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!

Have. Could have.

And no, it's the opposite. Everybody arriving at A&E is triaged and the most serious cases will be seen the fastest. I was seen within 15 minutes with stroke symptoms, the woman opposite me with stomach ache was called in three hours later.

How did you know the sleepers were homeless? Did you speak with them ?

lol at you correcting me.

No the most serious patients get admitted, you think someone having a stroke would be home in 3 hours??

There is a well-worn saying that if something is free, people will treat it as worthless.

Potentially not though if you can't ever get through to your GP which is a huge part of the problem. You also get mixed messages to go to the pharmacy for things that they then won't deal with and refer you to GP who you then can't get an appointment with. Yes people shouldn't be in A&E for many things but where else can they go?

Have. Could have.

OMG I'm cringing for you lol.

The PP is not your child or your pupil.

Our minor injuries/urgent treatment centre is fantastic. They have a doctor and experienced A&E nurses, a plaster technician, can x-ray etc and it's open from 8-8, 7 days a week. Not enough people seem to know about it though. My friend wanted me to take her to A&E when she had an unfortunate incident with a pair of secateurs, but I insisted that the UTC was just as good and would be far quicker. She had no idea we even had one and she's lived here for years, and they did a beautiful job of stitching her finger back together.

I was really cross with my neighbour a while ago when she fell down the stairs (pissed) and gashed her arm. Her DH was too pissed to drive her to the UTC so they called an ambulance, which took her to A&E in the city a few miles away, where she waited hours to have it stitched and added to the pressure there.

I've told her to ring me if anything like that happens again, and I'll run her down to the UTC.

A&E is like a tenth circle of hell on a weekend night. The city has loads of clubs and pubs, and the number of pissed up people injuring themselves, either accidentally or in fights, and ending up in A&E is astonishing. It also has a lot of rough sleepers, who often aren't registered with GPs, so you see a fair few of them in A&E, because they can't get help anywhere else.

YANBU

The only two times I've been as an emergency, I dragged myself in to A&E in the early hours, passed out, was seen immediately, and was on a surgical list by 8am the same morning.

The other time, I developed unexplained bruising 2 days after chemo, had been told to go straight to A&E if that happened, which I did on Christmas Eve. I was put in a room on my own immediately and treated within an hour.

I've taken 5yo ds once on NYE when his idiot father returned him to me with an unwashed 4 day old dog bite, and a raging infection. Again we were seen immediately, given a holding dose of ABs, sent home to avoid all the drunk idiots, and told to go back at 9am on NYD when they would be quiet.

I don't go to A&E unless it absolutely cannot be avoided.

If the population had been properly vaccinated, perhaps 10% less seriously ill people may have made life easier in A&E.

I was in A&e recently for 27hrs waiting for a bed. Then when I was discharged a couple of weeks later I was told at 8am I was being discharged by the time meds where sorted and discharge papers where written I didn't leave until 7pm, this is a bed being taken up unnecessarily that could of been given to someone in a&e. How many patients are taking up beds waiting to be discharged. They need to let people go and it will really help clear a&e.

How could you possibly know the homeless people didn't require medical attention?

This. Some people are lonely, inadequate and unable to cope with life. A and E is a warm, safe space. They gravitate to it because they don't have anyone or anywhere else.

I was in A&E in Italy last summer in a large city hospital. As soon as you walk in they quickly triage the patient and send you through some security doors to the patient only waiting room. Only the patient can go there, family are not allowed in & have to either go home or wait in a normal waiting room. It was so quiet, no abuse to the staff & plenty of seats. No children as they go a dedicated kids A&E. I was there 6 hours in total for a suspected broken ankle.

I’m a nurse, not in ED I should add but in critical care. I’m friends with ED nurses.

Yes there are people who go to ED inappropriately, but many of them do need medical care just not emergency medical care. Primary Care has semi collapsed under the strain so people struggle to see GPs, a lot of things aren’t caught in the early stages and get worse.

The people who are ‘time wasting’ are generally dealt with very quickly compared to those who do need urgent or emergency care.

I work at one of the largest hospitals in Scotland. ED Resus has breached capacity multiple times, they are all needing to be there. There’s many many frail, complex elderly patients who come in with chest pain, falls, chest infections, UTIs, fractures to name a few. These patients are often needing lengthy admissions, and once they are ‘medically fit’ they need more care at home or to move to a nursing home, so have to wait in hospital until that happens. This cycle continues as patients like that might need a bed for 1-2 years but 50 could need admitted a day.

ED has patients on trolleys and in cupboards and all sorts because assessment / short stay units are full waiting on ward beds and the wards are full with many people waiting on social care. The patients are more complex, sicker and frailer than before and for many being failed by social care and failed by primary care so end up in ED.

On top of that the NHS seems to be as cash strapped as ever with NQNs in September not all being able to get jobs. Every department in my hospital runs at red or black for staffing.

The NHS needs really innovative solutions and the government needs to be really honest with the public. However, the NHS currently is firefighting only and not capable of much dynamic policy or solutions.

The public seem keen to ‘bring back the matrons’ . My mother qualified in 1980 under the old system. Most patients 80+ who are kept alive now died then (treatments hadn’t advanced as much being one reason). There was more elderly long term care beds but there was also institutionalism and abuse. The NHS system of the 1980s would also buckle under the strain in the modern day.

On my most recent shift, the waiting times in ED was 30 mins for triage and 12 hours to see a doctor. Weekends and overnight is always busier.

`I broadly agree with this but there will always be times when the GP is actually at fault. Over 2 years I saw 5 different GP's about a problem I was having and all dismissed it as a 'sprain'. No tests and no referrals. In fact I think they started to think of me as a nuisance and when I called I was always triaged to a nurse.

I'm now waiting for spinal surgery and the delay has left me with permanent nerve damage in my arm.

I wonder if GP's expect the patients to be wasting time so they no longer entertain anything serious.

Love your name.

The elderly often don't have social care in place and so can't be discharged !

This is where a chair ward is needed, for patients to be transferred to whilst waiting for home time.

I don’t- a man with a big rucksack came in, got comfy, and plugged his phone in last night!

So literally if there are “too many patients and not enough staff”, they need to introduce a more effective system.

I know what you’re saying about not enough doctors etc but surely they could increase HCA and phlebotomist positions to help speed up the processes.

No but people should have a minimum level of common sense …taking in FIVE members of their family to take up seats and scoffing smelly takeaway should not be beyond anyone’s capacity 🤷🏻‍♀️.

Incredulous!

My friend is a GP and she has told me that lots of the people she sees dont need to be seen by a GP - they have minor ailments that they

How do people know if they don't go? Add in people with mental health issues plus some are just thick. I think it's balanced out by people like me who never go the GP unless im ill. Who has time to go for no reason?!!!

The idea that perhaps they can ride out a virus or minor knee strain with some self care is not even a consideration.

How do you know if a virus is bacterial or not? Or that the knee strain isn't serious?

We also have an ageing population & so not have the infrastructure to support it. Lots don't want to acknowledge this for some reason.

Honestly, I think part of the problem is that people only see when there isn't good service. It's totally unacceptable that some people are waiting for ambulances, or stuck in corridors, or waiting very long times to see the doctor, but they are still (fortunately) the outliers, not the norm.

I had a look to see if my A&E has live times up. It doesn't, but many hospitals do.

Cheltenham general has an average wait of 57 minutes to see a clinician and the average time in the department is 3hrs.

Gloucestershire Royal is much worse though (clinician 2hrs, average time in department is 9hrs).

Torbay - longest wait to see a clinician 1hr 54.

Midland Metropolitan University Hospital (for treatment or admission).
Majors Emergency Dept: 3 hours 30 minutes
Minors Emergency Dept: 1 hour 31 minutes
Children's Emergency Dept: 1 hour 26 minutes

These are averages, so whilst there will be some worse, there will be some better. In many A&E's it's possible to be in and out in a reasonable time, but no one talks about them.

How do you know if a virus is bacterial or not? Or that the knee strain isn't serious?

Well a doctor won't magically be able to tell on day 1 of an illness if something is bacterial or viral and a lot of the time it won't matter as your body will fight it off regardless. So you only need go to them if you're really sick or if things are deteriorating.

Likewise with the knee strain. You need to rest, ice, compress and elevate and see how it goes. Then go to a doctor for a referral if it doesn't come right.

It's a lack of open public spaces with facilities like being able to change your phone that's at fault imo.