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?

Our A&E and minor injuries are together and share a waiting room, and the same receptionists cover both so you check in and they decided whether A&E or MI is more appropriate.

You have no IDEA why other people are in A&E and are in no position to judge.
Last time I was in, it was on the instruction of my GP. Yes I looked fine, because the infected bite I had was hidden by my clothes, and had not YET become blood poisoning. I went straight onto a strong IV antibiotic, and had surgery later that day, and walked out once the paperwork was complete. Perhaps you think it would have been a better use of NHS resources to wait until I actually had sepsis and became disoriented, then hope someone would call an ambulance, so I could be rushed to A&E to be stabilised and then up a ward for a few days?

I think @CassandraWebb’s post cuts through all the crap and straight to the most important point. Nobody, not you or anyone else, has a single clue why any other person is in A&E.

My son went over on his ankle a bit while walking quickly to catch up with me. He couldn’t put any weight on it. At A&E he was white as a sheet, but no tears or much appearance of discomfort. He sat there stuffing a sandwich in his face and laughing at TikTok videos. Left the place in a boot because … oops … broken foot.

Smart move not including the poll, because you are being very, very unreasonable and I suspect you know that. You have no business scrutinising people and judging whether or not they are entitled to be in A&E.

But I would suggest that A&E is not the right place for this.

Last week I was there due to kidney stones – very painful. The waiting room was full with a number of people who were clearly drugged up and were apparently frequent attendees at the hospital. Some of them were going round begging cigarettes from other patients and swearing and shouting when refused. Then a physical fight broke out between 2 of them.

People who are sick, injured or in pain really shouldn't be subjected to that kind of behaviour.

Same with GPs. It’s about time we charged for appointments

Great idea, let's make it harder for people to get an appointment. Not only will they struggle to get an appointment, some people will also struggle to pay.

Yeah my friend and I both broke bones during a skiing lesson as children. He was making me laugh so much at a&E even I was shocked to find i.had broken a bone!

Another time I continued skiing for 3 days with my wrist in a bandage because I thought it was sprained not broken. And I am a huge wimp!

I will give you my example.
I went to the doctor because I had a hard lump on my neck the size of a pea. The GP had a look and deemed it to be a skin cyst. But they do not remove them. Neither did he refer me to whoever in our NHS board does this. It is the easiest, simplest procedure. He gave me a card for a private hospital that may do removals. I checked it. It was during the covid tomes and they had zero appointments.
I was quite puzzled, but what could I do?
Well, while waiting it got infected. I was lucky: antibiotics worked, the cyst did open, but not an open wound that needed packing, no further infection and no sepsis.
But you can easily get sepsis from things like this. In my little office, less than ten people, two of them mentioned that they knew someone with similar and who had open wounds that needed daily or almost daily dressing by the nurses. For weeks on.
Now... this is rather silly, is it not? It is literally ten minutes to remove it. Much cheaper to the NHS. Much safer to the patient.

Yes we have nurse practitioners and a paramedic who can prescribe. Lots of tests done at the surgery, definitely blood and urine but also more unusual stuff e.g. one of my kids had white coat syndrome so had a monitor fitted for several days so they got accurate BP and pulse rate. Also support groups so I get invited to a meet up with tea and cake every month with a carer support worker who can give advice/support or sign post you to services. We also have a satellite surgery which is actually in a hospital so easy to get things done there e.g. they phoned to say they wanted a follow up blood test and I could go to the surgery or the satellite where the results would be faster. I guess we don't know how lucky we are.

I've got similar although mine is more like a broad bean. It's been there since July 1989! GPs have commented on it over the years when feeling my glands but no offer to remove it.

I was sent to a&e by an 'associate physician' with a letter for something rare and obscure he decided I likely had after unexplained pain in my face and made an appt at my health centre.

Never heard of it and was terrified I was about to die.

Presented myself with my letter for the doctor to gently say he had seen this three times in his career and never in anyone without vision issues or under the age of 80.

This is another problem with the NHS. Complete lack of foresight (and resources).

If they would spend some money to sort things like this they would actually save money in the long run.

Same for consultants - if people didn’t spend so much time on a waiting list they would get sicker and sicker and end up in A and E.

So true. But let me give you an almost identical example, with a very different outcome, which highlights, I think, why it CAN work.

DH had what had started out as a blackhead or somethign on his back. It kept getting bigger and we'd attempt to get rid of it or leave it or whatever. Eventually, it got very big,r ed, swollen and sore (this is over MONTHS/years). We conteacted the GP via our online portal, with photos. He received a note to say the GP would like him to see a specialist (dermatologist I think) and it was scheduled for the dermatology clinic adjacent to our GP practice within the next week or two. She looked at it and explained to him that her view ws that it would most likely need to be removed but she would like him to take antibiotics first to see. She gave him information on how, if after the antibiotics it was not better completely (her expectation) he could contact the clinic directly to book an appointment for surgical removal.

He took the antibiotics. As it turned out, it has miraculously disappeared completely and so he has NOT booked the appointment.

If it can wor in my little corner of surrey, why can't it work elsewhere? I'm sorry for your hideous experience. It should not be like that.

Yeah, that insurance guy I was talking to I mentioned also said that in their existing models, post code is the most important variable for longevity models.

It's really really frustrating.

Like others have said it’s very hard for some people to get an appointment at their doctors. To get an appointment at my doctors I have to give at least 3 months notice that I plan to be unwell. 😂

Also from just looking at people you can’t always see what is wrong with them.

In the last year I have had to go to A&E twice. Both times I looked healthy talking and laughing with nurses etc but once I was seen by a doctor I then had to have a procedure done really quickly as it was an emergency situation, others in the waiting room probably thought I wasn’t an emergency and could have waited when in fact it was the total opposite.

I was one of those people who didn’t look ill enough to be in a&e 3 weeks ago!
Thought I had a viral infection or bad cold coming on as I woke up one day feeling whole body aches, then vomiting every time I stood up or had a couple of sips of water. Thought it was vertigo! I wasn’t getting better after 3 days so I phoned my gp at 8am, who have a system were you can request a call back if you’re quite far back in the queue. Got a phone call at 8.30am asking what was wrong, explained my symptoms, the receptionist then puts it all into the computer and you get triaged by doctors. Phone call back at 9am telling me to come in at 10.10am. I was referred to a&e because in the gp’s words the way I was presenting, pulse rate of 160, 90% oxygen levels and a high temperature. I can say now I thought I’d just be given antibiotics and be done with because I really didn’t feel that ill or have any breathlessness, didn’t imagine for a minute I’d need to be going to a&e.
After being called in to triage I was put straight onto oxygen, had an ecg, blood tests done straight away! After about 20 mins i was taken to the a&e ward where I was given iv antibiotics plus oral at the same time, put onto iv fluids, had an xray plus another scan afterward. Ended up being admitted and was in hospital
for a week on iv antibiotics oxygen and fluids for 5 days plus at ct scan. I had quite bad pneumonia. The doctor who had seen me in a&e came to see me 2 days before I got discharged and said himself considering how ill I was I looked quite well on the surface when he seen me.
That was very long sorry but just saying even though people might not look
ill enough to be in a&e, sometimes they are like me.

A&E dr of 25+ years here

There are definitely plenty of people who could be managed in GP but the issue is services are so stretched that people give up and decide the best option is to camp out in A&E.

They all get seen eventually, or sometimes streamed to primary care (we have GPs in A&E too so at certain times of day people will get to see a GP).

The issue is we can’t deal with a lot of chronic conditions/ medication changes a we’ve no way of following people up. I can totally see why people decide to come to us even though our waiting room is like a war zone!

where should people go if they cannot access primary care?

You will be also appalled to know that my child which was not involved in an accident, did not have a limp hanging off and was not in pain needed an admission and spent almost 2 months as an inpatient. How do you know by looking around who will need care and who doesn't?

Be that as it may, it would really help those of us with severe but invisible conditions (I have Myasthenia Gravis) or those who are just stoic, if you would acknowledge that op is wrong to think they can look around a waiting room and know who is sick enough for A&E and who isn't.

I was told by a GP I had bad wind, when I actually had an appendicitis! I sat reading my kindle in A&E while waiting to be seen, so to a certain type of person I shouldn’t have wasted A&E time.

I was in A& E 5 years ago. I was giggling, pacing and restless, I was fit and tanned and looked very well indeed. I'd seen my GP about sudden onset balance issues and he was concerned about my agitated demeanour and sent me to hospital. I was in for 3 weeks with bacterial meningitis and acute cerrebella ataxia. I must certainly have looked like I shouldn't be in that waiting room!

When money for services are cut, it just makes people act really petty about other people using services that they might actually need. People are often forced to go because they can't see their doctor, or they have been advised to do so because there is no service for them. Also, do you know there wasn't an out of hours clinic there? Once I got sent to one on a Sunday for a bladder infection. That was in the hospital.

Also, once during lockdown I had a massive infection in my tooth, one side of my face was swollen. I needed antibiotics, but when I rang the emergency dentist line, the person on the phone refused to give me any because the infection was not yet affecting my vision. I wasn't going to spend another night with a raging face infection. The advice on the NHS website is to go to a&e if you can't get a dentist. Blame the system, not the people using the service.

Visited an a+e in a major U.K. city, a paramedic checked at the door why you were there, so some gate keeping in operation and it was still very busy. Whilst there triaged and referred elsewhere. Instead of getting an appointment elsewhere, we were sent to queue - we were triaged a further 2 times and waited another 4 hours. We went through why we were there and all allergies and medical history 3 times, before finally seeing someone who gave treatment that could have been given at the first place. It was a DIY eye injury and we ended up with drops. Defo A+E as couldn’t open eyes when we first presented. It’s not joined up at all and the right skill set is not deployed at the right time. It’s a mess

There is nothing I'm the world that could make me sit in A and E unless absolutely necessary.