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!

My brother lives in China their hospital is a different world. I've taken some screenshots so he can explain how it works. Click on the pictures.

Seems efficient.

It is people who are the problem but not the people you’ve described. People coming into charge their phones and the homeless sleeping while shouldn’t be there aren’t actually using the service are they?

it’s people who go with coughs, colds, grazes, stubbed toes.

I think GPs have a lot to answer for here though.
There are so many cases of people calling their GP and being referred to A and E or ending up there out of sheer exhaustion when their GP won't see them to be treated. Its not Covid anymore and offering triage calls for 2 to 4 hours out of the day and no help if you miss that window just isn't good enough when our A and E departments are this over burdened.

That should say it's not Covid lockdown anymore sorry

YANBU.

Everyone so deflated, freedom of speech and rights so destroyed that people don't care and lose respect for everyone and everything.

Being a proud and respectable member of society just isn't encouraged anymore. Just what Starmer and Labour want.

I would love this system!

I was watching an old episode of 24 hours in A & E the other day. A woman in her 20s (I'd guess) came in with an injured knee and 3 accompanying adult members of the family. They all trooped in (I should say 'were allowed to troop in') with her, into a very small room, to see the nurse who did the examination.

You said 'and that's if you really need someone' and I took it that people should only be accompanied in extreme circumstances, sorry.

I'm sure many places would prefer it if people didn't have someone to advocate for them though so they can be fobbed off.

I actually think a lot of the problems are due to lack of GP appointments. I have been trying all week to get an appointment for my DS without any joy (you have to ring each day to check) their suggestion is I take him to the hospital. He doesn't need the hospital, it isn't an emergency, but he does need to see the GP.

My experience of A&E - at best it's well meaning but dysfunctional, at worst it's downright dangerous. Likewise the range of people that you get at A&E - at best polite and in real need (like they have actually had an accident or have a genuine emergency) and at worst time wasters or abusive idiots.

Combine the two variables and that can be a pretty toxic combination.

Great for staffing efficiency I would think. The monitors are also multi lingual. How great is that.

I once took my son to A&E and was out in an hour.

It was a Monday afternoon and it wasn't busy - the issue was straightforward but not something the GP could do.

Please don't call BS when you don't even live in the UK.

I agree with this.

Something has gone very wrong in this country. The entitled, selfishness of so many Brits is staggering!

A lot of people do end up in A&E instead because of lack of GP access. There are inbetween services though - a lot of places have drop in centres for minor injuries and conditions.

Sadly our local one only lasted a year and has closed again, I assume down to funding. So it's now a 12 mile drive to the next nearest drop in.

It's generally a lot quicker if you don't need a bed. The issue is often that there's no where to send the patients from in A&E. So you can't then use the beds/spaces to see other patients.

I've seen patients being stitched up on chairs by the nurses station, given results in the waiting area, on drips in the waiting areas etx.

If there's no beds, they can't unload thE ambulances, or get patients out of the waiting areas into the cubicles.

This is exactly true, having worked in a GP surgery. A simple sick bug requires a GP appointment, or a cold! The 20-45 year olds are the worse for this. absolutely no ability to look after themselves in a lot of cases.
They are also likely to not turn up for appointments, when the GP rings them (trying to track them down as not in the surgery) they say they are fine now. They have 3 text messages that give them the ability to cancel and they don't!

Your experience isn't necessarily universal. Last time I went to A&E, it was packed out but I was seen fairly quickly by a triage nurse and directed to an attached urgent treatment centre for more minor injuries (in my case, injuries from a fall including a broken nose). So far as I could see, everyone in the waiting area had a good reason to be there, and they were all perfectly reasonable and polite (indeed, we struck up some quite enjoyable conversations with them while we waited}. Some people, including me, had partners with them but no-one had brought in their entire family.

The reason we had to wait was that in a centre which was clearly designed to treat several people at once, they had one doctor and one nurse. Between them they had to deal not only with the patients but lots of things that other staff would or could have done, including fixing the printer, applying basic dressings, showing patients to the X ray department, handing out information etc. They were doing an absolutely heroic job but everything was taking much longer than it needed to. I don't know whether the lack of staff was down to money, problems in recruiting, people being off or whatever, but the patients certainly couldn't be blamed.

This was the situation for me. I didn't need to go to a ward but there were no A&E cubicles so I sat in a wheelchair in the corridor for 8 hours until a room became free. With me were two elderly ladies waiting for ward beds. There were several ambulance crews hanging around because they couldn't leave until their patients had been handed over and there were no doctors to hand over to. Meanwhile people being told (as I had) to get themselves to A&E if at all possible because there were no ambulances...

The thing is, a lot of the issues you mention are caused by inadequate mental health treatment that then escalates until people are in crisis or can't cope any more, and end up in A & E, costing a lot more money than if they'd had the help they needed when they first needed it.

And also, hospitals need to bring back "matron" types who promptly address unacceptable behaviour and enforce rules. The family should have been told that one person could accompany the patient into the waiting room, and the rest needed to leave. The women wanting to charge their phones should have been ejected immediately.

I visited my Mum in hospital recently and there were similar issues with people not leaving at the end of visiting time or eating meals at people's bedsides despite there being a written notice saying not to do this. I was shocked that not one nurse or doctor stopped to say, "Excuse me, that's not allowed."

I was on a corridor for 18 hours and on a trolly for 29 last week. Of 24 cubicles only two people were under 80/90. We have a separate children's A and E.
When I got to a ward they were fantastic.
Our social care is crap and this isn't getting better.
Love to know how we solve it.

Any public space is going to have its share of people who are not behaving in an optimum way. Add in 24 access and medical attention and you're going to have all types of people who are vulnerable, behaving in challenging ways, or there because they've no where else to go. There may well be higher numbers of these people in A&E of late, because other services that may have supported them elsewhere are on their knees. However, this is an entirely seperate issue to the poor state of the NHS. Remove these human 'inconveniences' and the waiting times would still be ridiculous. People would still be being treated in corridors and waiting years for operations to get them out of pain.

I've been in our local children's A&E more than I'd have preferred recently (pneumonia and anaphylaxis - different incidents) and we've been triaged pretty quickly - with the pneumonia within 15 minutes, and with the anaphylaxis in 5. Then it's WAIT obs WAIT doctor/ANP WAIT x-ray or sent up to paeds for observation WAIT doctor WAIT drugs (antibiotics or new Epi-Pen) home. Both times we were in and out within four hours, which I think is pretty good.

But there were a surprising number of children who apparently needed their entire family with them, which I found very odd. It's not exactly a fun day out, and I'd rather just be managing me and the ill child than managing us AND DH and the other DC! That said, I would have loved to have had another adult who could have gone and got coffee for me - there are no machines in A&E and the coffee shop and hospital shop are miles away at the main entrance, so maybe I'm just envious.

So it seems I have conflated two issues - yes the NHS is on its knees. But also lots of people in a&e do not need to be there and/or do not know how to behave in public.
Also I think we can confirm that a&e experiences are quite different across the country and varies from person to person.

I 100% agree with this.
It’s whoever created such a lazy, badly managed system.
Can you imagine if a private company was ran in this way? Say Amazon for example?

The length of time it seems to take A&E teams to fart around chasing up results, deciding what to do then probably telling you they don’t know, is often almost laughable, were it not so serious.

Im not saying people don’t get good treatment sometimes but in general, the systems in place don’t work for the number of people coming through.
The number has massively increased, yet the system hasn’t changed enough to keep up.

Let the military take over an A&E department and see the changes.
In fact, let them take over GP surgeries, outpatients, wards and A&E and see the change!

How many employees does Amazon have and what is the ratio of patients to nurse in an average A&E? Unless NHS can produce clinicians out of thin air, there will obviously be a wait. And seeing that A&E is open 24/7 there isn't ever going to be a time when you can see staff member right away. I don't really understand why you think it is lazy.. It's a simple matter of too many patients and not enough staff. And I don't recall Amazon needing to check with the government if they can hire an extra person whereas a lot of trusts in this country have recruitment freezes because they overspent money (on much needed staff!) and the government put restrictions in place.