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?

Imagine coming to a debate forum and just posting a sarcastic reply. What a sad little life.

Whilst there is a sense of entitlement in general nowadays, I don’t think that necessarily applies in this situation. It’s often that people can’t get an appointment with their GP for literally months. And then when their appointment comes, it’s cancelled and they have to wait ages for another one. Some areas are worse than others.
Yes, some people use A&E when it’s not necessary. But every time I’ve used 111, they’ve basically always just gone straight to telling me to go to a&e even when I haven’t thought that necessary.

Oh I wasn't being sarcastic. I am genuinely in awe of your ability to tell just by looking at people whether they are ill or not even though many conditions have no visible outward symptoms

When my husband had a TIA we probably presented (to you, at least) as not having anything wrong and we chatted to each other while waiting.

I had a minor biopsy on my face. The nurse at the GP removed the stitches. The wound opened less than an hour later - GP refused to treat it and said I should go to straight to A&E. Tried a private GP who had no space and also said the only option was A&E. Both the Gp and the private GP said that I needed to go in order to prevent infection.

i did manage a rather unorthodox way to see a nurse who took pity on my - 5 minute job to clean and apply steri strips.

Some years ago I helped an old man who’d had a fall which happened to be 100 yards from the GP surgery. He was bleeding from a few cuts. helped him to get there but they refused to see him to clean his cuts and referred him to A&E. We managed to get him to his house.

in both cases just a few minutes of preventative treatment would have helped to avoid possible worse issues and work out cheaper and more efficient than tying up resources at A&E

Edited to add that in both cases we wouldn’t have looked as if we needed A&E but that this was the route recommended by the GPs.

There is a point there though right? You can't tell by looking. You have absolutely no way of knowing whether the people who were in a&e at the same time as you needed to be there or not - not by sight anyway. They would have had to share their medical history with you.

I used to kind of think like that until one of the chatting and joking but look fine people were me and my mum. She had had worsening symptoms for weeks and the GP was pretty much ignoring them. Saw a private GP who advised to go and sit in a&e to get seen. We did wonder if we should but decided to just take their advice. It took 10 hours but after finally being seen was admitted to a ward for tests. She was dead 5 weeks later. So while the ideal route would have been GP, referral, appointment, it doesn’t always work like that especially when someone seems fairly “well” and they don’t get taken seriously. But my mum was incredibly unwell with aggressive cancer that has spread and killed her 5 weeks after diagnosis.

Clearly, if people have a low-level problem, they shouldn’t be in A&E. But I had bad wind once that felt like I was about to die or have a burst appendix, and it wasn’t until I let out the largest fart that I knew that’s what it was.

YABU - yes there are some malingerers I am sure but the majority of people don’t want to spend 12 hours of their day having something minor checked out and we are not our own personal x-rays.

My last trip to A&E:

• Antibiotics prescribed for a chest infection ran out while infection not cleared
• Phoned GP surgery asking for prescription renewal, advised would need to see the GP
• No GP appointments available until following week, told to phone 111
• Phoned 111, spoke to someone, described symptoms (chest pain, coughing up mucus with blood)
• 111 told me to go to A&E
• Went to A&E, six hours later, emerged with antibiotics

I had 3 trips to A&E recently. The first one I didn't have to wait at all, I was in emergency surgery within an hour of rocking up, I looked like and was very close to death.

The second time was because I had had emergency surgery 4 days prior my GP wanted me to have blood tests to make sure the symptoms I was having wasn't sepsis as I have a history of sepsis. I looked fine, maybe a bit uncomfortable because of my surgery but fine.

The 3rd time again referred by my GP as I had pain in my leg, I needed blood tests and a scan to rule out a clot post surgery. Again I looked fine but the tests couldn't be done anywhere else.

The problem is the lack of alternatives to A&E not the people who look fine who are using it.

I asked an A&E doctor on Tiktok roughly how many people shouldn't be attending A&E and he reckoned about 50%

It can be a frustrating system. My ds has a serious but managed health condition. He has regular hospital stays, however if he gets even a small fever we have to go to hospital. We have to “check in”’at a&e the then his medical team come and check him out. We can’t just go to the ward. We normally ring ahead to his team and someone come ones down quickly but it’s frustrating. Also had people shout that he’s jumping the queue!

This. My GP receptionist told me on the phone that the GP is for routine appointments and not for anyone who’s ill. Couldn’t believe my ears! They made me go to A&E instead so I could wait 8 hours overnight with my toddler just to get an antibiotics prescription.

The NHS is run entirely on "gate keepers" whether the GP receptionist or the A&E triage nurse or other health care professionals actually having the "face to face" contact with the patients. And yes, it does cause a lot of time wasting, appointment wasting, etc., as patients have multiple appointments and multiple long waits, going through all the various stages, until they finally get to where they should have been in the first place, i.e. face to face with a doctor or in an x-ray or scan unit!

I actually agree it should be turned around, but it's like turning around a giant oil tanker - there's too much momentum to stop the way it works.

When you go to clinics abroad or private in the UK, it's the opposite, you see the "big man/woman" first, and then get directed to the right person/equipment.

Basically, the NHS has been flooded with "cheaper" staff who are thrown out to gate-keep and fend-off patients. You see it in most out patients clinics. A receptionist, then a HCA picking up your form to take it somewhere else. Then a different HCA calling you through to sit in a different waiting area. Then another different HCA weighing you (whether relevant or not). Then another different HCA taking you through to the inner sanctum of the waiting area outside the consulting room, then called through to see a junior/trainee doctor who takes history, etc., then finally called through to see a registrar who takes more notes, and makes you wait in the corridor while he chats it over with the consultant, who may or may not grant you an audience if he deems you worthy! If not, you get called back in by the junior/trainee doctor often just to tell you they're going to refer you for an x-ray or MRI scan or whatever, which is what was blatantly obviously going to be required from the moment the GP referred you months ago!

Apologies for merailing a thread with a personal experience....

I developed excruciating tooth ache last year, I suspected an abscess or some kind of infection. I contacted the dentist who couldn't see me because they had no emergency apps, I went to the GP surgery, they don't do dental, I spoke to the pharmacist who couldn't deal with 'dental' either. I phoned 111 in the hope they might be able to direct me to an emergency dentist who wasn't my own, I waited 24 hours and hadn't received a call back. By that time the side of my face was so swollen I couldn't open my eye. I went to the local minor injuries clinic, they don't do dental either so I went to A+E. I was mortified to be taking up time just to get a prescription for antibiotics but it's not as if I hadn't tried literally everything else. I wonder how many other people have similar experiences.

DH had to go to A&E recently. He probably looked "fine". He had dislocated his toe, it had gone a funny colour indicating that blood supply was being restricted. He needed x ray and then a doctor to manipulate it back into position followed by another x Ray. After that, just painkillers fir a few days.

Minor issue, but untreated he could have list his toe...which would have been serious treatment.

The hospital triage into minor injuries and a&e on arrival

I agree - but I also think that’s caused by the fact people can’t access any medical attention, often for weeks.

My GP’s standard offer is now a phone call in two weeks. That’s not much good if you are in pain or it feels serious and needs more immediate attention.

It’s very easily resolved. I live in a country where most A&E departments have a primary care general practitioner facility in a different building but on the same site. It opens 24/7 the same as the A&E dept and patients get sent there at triage if the problem is too minor for A&E.

My son "looked" fine and was chatting away during a long wait in a&e but 12 hours later was in PHDU and the doctors were debating admitting him to PICU.

I "looked fine" when my GP sent me because he was very worried after examining me and the tests needed to be done urgently and could only be done in hospital

Some people are very good at carrying on looking fine even when they are very ill.

I once got discharged from hospital because the doctors decided I couldn't be that ill because I was chatting to my friend and giggling away. I was readmitted the next day and needed emergency surgery

I recently broke my foot but knew it was just a top bone that would likely heal and I could walk mostly ok. 2 weeks later and it was becoming problematic to even get a shoe on. I felt it pointless to clog A&E by this point as it wasn’t exactly an accident or emergency 2 weeks later. I got a GP appointment in the hope they could perhaps get me booked in for an X-ray in a couple of days time or something.
But they took one look and told me to go to A&E because apparently they can no longer refer people for X-rays like that. I said it was ridiculous for me to take up space in A&E when I could clearly wait a few days. But no, I was told to go to A&E or a walk-in. I went to a walk-in and was told it was a 5 hour wait for triage and no x-rays were left that day so I’d be called back tomorrow after triage. I told them a GP had already triaged me, but they said it doesn’t work like that. I left. I didn’t have 2 days spare to wait.
I didn’t go to a A&E department because I’d have felt like a fraud. It wasn’t an emergency.
It sorted itself out after 8 weeks, albeit I still have a small lump on the fracture site. At least I can get shoes on now!

There’s a definite gap between GPs and A&E, and walk-in centres are just overloaded with people who can’t get GP appointments (it’s a nightmare getting one at my practice)

I wonder how many people are sat in A&E because the GP has sent them, when there really should be a way of dealing with these ‘inbetween’ issues, leaving A&E for the genuine emergencies.

You're probably right. But have you tried to get a GP appointment recently, or a referral for further treatment? People feel they have no choice.

@PrettyPleaseXo
Last year I went to A&E with a kidney stone, didn't know that was what it was at the time.
Amongst the pain and throwing up I did manage to notice the waiting room was standing room only, I didn't need a chair as I couldn't get off the floor!
It was 2am and I was basically taken straight to a cubicle.
I was in hospital for 2 days but what stuck out was that I was in a cubicle in A&E for over 12 hours (no beds available on the wards).
I went in just after 2am and went up to the ward at 14:30 the next day.
Not sure if the people in the waiting room really needed to be there, they could be family members supporting a loved one.
What I did take away from it was that the staff were lovely, very caring but the pressure the NHS and the staff are under is immense

I spent a whole day in A &E recently with DD who’d fractured her wrist. It wasn’t severe just a buckle fracture still needed diagnosed though. We were chatting in the waiting room to keep her spirits up and it didn’t hurt thst much as long as she held her arm still but any movement was needed rally painful.

A Gp wouldn’t be able to X-ray so I’m not sure what good sending us away would of done.

Yanbu.

I was in UCH A&E with suspected fracture last year. They came and announced to the waiting room non urgent cases were a 3-4 hour plus wait time and I'm not exaggerating when i say about 40 people stood up and left immediately. It was comfortably more than half the waiting room

Separately, I have had to go in regularly due to a heart condition and regularly get filthy looks as I "waltz through" and get seen almost immediately. I do a small queen wave as I am wheeled past on my guerney

I was actually delayed from treated last time by a man in front who took forever to check in and his medical issue was 💯 non urgent - he was debating /angling to try and get a non urgent day patient type treatment and was just arguing with front desk for ages. They were clear thry didnt know definitive but he probsbly wouldnt get this treatment so he turned around and left!! Not really an emergency then...!
this was at 2am on a weekday.... WHO does that?

The answer to lack of GP provision isn’t walking into A&E! It’s 111, pharmacy or urgent treatment centre.