It's not A&E that's the problem - it's people!!!

[eqpi4t2hbsnktd]

Was in A&E last night. Busy east London Hospital...
3 hours in and out. Staff amazing. Tests done etc... Facilities (not pretty) but fine. Had a seat. Seen in privacy and treated with respect and care...

However the people waiting were awful.. one woman kept coming in a racially abusing the reception staff... security kept taking her out. Stopping the staff from getting on with their jobs.

Entire family (6 of them) eating a curry and having very loud family time up the back of the waiting room - so loud that the Dr.s calling people's names were not being heard... causing delay.

2 homeless people sleeping across multiple chairs (not begrudging them a warm spot to sleep.. but they should not have to be there.)

2 woman came in just to charge their phones up!

It's not the NHS that is on its knees it's society. And A&E is the harsh reflection of society!

Maybe it was people in your case OP. But after a recent visit to A&E, where I saw 8 or 9 people parked on trolleys on the main walkway for the whole time I was there (12 hours), I would absolutely say its the NHS that's the problem, i.e. underfunded.

She's commenting specifically on her experience, her observations are valid and in no way detracting from the points of view of the staff.

One part of the reason the NHS and other public services are on their knees is because the public misuse them, as observed by the OP.

How very rude of you.

Was the a and e in question Homerton Hospital in Hackney? I've had to use that a and e in the past year after falls and post- operatively and have never had to wait more than 3 hours. The staff are very organised and committed to treating patients as efficiently as possible. I've been shown respect and understanding each time.

The funding for staff comes from the same general pot. Every position needs to be approved and long-term funding needs to be bid for and signed off by trust/commissioners. Often, there is no long term funding which is where agency and locums come in. So you get half the staff for double the cost. Even if you do have a budget for permanent staff, it's impossible to fill some positions because of pay and conditions. And, as I said above many trusts have recruitment freezes so they are literally not allowed to recruit.

It's a day out for some of em!!

Of course it's the people.

Not enough healthcare professionals (people)
Too many patients (people)

Think it’s a mix of both. Was in A&E last Friday as daughter had cut her ear badly and it was very bloody. Took 90 minutes to triage (usual experience about 15 mins) but probably could have been patched up at a minor injuries clinic if that existed. That said, there was a family of six, multiple parents accompanying their teenage children, overcrowding.

I've been to a&e many times and always been seen within an hour.

When it is actually an emergency (eg someone is at risk of dying due to their health condition) I've always been seen fast. I've been seen instantly on two occasions:

• baby needing breathing support

• child with severe croup also struggling to breathe. He was given steroid injections within 4 minutes of arriving.

Unfortunately people don't always realise that sadly a lot of things that are horribly unpleasant are not an emergency.

• pain often is not (it can be), even quite severe pain , especially if the cause is known
• a lot of limb injuries including broken bones aren't emergencies

If you are being kept waiting 12+ hours its because other people coming in are more immediately unwell than you and you probably could have gone to a GP or out of hours service.

I think there needs to be an additional service that's essentially a triage for the fracture clinic as a good proportion of break or sprain needs an X-Ray and if nowhere else can do it you end up in this backlog where you are very much not an 'emergency' in that your life is not immediately in danger but you do need to be seen in the hospital where they can appropriately treat the break.

I totally agree with this.

Also, under resourced adult social care compounds the problem. My sister works on a ward and they have a huge issue with elderly patients bed blocking because they can't get social care packages in place quickly and patients can't be released home without having the support in place.

The meal eating family should have the patient, one other, no other family members.

111 also is not fit for purpose. It can't risk assess people accurately so it sends far too many people there who don't need to be there

I no longer use it because it resulted in me being sent to a&e inappropriately when what was needed was out of hours GP services. Weekend GP services would be a huge help.

Also, under resourced adult social care compounds the problem. My sister works on a ward and they have a huge issue with elderly patients bed blocking because they can't get social care packages in place quickly and patients can't be released home without having the support in place.

this has been an issue for years. Elderly people used to be sent home with family would care for them. My own grandmother came to live with us for 4 months once after a fall, 2 hours away from her own home. The alternative would have been her staying in hospital. We all pitched in to look after her, various family members came down.

This 100% i also don't ring them anymore as it just can't handle people with rare or complicated conditions or medical history. Everytime I have rang them they have tried to send an ambulance which obviously I refuse as its not needed.

I couldn't find this original comment but if you go to the gp they can refer you straight to xray which is just sit and wait where I live. There is absolutely no reason to be going to a&e for this.

@InDogweRust

"probably could have gone to a GP or out of hours service."

No. No you can't. A lot of basic services that could do and should be supplied by lower key suppliers, like an out of hours service, aren't available. You can't get an x Ray for a broken leg fur your young ds. You can't get an iv infusion from a gp. As a diabetic I needed one, gp sent me to A&E. Surely they should be some local service I could've got that from?

111 is not fit for purpose. You phone, they tell you to go to A&E.

Your one visit isn’t everyone’s experience though.

My adult son’s feeding tube got buried into his stomach so needed A and E. He had both us parents with him as he requires 2 carers. He remained in A and E for over 24 hours before a ward bed was found, another 48 hours before the operation could take place. By then, he’d developed sepsis.

Unfortunately, we are regular NHS users. We don’t abuse the system but over the last twenty years have seen it get steadily worse.

My son was admitted with a life threatening condition via ambulance. His life saving treatment continued to be given while he lay on a trolley in a corridor where he remained for 3 days before he was found a proper bed. I think it was 8 blood transfusions while in the corridor. The doctors were amazing, the nurses too, but a absolutely horrific experience.

This is not just an a&e issue, its a lack of ward space issue. Your son was seen and treated, the issue is that once someone is admitted and in a bed, the systems amd processes to ensure they are moved on as soon as they possibly can be, are poor. This means too much bed blocking on wards. I and my DD have been admitted for a few things over the years amd it takes ages for them to get around to discharging you when you are perfectly able to leave. I self discharged on two occasions for this reason.

No. No you can't. A lot of basic services that could do and should be supplied by lower key suppliers, like an out of hours service, aren't available. You can't get an x Ray for a broken leg fur your young ds. You can't get an iv infusion from a gp. As a diabetic I needed one, gp sent me to A&E. Surely they should be some local service I could've got that from?

Going to a GP you can actually be referred directly for these things same day, and bypass a&e. I've been in with a poorly child and been referred directly to the children's ward at the hospital by the GP thus avoiding a&e. You can get an xray same day at minor injuries for broken bones (ive had them twice in the last two years, one was on a weekend).

There needs to be more systems for GPs to refer non emergency cases straight to the appropriate treatment providers for situations where someone needs seeing in a matter of days rather than weeks.

Just over two hours in and out of minors. Ambulances queuing outside.

The only problem I saw was three relatives accompanying one patient in a crowded waiting room.

Not all hospitals work like that though.

My son was transferred from the hospice to hospital, via ambulance. Everyone has to go via A and E, at our local, before transfer to a ward.