To think 70% of people shouldn’t be in A&E

[PrettyPleaseXo]

Recently I was admitted in excruciating pain to A&E due to kidney stones. Over the time I was there it got progressively busier as expected and there was corridor care (I was stuck in a corridor without pain relief and crying in pain for two hours) and ambulances backed up out the door.

When I was discharged and went back out through the A&E reception/wait room I couldn’t help but notice
that 80% of the people sat there looked perfectly fine, chatting etc and didn’t appear to be in either an accident or emergency.

AIBU to think that unless you’re seriously unwell, in acute pain or have an injury that needs immediately addressing you should be turned away from A&E and told to go
to the GP instead?

Yup, it's true. You'd be amazed at the people prepared to sit for hours for the most basic of things 🙃

Our GP surgery is amazing and just this week I had a callback, appointment and antibiotics all the same day I called. First time I’ve ever lived anywhere with provision like it, I love them in there. Another day and I’d have probably been at A&E with a horrendous infection (it was much worse than I’d thought) so well done them for keeping me out.

I think their secret is a very efficient callback system and good staffing levels.

I’m an HCP in a team that works with people who use A&E “inappropriately”. It’s really complex. There are many many reasons why someone may present themselves there for reasons that are neither accidental or an emergency. In many cases we are successful in putting things in place to help reduce / stop those clinically unnecessary visits. But it relies on other services being available, such as mental health and social care. We’re also quite an expensive service at point of delivery as we often need to work with people over quite a long time. Although it absolutely saves money in the long run, we are constantly having to justify our worth and explain why are numbers are lower than services that have. Say, six sessions then discharge.

from a personal perspective, I don’t think I or my kids have ever sat in the A&E waiting room wailing, bleeding every where or vomiting, but we still needed to be there. A suspected broken arm, an early pregnancy bleed, a fall from a climbing frame onto bar stomach first.

you really can’t tell just by looking at someone.

i live in Cornwall and unfortunately the issue we have is that X ray machines are closed after 5pm in our minor injury units and some don’t have X Ray machines at all. So if you break your arm after 5pm you’re stuck at Treliske A&E unless you drive a long way to either Bodmin or possibly Penzance. Apparently Falmouth has one open until 8pm but it’s sometimes closed due to staff sickness or holiday.

The last time I was in A&E at Treliske (such a sad memory for me!) it literally smelt of alcohol. And was mainly injured drunk people and elderly people who had falls.

It would really help if we had a minor injuries near Treliske. But it has to be open late (11pm) to be effective and have an X Ray machine that can be operated by several trained staff.

Im sure our Newquay MIU is closed on bank holidays. May have changed now though.

It’s just so confusing and disjointed. I guess the lack of money or even problems with recruitment is the problem here. I hate living in Cornwall (I am from Cornwall) so can’t expect others to move down 🤣

I’m lucky that we have the same. My GP surgery is brilliant. Online consult then a same day appointment. It’s a busy inner city practice too so I don’t know how they do it.

I was there once with quite a big gash in my head having fallen off a ladder. But it was in my hair, so not visible, and I felt fine. My GP couldn't have dealt with it.

However I'm sure you're right about many of the people there.

I heard a recent interview on radio 4 with some government researcher - who when interview started saying vast numbers didn't need to be in A&E actually said figures showed that was wrong and most did now though they were trying to improve alternative provisions.

He also spoke about how paramedics are getting good at treating and stablisng patients at home - which is what first happend with Dad - stablised enough to see GP later on - but I know neigbours had a go at Mum for calling an ambulance in first place as they didn't take him into hospital it must not have been needed. The paramedics and GP said she did the right thing - he was unconscious and have a fit for first time - lots of underlying medical issues and various medications - I think most people would call ambulance in that situation.

Number of GP per hundren thousand of population varies across the UK - as does population demand - age and general health playing a role - it's often harder in rural or deprived area to get GP appointments than in more affulent areas. I suspect that why there's such a variation in posters experiences.

I think you are right, but I also think that it is the lack of other services that is the biggest problem. When I was a child 30+ years ago, you could:

1. phone your GP, get through within a couple on minutes, and book your appointment to have your regular condition monitored, or your check up before your repeat prescription of your long-term medication.
2. turn up at the surgery, with your child whose sore throat and fever meant that they probably needed urgent antibiotics for their raging tonsilitis, and sit, may for a while and then be seen.
3. Ring your surgery and get the duty doctor to do a same day visit to your elderly mum who was coughing and had a painful chest, and they would check her oxygen saturation and, if it wasn't so low she needed A+E for oxygen, prescribe antibiotics for her chest infection at her bedside.

Now
You keep trying but you can't get through. You are running out of medication and don't know if you are controlling your symptoms well enough.

You spend ages on the phone and then don't get through or there's no appointments that day so you have to ring back the next day. Your child is in pain and you guess they need anti-biotics. You maybe ring 111, who phone you back hours later, and sends you with a feverish child who just wants to sleep to an out of hours appointment somewhere miles across the city. At least if you just take them to A&E straight away, you are going somewhere you know where it is, you can go in the day time, and there are probably good bus routes to it if you don't have a car and can't afford a taxi.

You can barely get through to your surgery and when you do there's no appointments. If you get triaged through 111 they will probably tell you to take your mum to A&E anyway. When you do there will be a long wait, so you might as well get in that queue.

There is so much focus on A&E, but the real problem is the totally lack of other services.

Please 🙄I have to go semi-regularly to A&E as i have a chronic condition that flares as it wishes and with varying severity. I look fine however ( while I'm visible) but the rest of the time I will probably be stuck in the bathroom unable to keep anything down and horiffically de-hydrated. The GP can do sweet FA, and in the past landed me in resus due to downplaying things.
The local minor injury unit has little provision past putting a sticking plaster on, or (if you are lucky and someone who can prescribe is in) antibiotics. They only have an x-ray tech twice a week, and no provision to actually put a plaster cast on if you have broken something!

My GP surgery also currently only contains 1 locum - of questionable usefulness - known locally as the chocolate tea pot locum, and one poor very overworked practice nurse. There has been 3 new housing estates go up in the last 2 years, and a full hotels worth of imigrants just down the road, who have the "priority appointments" and a weekly locational visit.

you are lucky if you can even get an URGENT appointment for 3 weeks time - and thats for an already nasty oozing infection that needs antiobiotics, as the local farmer found out the hard way. (he went to A&E when the recpetionist told him that, and ended up admited for 10 day on IV antibiotics)

I was suposed to hava a weekly heart monitoring session at the GP, but they cancelled it due to lack of staff, and then i ended up in the hospital.

GPs surgerys are understaffed, underfunded, and over prescribed. and i can think of a few ways to deal with it too.

In the mean time. I will continue to go to A&E when necessary

Yabvu. Firstly, make your mind up, is it 70% or 80% you think shouldn’t be there? 🧐 Secondly, you have no idea why people are there. You have no idea how people hide or express pain. My family a+e visits include a small open fracture to a finger - no noticeable pain, fractured ankle - no noticeable pain, deep cut with foreign object in wound - no noticeable pain, retained tampon - no noticeable pain, heart palpitations + chest pain - no noticeable pain. I could go on, but really, just stop with your judgement 🤷‍♀️

I kind of agree but sometimes when the other services are full it's the only way to be seen!

My son (2) had a serious choking incident at nursery this week. They advised being checked over by a doctor. I rang the GP, who agreed he should be seen, but all their appointments were full, so directed me to the urgent care centre. Rang them, they were also full so said we'd have to go to Paediatric A&e. It was frankly a bit ridiculous, as most of the other kids there were obviously sick, and DS looked perfectly fine, but I had tried the more reasonable options.

Believe me, I have no desire to spend an entire afternoon off work, sitting around in A&E either, we really only needed a quick 5 min appointment with a doctor.

I think it's so hard to judge - as many posters have said, you can look fine but have a genuine need to be there.

But, last time I was at a&e (with my disabled brother who'd had a seizure), there was a lady there with her 3 kids. The youngest was about 3 and he had an earache. All 3 kids (including the sick one) were running riot through the department and eating copious amounts of snacks etc.

The lady was very vocal and complained constantly to staff about the wait. Her child seemed fine to me. And I say that as a mum to a DS who had repeated ear infections as a toddler, including two separate incidents of a perforated eardrum (with hearing loss as a result too).

The only justification I can think of for bringing that child to A&E on a weekday afternoon is that the family didn't have a GP to prescribe antibiotics. Which begs the question, why not?

There was a similar thread to this yesterday. I was advised to go to A&E after fainting in a supermarket. Felt fine enough for DH to drop me and run (only 10 minutes from the hospital). I probably looked fine to most people, but, blood tests found I was severely anaemic, to the point it was life threatening.
If I had ignored advice, or gone home I might not be here now.
My experience was good though, triaged an hour after arriving, bloods etc seen by dr after 4 and on a ward having a transfusion after 6 hours.

My minor injusires has an xray tech twice a week, and no ability to put a plaster on if there is a broken bone... they just send you off to A&E anyway - in which time youve sat in MI for 4 hours to be seen, then tottle off to A&E where you have to wait even longer. MI also cant give you anything stronger then an Ibuprofen for the pain - which doesnt even touch the sides with a broken bone 🙄

My husband don't need to be there either (at urgent care as was told to go there but at ours A&E are all combined) but needs his dressing changed after an operation and there is no nurses appointments in our surgery for 2 weeks.
What is he supposed to do?

The whole system is on its arse with demanding pressures. Yes, a lot of people may not need ED but where else can they go with the lack of services within the communities. It is a matter of time before it becomes private. There just isn't enough money to go round and the money the NHS do have could probably be spent better. Too many chiefs and all that. Is my opinion anyway not saying my opinion is the right one but that's how it would appear anyhow.

Where someone mentioned people go to A&E as it's the only way to see a Doctor, on the flip side you get people ringing their GP because they don't want to wait X amount of hours in A&E. These people should be in A&E as it can't be dealt with at the GP surgery eg chest pain, falls and in pain, urine retention and head injury for example.

They should have a 24 hour GP next to A&E so patients not needing A&E can be signposted there by triage.

The simple logic @phoenixrosehereis that people with time on their hands will pop down to the Dr /A&E more regularly than those that work FT. Most GPs will say the same. FT people don’t have that luxury.

The Penzance one is also usually closed overnight now I think, I saw a campaign about trying to reopen it.

Our a&e has this now. So the OOH doctor provision is in the same unit. You go through the door, talk to the nurse on reception and are directed to either OOH or a&e. Seems to work well.

No one is there for fun thats for sure! Unless you are medically trained, and even then how can you know someone "looks fine" FFS! There is a growing population in this country .Most people will need urgent care /A and E at some point in their life .Hospitals are under immense strain now .Our local Hospital has A and E ,and Urgent Care next door .Many people seemed "fine " on my last visit but clearly werent and nor was I ! Try not to judge everyone so harshly you may find you dont look "ill" next time but worries over constipation ,heavy bleeding or an accident at home may not be visible

In terms, that they’re not there because they want to be.

There are also NHS bonkers workflows/policies which don't help.

So on holiday in the UK and dd breaks a finger. We go to the local hospital minor injuries and they x ray and strap it. They say she will need to be seen in fracture clinic back home the following week. They write me a letter and even give me a disc with the x-ray images on it to take home.

I get home, ring up the fracture clinic who will not see me without a local dr referral and tell me to go to a&e. I think this is bonkers and ring my GP and ask if they can refer me to fracture clinic. No they can't. So 7 hours waiting in a&e to be seen, new x-rays and an appt for fracture clinic!!!!!! Crazy.

DS years ago was once ill on holiday (febrile
convulsion v high fever general lethargy) Ina mountain resort in Austria about 45 minutes drive down a mountain if you needed a hospital.

the private health clinic there was absolutely amazing and actually not that badly priced for the care we received. 3 doctors appointments, a room where he could be monitored in and really good communication.
yes it cost £300 for the whole thing but it was amazing.

expecting to be able to access healthcare when we want it should be a basic minimum