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?

50% of the waiting room will likely be the plus ones who have come with their relative/friend who needs to go to a&e.

Also when you have had an op or similar on discharge the ward advise if you have further problems you go back in via a&e.

Our A&E is in the same building as the minor treatment centre - seperate waiting areas, but inevitably the 2 merge .

Prior to this , I have been in A&E and heard people needing help with sunburn / ingrown toenails,

THink some people assume A&E stands for Anything and Everything

Agree with PP, when people can not get to GP, that is when A&E becomes bottlenecked. My GP surgery has limtied appoitments and if you miss them (8am wait) then you have to ring back the next day.

Weekends and bank holidays add extra stresses to the sytem!

Don't forget the small percentage that believe that if the surgery is closed for the day your next port of call is A&E for things they shouldn't even be seeing a GP about ie, a cold or because an 10 year old child fell off a wall that was 3 bricks high, no obvious injuries and the child saying they had no pain and yes it does happen, just ask my Husbands ex. Some folk love the drama of going to hospital, they love being able to post sad face pic on SM from the waiting room, they thrive on the "oh Hun, so worried about you, " replies from their mates. Sad buggers.

Don’t need A&E, but need something beyond GP and reasonably swiftly. Eg. Certain checks for certain chronic conditions. There should be better routes for these things but there aren’t.

I like that idea, @ScaryM0nster!

I'm imagining a nice big, airy waiting room with different doorways where triage nurses and doctors periodically appear to call patients through for, say, 'Auto-Immune / Inflammatory Disease Flare-Ups', 'I Suspect I've Got (Another) Blood Clot (Embolism)', 'My Mental Health Has Taken a Dive' (probably need to call that one something like 'the mindfulness suite'), and 'I've Got Something Stuck In a Bodily Orifice By Complete Accident'.

Then the main A&E can focus on 'I Think I've Had a Stroke', 'I'm Having a Heart Attack', 'I Can't Breathe', RTAs, burns, etc.

Those people probably thought the same about you. Your medical diagnosis of other people as you walked by may not have been accurate

It must be impossible to weed out the piss-takers. Imagine - just one mistake.

However, last year I was bitten by a dog. Blood spurting out and I couldn’t stop it. I was welcomed in A&E practically on bended knee - the doctor who stitched me up said I was the first genuine case they’d seen that morning.

When I checked in there was a woman behind me who said she had a runny nose and hadn’t slept all night. When the receptionist said to take a seat but the wait was around four hours, the woman said, “Ok, I’ll go home and you can ring me when it’s my turn.” Hmmmmm.

I was in an and e with my daughter a few weeks ago. She probably looked fine but I’d had to give her an epipen a few hours before so we had to sit in the waiting room for six hours after she’d recovered from the reaction in case there were any issues from the adrenaline or a rebound reaction. You def don’t go there unless you have to, it’s so boring and also not a fun environment to bring a child. Had somebody a few years ago openly complaining on the phone that my daughter was in ‘with a bit of a temp’ - she’d been sent by the out of hours dr to rule out meningitis.

Sorry to hear your plight OP. Sounds awful. I absolutely dread any accident or ill health.
So little available.

I agree. In my area the surgery is fully booked a month in advance and they release appointments for another week on a Monday morning. If you want an appointment at all it's best to be waiting as soon as the surgery doors open because they will prioritise the person in front of them over a ringing phone.

Sometimes its hard to tell just by a glance. My DC had an accident earlier in the week, we thought it was fine, now suspect it may be a fracture. They look well and happy, but the only place to get an X-ray is A&E. So we will be cluttering the place up.

I always say similar to this. IMO, an independent prescribers qual should be MANDATORY for anybody doing nursing or midwifery. It’s absolutely insane that you can wait 2 hours to be triaged in a walk in centre for eg chest infections then have to wait hours more to see a prescriber. No wonder the NHS is so crap it’s whole system is beyond inefficient

Yeah they wouldn’t be IF the GPs were doing their job and not sending people to A&E to cover their asses, and/or IF GPs had facilities for a quick blood test (which totally exist in other much poorer countries) or an X ray so they wouldn’t need to send people to A&E for that, and IF there were more minor injuries or issues walk in centres

Toddler with a crayon up her nose, I mean, I suppose she was fine as in it wasn’t bothering her, but it still needed removed.

I love your laid back approach to this! 😀

Do you not think that this entire post is ‘entitled’ ? You think you’re entitled to judge whether someone’s attendance at A&E is valid ? Just because they're not visibly writhing in pain ?

At ours for example children’s A&E waiting room is the access point for everything. Took both of mine at separate occasions last year - first DD badly sprained her ankle, second DS fell over and needed 12 stitches in his knee. Both needed x rays and then DD a boot - DS ended up being stitched in minor injuries.

both looked fine in A&E - DS in particular I think becuase adrenaline had kicked in (he walked 10 mins with blood pouring down his knee) and shock kicked in later when he got home.

I think people have taken it upon themselves to decide that whatever their complaint, no matter how minor, that their doctor’s surgery should see them TODAY - in one day - without fail.

There are those of us who are old enough to remember that this was indeed the level of service that the NHS provided.

It is also the level of service provided in countries such as Germany, Austria and in Scandinavia - countries that have far more doctors and medical staff per capita than the UK has. Austria has twice as many doctors per capita than the UK has. Countries that invest up to 30% more per person each year on healthcare than the UK does.

When the German and Austrian healthcare services were re-established after the devastation of WW2, the underlying principle was that the level of healthcare that previously had only been available to those who could pay would be available to everyone. This is still the case, and any politician, right wing or left wing, who dares to tinker with this is quickly shown the door.

The NHS was also founded with similar guiding thoughts - all tied up with the idea that every family, rich or poor, had suffered during the war and that post war, the country would be "a land fit for heros" (which was actually also the promise after WW1) and that the NHS would be the envy of the world. The Conservatives opposed this and have spent over 70 years trying to undermine this, culminating in 14 years of Cameron, Lansley, Hunt and Hancock doing their best to destroy the NHS.

The easy ones aren’t the problem. Yes it’s not ideal re overcrowding but you can get through minors quickly. The problem is the very sick people who need a bed but can’t get one. You don’t have 80 year olds on a hospital trolley in a corridor for 36 hours because a few people have turned up with a splinter. They are there because hospitals are full and there isn’t the right flow.

Obviously it’s not ideal to turn up at A&E if you could be seen elsewhere but those people are not at risk and don’t really take much time to deal with. It’s an absolutely false narrative fo be blaming the public for being in the wrong place when long waiting times are systematic failures to invest in bed capacity.

The last time I went to A&E it was Christmas Eve and I had developed extreme bruising two days after chemotherapy. Instruction was to go to A&E asap, they would send an emergency ambulance if I had no transport. I might have developed sepsis.

Intravenous ABs later, I was sent home.

I was isolated while waiting, but would have looked perfectly normal with my clothes on.

Of course some people would be better treated in a different setting - but we don't have those settings.
I think having urgent care units would make sense. Somewhere you could get quick turn around tests and treatment that does not warrant a&e but is too pressing to wait for a GP.
I regularly have to go to a&e for blood tests as the community / GP testing turnaround is 6 days and that is too long for me (medically, not being demanding).
I could be in and out of an urgent care type place in 20 mins!

My 93 year old mum recently spent 48 hours in a&e, 12 of those was in the corridor, she had fractured her hip, no beds available. I remember a young lad being there with his mum, he looked fine but his mum later told me that he was admitted with sepsis.

GP can give you a form to get an x-ray though. Then you just tip up at X-ray for the imaging. Lots of imaging centers around now.

I think lots of GPs are running a really bad service. So much can be triaged by them via Econsult. We haven't seen GP for years, but have had all sorts of tests, after a quick chat on the phone. None required going through A&E.

You have no idea of peoples situations or how they hide their pain. I went to a&e as a teen as I kept getting recurring ear infections and I was in agonising pain- I had a chronic illness and could hide my pain well. Well when I finally got seen, I had a mastoid infection where the infection was septic and they said if I wasn’t treated within those few hours I would have had a brain infection and likely of died. But if you saw me in the waiting room, I was playing mobile games with my mum and looking ‘normal’ but I was nearing death in all honesty.

I’ve been with my own son in a&e where 111 called an ambulance and the ambulance sent us there, if you’ve ever known kids they are up and active and can go downhill very quickly.

I’ve also broke my hand but I was there laughing and joking with the nurses/doctors and keeping up the spirit because I tried to get on with things and had a high pain threshold - but you’re saying I shouldn’t have got my broken hand fixed because I didn’t deserve to be there??!?

everyone has a right to get their health checked, gp’s and 111 can send patients to a&e to rule things out. Patients can keep their spirits up by appearing normal, like do you expect people to be gloomy and put on an act just to look the ‘part’

Study after study after study has shown that A and E gets clogged up because the primary care system doesn't provide what people actually need. When you do provide what people need, attendance goes way down and millions of pounds are saved.

It is utterly utterly pointless for GPs to see each patient for 10 minutes. They might as well not bother. Once GPs can see patients for as long as they need and all the services the patient might need are close by and easy to access - social care, social services, OT, physio, housing support etc, - then people's problems get solved and they go away. The objection always raised to this idea is that it's expensive. It is not. It is far far far cheaper than the current broken system in which people come back for appointment after appointment, falling through the cracks, getting worse, needing more care etc. Solve the problem comprehensively and quickly, people are happy and they get on with their lives. They get jobs, they do more exercise, they are generally healthier. It is totally logical. However, if I see one more study 'discovering' this I will scream and pull all my hair out.

I will also add that in 2020 people were told that an illness that had almost no chance of killing them warranted shutting down the whole country and cutting the economy off that the knees. You can't incite that level of pointless fear in a whole population and then expect that population to have a sensible approach to their health.

I was in A&E not long ago with my DD1. We were chatting and looked fine. A second look would have shown you both legs wrapped in clingfilm due to burns from boiling water. She could chat because she had morphine for the pain. People cope kn all kinds of ways whilst waiting.

Totally agree I was sitting close to reception waiting to be called in to be with my very elderly mother who was brought in by ambulance one time and I could hear the reasons people came to A and E some of them were not needed to be seen urgently , a few examples, one man came in looked fine said I hurt my toe last week it’s still hurting , another I’ve had this cough for a few weeks asked if they had seen a GP both said no , when they were told it would be hours before they were seen they said fine and took a seat and sat on their phones drinking coffee in an incredibly busy casualty dept
Honestly a trip to a GP would have been better and there were more examples I felt like someone medical should have came out and said nope go home see your GP.