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!

Well a doctor won't magically be able to tell on day 1 of an illness if something is bacterial or viral

Who gets a doc appointment on day 1 of being ill? 😆

and a lot of the time it won't matter as your body will fight it off regardless.

You often don't know this if you haven't seen a GP though.

So you only need go to them if you're really sick or if things are deteriorating.

The hospital doctors I know say too many people are in A&E because they haven't been able to see a GP and have deteriorated.

I recently updated my paediatric first aid for work. I understand it's best to be safe but the advice for literally everything is get medical advice, if it's not recommending A&E it says call 111. eg any bite must be checked by a medical professional even an insect bite or a bite from another child that hasn't broken the skin! I could not believe what I was being taught. Now, knowing it is ridiculous, when I inform a parent their child got bitten I will be telling them the advice is they get it checked. I can't say it's stupid advice I can only try get that message across by phrasing it "the advice I need to give is.." or something like that. Then a parent will probably feel pressured to get the kid checked when they think it's stupid so as childcare doesn't judge them as neglectful.

Every time I've called 111 I've had to go to A&E, once was because I needed an urgent prescription my gp had messed up- it was a pre existing condition I knew what it was and was still told I had to be seen urgently because some of the symptoms ticked the box for that. Complete and utter waste of NHS time and money.

And then I have had to go to A&E because it's an emergency but it would not have been an emergency had i been able to get gp appointments and refferals for my worse health condition that I can't get anyone to treat just refer me from department to department.

My last trip to A&E was for a child and it was around 3 hours. Lovely staff, reasonable wait, clean etc. Maybe because it was kids emergency department but I was surprised as was expecting the hours and hours everyone expects.

Not if it's for something like a fracture. That needs seeing quickly and will need x ray and plaster cast that a gp cannot do. Or a wound that requires stitches etc some things need seeing urgently but the treatment needed is quick in A&E then they follow up with primary care at a later date

Being in and out in 3 hours tells me you could of waited for a GP appointment

So much nonsense. I've needed stitches & been done in 3 hrs. You do not have to be dead for a legitimate reason to attend A&E.

It's not all down to social care . I'm a " frequent " visitor to A&E and same day emergency care in my specialist hospital partly bc when I flag up issues with my team they ignore them when they happen and then I get more and more poorly and end up in A&E bc no one has helped at the start. I have a brilliant gp but let's lots that only hospitals can do . I

I don’t doubt the NHS is underfunded but some people’s behaviour at A&E (and generally) is beyond unacceptable and I have no idea how staff don’t lose their shit every day, let alone continue to be highly professional.

This to 100% lots of medically fit for discharge patients in hospitals waiting for care homes, care plans and or equipment.

Last week my local A&E announced that their current wait time was FIFTY hours. Last time I was in there, the waiting room seemed to be approximately 80% homeless heroin addict/alcoholic.

The problem is there is often a reason I woke up in a&e once had no memory of what happened and a nurse with a right attitude wouldnt tell me anything all she said was i should be greatful they haven't called the police and pressed charges on me for assaulting medical staff i was so confused and didn't dare question it i stayed quiet and I got discharged shortly after with no clue what had happened. Later that day I collapsed at home it turned out I had a bleed on my brain that they had completely missed. It's not always black and white in a medical setting why someone is acting the way they are whether it's a brain injury, dementia, drugs (even prescription drugs), mental illness, infection, low blood sugar etc etc

True, it’s not obvious why someone is acting as they are in a medical setting, but that doesn’t account for the notable deterioration in behaviour and attitudes the last 10 years that’s observed across society.

Bad behaviour includes bringing 6 people with you and eating dinner whilst sitting next to someone very unwell and generally being inconsiderate.

I agree with that our a&e is actually really good at chucking people out they usually do regular announcements to tell family/friends to leave they never stopped from covid and iv never seen anyone eat a takeaway in a&e so I don't no how they would respond to that.

True, it’s not obvious why someone is acting as they are in a medical setting, but that doesn’t account for the notable deterioration in behaviour and attitudes the last 10 years that’s observed across society.

But some of this is just because there are more people in the first place, more older people, mentally unwell people, lack of investment in the country & its people in general.

I had to go to A&E two weeks ago with a couple suspected fractures, as all the minor injury units here are closed at weekends. I went with a great deal of trepidation, having checked the current waiting times before setting off, but in fact I was there and back within four hours, including over 30 miles of driving, parking and DH fetching a wheelchair for me. And yes, there were fractures, so waiting for a distant GP appointment wouldn't have been advisable. I waited until Sunday morning rather than go straight away on a Saturday night, admittedly, so drunks and family gatherings were thin on the ground.

No I went to a&e recently with chronic back pain and I'd lost the ability to walk. I half knelt half stood for three hours crying in agony, an elderly woman sat in a chair shaking and confused and kept falling on the floor. A man with a head injury dripping blood on the floor. A woman screaming in agony with (I assume) abdominal pain. And we were in the fast track bit. The non fast track was rammed.
The staff completely ignored everyone.

During my stay my pain meds were given wrongly on 4 different occasions, one of which could have killed me. Incorrect information was passed on to the nurse cause me significant pain. I was also sent home with incorrect meds which wasn't resolved for several weeks causing additional pain and discomfort.

A friend recently attended a&e with her mum who had internal bleeding. There was discussion with the doctor about surgery. The doctor then decided surgery was not viable so she needed moving to icu but didn't tell anyone so she stayed in a&e. Nurses kept the patient waiting for surgery , told family she was stable so they went home. She declined and died alone with a nurse only noticing when she went to do obs.

Another elderly person I know went in with breathing difficulties, spent 6 hours waiting in a ambulance. Eventually got a bed and was put on oxygen, staff regularly forgot to feed her or take her to toilet. Some staff seemed to think she could do it herself. She was sent home with no care plan. And has high levels of confusion (presents like dementia) which only started after being on hospital.

People don't like to accept that half the problem with the NHS is the people who use it, they would rather scream about how the tories have underfunded it! The NHS wastes absolutely thousands each year and so many people waste NHS resources it's unreal! From the neurotic people who ring the GP and demand an appointment every single time they or their child has a sniffle, or the people who don't turn up to appointments, the people who turn up to A&E with minor ailments that they shouldn't be wasting A&Es time with, the health tourists who come from all over the world, get treatment and then sod off again without paying, it all needs ripping apart and restructuring.

When annoying crosses over the line into anti-social then it's time for The Order of the Boot. Too many seem to think NHS staff are fair game because "I pay my National Insurance y'know!"

I'm security in an nhs hospital that works in a&e, people book on for some where to sit, even when nothing wrong with them it's a joke, half of the time it's like something out of a carry on movie, why 1 person needs a house hold with them is beyond me.

You be wrong. I was in and out with a broken wrist - assessed, x-rayed, remote consult with orthopod, treated, cast put on - in 2 hours. Staff said it was a quiet night. (I came in at 6pm.) I was impressed.

DH has terminal cancer and is very anemic. Several times he's been sent to A&E for an emergency blood transfusion. We have had to wait several hours to be triaged each time.Twice he passed out before being seen. Yet once through the triage door they couldn't do enough for him
There were several obviously very ill patients waiting to be seen but plenty that didn't need to be there. Colds.small cuts..family days out etc.
DH has refused to go to A&E anymore. .

Yep. It’s become a sort of night holding pen for disaffected and homeless people quite a lot of the time.

Here in Wales, it's very much the system that's understaffed and broken.
https://nursingnotes.co.uk/news/nurses-declare-national-emergency-after-being-forced-to-treat-patients-in-car-parks-cupboards-and-corridors/

"It's not the NHS that is on its knees ". No it IS. You just had a good, quick A&E experience, if you were in and out in 3 hours. Most people can't even get seen by triage within 3 hours, lots of people waiting hours, lying on trolleys in hallways overnight etc.

Plus the nhs is on its knees.

But I don't see the nhs as some grey enigma that's underfunded. I seen so much individual incompetence, and mistakes, and people not doing basic parts of their job. And cost cutting. It all comes down to money. And incompetent staff.

For example, I've seen staff claiming referrals not received. But that's just not true, everything's electronic, they don't get lost in the post or lost because of a carrier pigeon.

I've seen consultants discharging patients after operations telling them to take paracetamol. How is that ok. Trying to save money?

When then because they are so ill, the patient returns to A&E the consultant comes to see him, before rushing off to perform surgery, but whilst saying patient needs pain medication he forgets to actually prescribe it, so ward sister says she can't give any medication because it hasn't actually been prescribed. She says she can see it on the action plan but it hasn't been prescribed. She's phoning and phoning for ages but no one responds. I myself then go to a different dept, and only then to I get action. I go back to A&E and then medication is given. How is that ok? The consultant didn't do his job properly.

I've made 8 phone calls to try and get my 2nd osteoporosis annual infusion. But I then am told I should've had blood tests 3 months ago. No one said! So they say they'll send over blood tests details to gp. But they don't send. So I chase. She admits they haven't been sent yet. Turns out my vit d is low, so I need a dose, so now can't have the infusion for 6 months.

These are minor mistakes. People not doing their jobs properly. I have a list of jobs to do at my work. What if I didn't do them?

These are really small little jobs, but they're part of someone else's job and when they don't do them the whole system stalls.

How do you explain the lost referral, a consultant not actually prescribing or documenting the medication a patient needs. Staff not sending blood tests to gp.

Why are these small failures allowed to occur? The NHS isn't failing, as if it's some sort of grey enigma. It is failing because of individual incompetence and negligence and failures of individual staff.

Imagine if I did payroll. 12 separate things to do, to run the whole process. I do 11 but not the 12th. But then 'forgot' to send it to the bank. So you don't get paid. Oh well......