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!

It's just so sad to watch the NHS crumble ... People have no idea what the alternative might be. I know of someone who broke their wrist whilst in America. It cost £4500 to sort it. Luckily she had insurance but can you imagine how that will be for us if we don't have the NHS.
Incidentally, as I said in my earlier post, I was at A & E with my Dad (dementia) after his 3rd fall in 4 weeks resulting in a head injury. He needs to attend hospital as he's on a blood thinner so ought to have a head CT.
After his second fall (28/12) his care home called for an ambulance. He waited 29 hours only for it to be stood down. They didn't even send an out of hours Dr to look at him.
I wasn't allowed to take him in case he deteriorated en route and I wouldn't have had any medical assistance. Would've been a logistical nightmare anyway with his dementia.
I have the utmost respect for the NHS and it's workers but something drastic needs to be done to try and save it as it's not sustainable if we carry on as we are.

And here comes the scaremongering. 'I know of someone......'

I used to live in the US and ended up in being involved in a rather nasty road accident. I had treatment for practically a year, including a and e, physical rehab, therapy to help me over the trauma and even my taxi fares to and from the various hospitals were picked up by my insurance. There was no demanding a credit card before I was put in an ambulance, and in any case I was unconscious at that point. They were all more bothered about saving my life and the finances were sorted later. I'm not very wealthy, but I had medical insurance over there (and have had basic private insurance over here for years too.) The treatment was excellent and I for one would have no qualms about going over to a similar system. And I've actually been there rather than heard stories from my friend's dogs auntie's hamster 🙄 the NHS can't continue as it is, there's too many people now for it to cope with.

A lot of people on this post seem to be focusing on the time OP waited. That’s not what the post is about, it’s about people being there that clearly don’t need to be which is pretty much every A&E and hospital in the Uk and how society is part of the problem.
Did anyone see the recent story about the nurse that was stabbed in the neck in a&e. The man who did this was arrested straight away and taken away by police which suggests he didn’t need to be there in the first place as he was clearly medically fit! Absolutely awful!
https://news.sky.com/story/man-charged-with-attempted-murder-after-nurse-stabbed-at-royal-oldham-hospital-13288253

How will involving insurance companies make it cheaper?

You've lost me, why is making anything cheaper a priority? It's the lack of a decent health service I have an issue with...

OK then, how will involving insurance companies improve the situation? Why couldn’t we just fund the NHS properly through taxation? What would your model look like and what would it cost?

I was in A&E recently, sent by my GP surgery who were so we about my high blood pressure that they said I was in imminent danger danger of a stroke…. Even though I had no real symptoms!!!
I got there 6:45pm ….. I left at 3:30am, with a half hour journey home.
it was packed in there, with ambulances queuing… in the end, after a few tests and an X-ray all they did was up my medication! Clearly no beds. I know the surgery thought I should be hospitalised….but people were also there for the seemingly flimsiest of reasons too. The receptionist booking me in asked if I’d rather see the in-house GP but I’d already seen a GP! And had the fear of god put into me!! So I declined that. But I felt such a fraud when I left, with just medication upped, and very guilty.

Because there's not enough tax payers to fund the NHS properly, life expectancy has increased since it was introduced and so has the range of treatments and support services that are now considered 'normal.' No idea on cost or model, its not something I could just knock up in 5 minutes on a Sunday morning 🙄but there are too many people trying to access services and too much stuff being funded that shouldn't be. People need to be responsible for their own health more and if that means a few quid per month on insurance so be it. The dog's health insurance is more expensive than mine! The idea that the NHS is somehow sacred has got to go, it's an inefficient failing service full of overstretched people who can't do their job properly at best due to resources and time, and at worst full of angry resentful staff who are clearly hating every minute of being there.

The problem is, and an NHS consultant actually said this to me and its been borne out of my own experience of paying for treatment, that private treatment is ridiculously expensive in the UK. In Europe, its more affordable to go private so more people do it. I have a disease that the NHS won't treat, 2 lots of very expensive surgery in the UK barely touched the sides, whereas the surgery I had in Germany was not only much cheaper but had better results. That's where surgeons answering to and being appointed by insurance companies would be an asset.

Oh but they do!

I walked in a local jewellers a few months ago, explained my ring was stuck because my finger had swelled up (arthritis) it was cut off within 2 or 3 minutes, taken for repair which took around 7 days, at the cost of around £30.

My post should have said 'not all jewellers will do this'. As I said I know the nearest independent jewellers to me won't.

Our local A&E is in a nice area and it’s sub-optimal - no capacity for emergency surgery, no consultant on premises overnight or weekends.

It is badly managed and badly run. The staff are poor, it’s a bad option for rotations and nursing and admin staff are very rude and comparatively rough. Utterly dreadful and more about culture than funding.

The dog's health insurance is more expensive than mine!

Lucky you! I was made redundant last year and my private health cover for DH and me expires at the end of this month. I got a quote to extend it and it was over £27k per year if we wanted to continue with the same cover levels and cover for pre existing conditions. The cheapest we could get it down to was just over £12k a year and that was with a large excess and without cancer cover and very little outpatient cover.

Ok. x

Sorry, I ought to clarify they were on holiday so had insurance but the bill was £4500 nonetheless.
No desire to scaremonger ... Just pointing out that medical care does have costs attached and who knows how the NHS will look in the future.

• Edited for spelling

I think the US model is not one we can compare to. For example people who require insulin to stay alive are forking out thousands in costs a year. Not everyone is able to afford the health insurance just like in the Uk.

i Agree however there should be some deterrent especially when there are people who fail to attend their appointments which can sort out the very thing that they have attended a&e for!

I know I said it before, but I think people are being unduly pessimistic here. Yes, there is a HUGE amount of improvement we could do in A&E, but people hear the horror stories and assume that they are the norm and that the system has collapsed, rather than them being unacceptable outliers.

Most people are seen, treated, admitted, discharged etc within the 4 hour target. The percentage waiting 12+ hours is 10%, which is too high, but by definition not the average experience either.

Have a look at this for more data on the 4hr target and performance.

https://www.kingsfund.org.uk/insight-and-analysis/long-reads/whats-going-on-with-ae-waiting-times

I agree, but I’d like to know the stats on how much of this is down to 111.

We’ve had a few issues with them sending unneeded ambulances out and advising us to go to a&e. The last time we were advised at 3am Saturday morning to go straight to a&e, a&e were waiting for us, we had to ask for x specialist, only to get there and be told they are not equipped for x emergency never had been sick of 111 telling people to go to a&e. 111 had actually called us back after our initial call to tell us to go to a&e so it wasn’t part of the original call.

Another incident I was pregnant and having what we believe was a reaction to some medication, severe V&D a lot of pain. DH called our gp, they said call 111 who sent an ambulance and separate paramedic out, by the time it arrived the worse had past but still in pain and couldn’t sit up straight away. They asked if I had any bleeding, no, said they didn’t know why they were sent out, we had no idea why either. My DH was trying to establish if he needed to take me in a because I was screaming with tummy ache and was worried about the baby. An ambulance was pointless as DH could have taken me if they said go to hospital.

We’ve got to the point now that we make our own calls and don’t call 111.

It’s not always the ‘people’s’ fault that they’re forced to present at A&E. If you live in an area like I do, with no such thing as a “minor injuries” unit you’ve got no option but to go to A&E. If you went to your GP they’d just send you to A&E with a suspected fracture/sprain.

A few weeks ago my daughter had a very bad chest and needed an inhaler. It’s on a repeat prescription but we have to wait five days for a repeat and she really needed it straight away. I tried to get a GP appointment but couldn’t. Rang 111 and was directed to the pharmacist. The pharmacist said he can’t prescribe things that are on a patient’s repeat prescription unless it had been prescribed in the past year (which it hadn’t) so to go to the walk-in, where we were told exactly the same thing and directed back to our GP. I went to the surgery and relayed all this information and they said I’d have to take her to A&E. Just for a bloody inhaler! I managed to get one from a friend who had a spare one, but this is why A&E is in such a state, and it’s not always the fault of the patient. Sometimes there are no other options.

If the insurance was with a private firm, there'd be more effort made to be efficient, less waste, and none of the nonsense spending, poor decision making etc.

@Anonym00se

I agree, a lot of the problems in A&E are caused by the GPs. We had 3 consultations with MIL's GP in December with a very clear chest infection. First time, the GP said it was severe chest infection and prescribed antibiotics. They didn't clear it up. A week later, a different GP appointment who claimed her chest was clear and told us it was just a matter of waiting for it all to clear. Week later, it was a lot worse, another different GP said the same, just to wait, after what was little more than a 20 second "examination". Week after, she was in a terrible state so we took her to A&E - a quick examination and they said it was very severe pneumonia and put her straight on antibiotic drip, and asked why we hadn't had the GP out to her - she couldn't believe when we said we'd had GP "consultations" the week and 2 weeks prior as she said her chest was so bad, there was no way it was clear a week/2 weeks ago!

Rather than concentrating on A&E, I think serious questions need to be asked of the entire GP system which is no longer fit for purpose.

I find it bizarre that people like OP are complaining about half a dozen people, eating curry in the waiting room, rather than the tragedies of 14,000 deaths in 2023 due to excessive waits in A & E?

rcem.ac.uk/the-facade-of-everything-is-fine-has-been-demolished-now-we-must-fix-what-is-broken-rcem/#:~:text=Lord%20Darzi's%20report%20specifically%20referenced,health%20service%20was%20founded%20in

A&E is for Accidents and Emergencies if people can wait 12 hours is it really appropriate to be seen in A&E ?

So, how can you tell @Roco11 which 14,000 plus people are going to die this year, due to waiting too long, and which ones don’t need to be there by 12 hours?

I’ve been to two A & Es recently with DD1 and DD2. DD1 fell and refused to get up off the floor. We waited 8 hours for an ambulance, who took her at 3.30 am to the Rapid Assessment Unit at our nearest A & E. After a few hours, with no assessment never mind a rapid one, she was moved to Majors. We saw from trying to find our way out all day, there are in A & E:

Majors - 50 cubicles
Minors - 50 cubicles
Rapid Assessment Unit - iirc about 6 cubicles
Emergency Assessment Unit - from memory 10 - 15 beds

It is beyond me how pp can tell, from sitting in the waiting room that half the patients don’t need to be there, when at our hospital, there were around 120 patients out of sight from the waiting room? I heard a nurse talking about how the place was full, and they couldn’t take any more people from ambulances!

DD1 was given breakfast and menus to choose a cooked meal for lunch and dinner.

Ditto DD2 in Ambulatory Majors at another A & E in our county, also had menus to choose cooked meals.

Both DDs could probably have chosen curry on the Asian menu, along with many other patients in Majors at both hospitals. Would OP have been complaining in Majors, that people should not have been eating the hospitals’ own food? Personally, DD2 and I both find the smell of vomit way worse than curry, bearing in mind, we were in the middle of a quadremic including norovirus.

At hospital 2, a HCA came up to me, looking after DD2, to say that if I wanted anything to eat or drink, just to ask him. Surely a much more sensible approach?

DD2 after 15 hours in A & E, waiting for a bed, was taken to a specialist centre. Admittedly it wasn’t A & E, but the staff told us, we could visit her and get food and drinks from the kitchen, whenever we wanted. Funnily enough, the consultant who assessed her in A & E, didn’t tell her, if she could wait 12 hours, she didn’t need to be there!

not at that time in the evening. minor injuries did it when my husband, but they were also closed at that time. it's not like I could leave it overnight, the way it was swelling. it was an emergency, and therefore exactly the right place to go about it.

A&E round us actually has a GP as part of the offer. I recently had an allergic reaction (woke up absolutely covered in hives)- phoned 111 who told me to go to pharmacy. Went to pharmacy at 9am on the dot. They told me they couldn't give me the antihistamine because I was breastfeeding and needed to be prescribed by a dr. This was about 9.05am, by which time obviously all GP appointments were then gone for the day so my only option was A&E. after a few hours I was seen by a GP there who was able to give me the prescription. More administrative than anything and a huge use of resources in my opinion which could have been prevented if the community based healthcare was more cohesive.

A proper discussion needs to be had about what we want, what we’re prepared to pay for it, and how much of our tax or insurance premiums we’re happy to pay for administration and shareholders’ profits.

It’s interesting that you say that too much stuff is being funded that shouldn’t be, yet you are dissatisfied with the decision that your disease is not considered eligible for treatment on the NHS.