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

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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!

I have been to A&E 4 times for me and twice with my kids in the last 10 years. All for broken bones and was in and out within 4 hours each time. Once included a neurological exam as well as x-rays (questioning why I'd fallen so many times!) and treatment (stitches, getting a walking boot or wrist strapping etc). This is at a big city hospital thankfully with an excellent children wing and minor injuries.

Thankfully I haven't had to go in the last 2 years but was told on recent first aid training to not call an ambulance unless we can't safely move a patient as it would be faster to take ourselves, due to location and ambulance waiting times.

Because individual clinical staff do not usually have the authority and/or skills to design and implement good systems. They are in general victims of the poor systems themselves.

Despite hospitals having little pockets of well-executed quality improvement, good systems of care exist mostly because of good, wonderful, smart people holding everything together with sellotape and elastic bands, rather than because the process was systematically designed to achieve desired outcomes.

The NHS has for so long relied on the false economy of stripping out and under-valuing management (and I mean real, effective, quality management, not sidelined clinical staff with a clipboard) and those chickens have now come home to roost.

Quality costs, but poor quality costs much, much more in the long run.

@InDogweRust "Your son was seen and treated"

Really- would we call that treated? 3 days having blood transfusions in a corridor.. how much sleep do you think he got in a corridor? Do you think meals were reliable? Or that he could get changed into pjs? Do you think corridors have showers?

It's a disgrace.

When will private services step up and offer a radical alternative - a private A&E? It's long overdue.

That’s a very interesting post. How would you organise, staff, equip, and above all allocate enough funds to treat all the hundreds, if not thousands of different injuries and illnesses that must chug through any A&E on any day? You will need all sorts of specialists, all sorts of support staff, radiologists, paediatricians, etc…… all sat ready and waiting for the next case. On the plus side, drunks, druggies and the abusive could be sifted at the door, or perhaps allocated a nice security guard and a private room to sober up in I suppose🤔

I don't blame the medical staff because they were so worked off their feet due to staff shortages that one of them had been on duty since 7am and by 2pm, she hadn't even had time to sip water, in that overheated, airless space. She was showing signs of dehydration - forgetfulness, clumsiness. I made her stop and drink some water. Her bottle was full, so she clearly hadn;t had a chance to sip from it once, let alone eat.

It's not the medical staff's fault that there is no TV monitor explaining the average wait time or who will be seen next by whom, or that there is no admin desk in the main waiting area so the medics are accosted by a stream of people complaining they have been waiting hours, because there is no receptionist to act as a buffer.

Yes, they made some bad mistakes and didn't communicate well, but I could see why - they were stressed, overworked, badly under-equipped. Next day, due to the chaos at A&E I had to take DS back for a second opinion and went to another hospital instead. It was clean, calm, aired, orderly, with monitors working. We were seen in minutes. I don't think it is up to medical staff to organise this set up. The NHS is bloated with non-medical middle managers on good salaries. They need to sort out a better system for how A&E departments are run.

If buses are always late, I don't blame the driver. If cafes are chaotically run, I definitely blame the bosses not the staff because they clearly haven't been trained.

Older MN here - I hear people saying the NHS is on its knees but in my humble experience it has always been like this.

Aged 12 I fractured my pelvis was brought in by car !! And I had a 12 hour wait before I was put on the ward and given zero pain relief until I was on the ward.

waiting for x ray on a trolley in the hallway I was just a child (30 something years ago)

I just think with social media and news spreading quicker it’s more widely known now about wait times, people hear more of the stories.

You have to ask is the NHS spending money on its core business? Would be interested to know how much other healthcare systems spend on roles like 'diversity managers' or 'inclusion and belonging leads'.

We need to face reality and impose a charge for medical treatment to sort out the time wasters who clog up A&E. For example in the Republic of Ireland it’s €100 to be treated with similar charges across Europe. Last week I escorted my 92 year aunt to A&E in Newcastle , taken in by ambulance and was frankly appalled by people demanding to be treated for minor ailments that could have been dealt with by a GP or pharmacist wasting everyone’s time.

But 30 plus years ago, the majority of people in the UK could see a GP a lot easier than they can today.
We had family Dr's who knew us...mine had even delivered me.
Now, in the rare event people can actually see a GP face to face, he is often a stranger who knows nothing about the patient he is seeing.

In my area, it's nigh on impossible to make an appointment. It has to be submitted online, then it can take 48 hours before anyone responds, then if you are still alive, it MAY be passed on to a GP.

That's the main reason A&E's around the country are finding it hard to cope.

This. And missed triages. And lack of communication. And aggressive staff when I questioned said lack of triage on a 14 year old with a broken foot. Was told by vile nurse that I should have gone to the garage down the road and bought the child pain relief but was told by reception that he couldn't have any drugs until he'd been triaged which never happened. When I complained the nurse refused to treat said child meaning a further 7 hour wait in another town. Plus a formal complaint response that of course sided with the angel that worked for the NHS until I took it further. In my experience, it's not A and E that's the problem, it's the staff!

That's not the case in my area

I think you are lucky then.

The family’s looking after adults do my head in, a few months ago I had to be there with LO and there were multiple families with 4/5/6 people for one adult who needed care.

Take all the valuable seating space (without offering others in need) and inconsiderate in volume as you say.

It depends when you go too, I think. This was early morning, Hubby got something in his eye at work the day before. We called at specsavers, they examined it then told him to go to A&E who then sent him to ENT dept. He's was out within an hour after getting the piece of brick scraped off his eye ball.

Rubbish!! I live in Birmingham and took my son to an and e with a broken collarbone last week, we were in and out in less than 2 hours. Obviously with an X-ray. You can check the waits at your local hospitals before you go now which is great as you go to the hospital with the shortest wait, some were saying only 1.5 hour wait earlier. No need to talk to the OP like that when you dont even live in England.

My sister works for NHS Scotland as an A & E receptionist and apparently last night they had to call the police as some teenagers were swearing at the staff so a nurse called the police - 10 of them came within a few mins.

My friend is an A and E consultant, she said in Covid she actually did her job, people only showed up with life threatening conditions.

The headache and earache and I’m going to bring my whole fucking family brigade stayed away! I agree with you Op.

Oh and to add, when I went with palpitations, I was seen and discharged within an hour. Nothing too bad, just a virus that had affected my heart. I apologised for wasting their time, they assured me they’d always rather someone with a heart problem come in.

I disagree with you OP. My eldest daughter required emergency treatment this week. Absolutely fantastic paramedics. Ambulance arrived in 20mins. Very surprised. Daughter needed to go to hospital. Assessed as not "fit to sit" in A&E. Suffering by this time with hypokalemia and heart arrythmia. She remained in ambulance outside A&E for 10 hours. All treatment given in ambulance. Drips, blood, you need it. Ambulance unable to attend other people. Daughter ended up in shocking conditions. This is not as a result of "other people" unless you mean government "people's" policies from the last 15 years? !!

I'd put them in one of those drunk tanks that the NHS has adopted.

"'Drunk tanks' to ease NHS pressure - BBC News" https://www.bbc.co.uk/news/health-46591187

Eating a curry as a family of six in a&e waiting? Yes,all right,did it, I think they should wait without impacting otherwise or be told to leave

It was great at my hospital clinic I have to visit every four months during COVID. In and out in under an hour all tests done. Consultant seen

Everyone saying it's not possible to be in and out so quick, maybe it isn't always but sometimes it is. I was taken in to our local A&E this afternoon by ambulance at 3.45pm. I've an two ECGs, a chest X-ray and full bloods. Confirmed not cardiac as initially suspected. The longest wait was waiting for my blood results to come back. There was one person ahead of me in x-ray. I'm home now and have been for about 45 minutes. However a friend visited the same hospital about 2 weeks ago and waited 18 hours. I think my situation today was very rare, and not the majority of peoples experience, but it is possible.

But, to the point of the thread, I agree that people are taking advantage. And a lot of the time it's not worth the hassle the staff would receive if they challenged these people.

My recent experience of A&E was in autumn when my father had an issue with his catheter that we couldn't resolve and we thought that was the only option (we should have contacted the district nurse). We were there for around 11 hours but his catheter problem was fixed. The problem with the NHS, apart from general poorness like poor communication between departments and inefficiency, is there is too much demand. An ageing population combined with COVID has exposed just how dreadful the health of the UK's population is, the whinging about nanny state and don't-tell-me-what-to-do (i.e. attitude problems) every time the government has put out public information messages advocating healthy living has compounded the issue, and the consequences are now manifesting themselves in the form of more and more people with long term health conditions who are constantly in and out of hospital, plus rising levels of mental health issues for which there is grossly insufficient services so they end up going to hospital as well. This is what happens when a population collectively chooses poor/unsustainable lifestyle choices without caring about the long term individual and collective consequences. The same sort of thing will happen with fossil fuel consumption and climate change consequences in a few decades.