&e . Because I felt so sad seeing how much people were suffering

It’s like the children’s wards at our local hospital. Talk about migraine inducing! It’s like someone thought - yeah - kids - primary colours!!! and went all out on the bright red and yellow. The least relaxing environment you could imagine and must be doubly awful if you’re ND. Neve going to make anyone feel better or less anxious about why they’re there 🤯

A&E here is weird. One person at the desk, next couple of people are in-between the entry doors and everyone else outside. Then you go right to the bottom of the corridor to turn around and queue to go back the way you came to speak to someone else, then back right again to wait for someone to take you all the way left past the initial reception (while everyone queuing has to let you through) it's such a poor design and winds me up so much

Agree. The standing thing to check in. I was in a line of about 10 people. Women of 80+ crawling on the floor because they couldn't stand. People leaning against walls to get a breath.

Then the very very quiet calling of names "mr mumble?" Said at the level of a mouse whisper. Mr mumble can't hear it so waits another 4 hours before asking why he hasn't been called yet.

I lay on a trolly all night in A&E having been brought there from a part time A&E by ambulance when it was closing for the evening (8pm). I was sent to the first (part-time) A&E by my GP that morning.

So In the overnight A&E I had a trolly to lie on in a busy cortidor but no blanket or pillow. Apparently there were none to be had. When I was finally admitted to a ward later in the morning (more than 24 hours after my GP sent me to the first A&E) and saw a bed with pillows and a blanket I cried.

I had a suspected stroke & was in hospital for a week. Still upsets me thinking about it.

I did look for wheelchairs but there weren't any available and DH had to sort parking so had dropped me at the entrance (as there is no car park remotely near a&e)

The only big family that showed up last night was one where I imagine the patients life was hanging in the balance, I don't begrudge them that. But yes I have been in children's a&e with my son before and some people have been there with half their extended family

The standing in a queue to check in at A&E has worked in my favour twice due to my bodies inability to stay conscious whilst unwell or in severe pain. I have fainted in the A&E queue twice once with kidney stones and once with a broken and dislocated elbow and manged to get fast tracked to a trolley. Admittedly a trolley in a corridor but definitely more comfortable than an A&E chair. Its the multiple accompanying people that I don't understand. 1 person for company but the whole family?! Who wants to sit in A&E voluntarily!