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?

There is quite a lot of evidence to support this point. During periods of junior doctor strikes, consultants have provided cover and waiting times have gone down significantly. Some A&Es have adopted the model of consultant led triage. What would be even better for a lot of patients would be consultant geriatrician led triage. Too many older people come in via A&E and leave hospital in a worse state than if they’d been stopped at the door in the first place. You need experienced clinicians to make that call though.

It shouldn't be called a & e. It should be called accident, emergency and cases that just can't get a GP appointment. "A, E & Sorry, no Gp"

Like others have said you have no idea at all.

DD had some weird chest pain a few years ago, which had improved a bit by the time we got there (after been in agony for hours in the night). She'd improved so much that the triage nurse rolled her eyes hard at us. DD was sat chatting. People would have thought she was OK. Turned out her lungs were full of clots and she nearly died.

I'll tell you something....if she feels the slightest bit off with regards to her chest, breathing or her legs feeling funny we are straight to a&e now!!!! I don't care what anyone else thinks. It's the only place to get the blood tests and scans urgently.

I sent dh to a&e a couple of years ago with a weird rash/blisters which he'd seen the GP for multiple times and got nowhere, but on this morning I thought it looked worse/really not right. He was admitted as a medical emergency, kept in for weeks, treated as a burns victim and was seriously ill with a rare condition. He wasn't in pain, was sat chatting, his skin issues were not visible to anyone in the waiting room.

Where I am, a and e effectively acts as the doctors.
My elderly mum has a doctors surgery where literally there are no doctors " we don't have any GPS on a Thursday or Friday." Call 111 and that is where you are sent. 1 waiting room. You are there for hours alongside all the traumatic injuries and illnesses.
It's just impossible. No one is there for a day out.

Completely agree, I'm of the age where I only see the gp/worry about something if it's fallen off, or I can get the duct tape to fix it, and thats with having life long issues (which I'm on meds for), last time I went to a&e/called ambulance was because I had a tmi, and that was only after a lot of people said, 'your not right'.
The level of 'I'm not feeling great so need to be seen now!' is ridiculous, additionally add in the problems of drug addicts (not their fault), street drinkers, general anti social behaviour causing minor scuffles, police get involved, person cries wolf, off to a&e.
In my wierd 'this is how we fix things' world, there would be 3 types of a&e, one for the police/prison service, one for the addicts, general difficult social problem people, and then the general one for everyone else.
Add to that, if you turn up at a&e for nonsense it's £10 - not huge but enough to make people double think.

Yeah this.
Also, a lot of people you would have seen would be accompanying someone else so it’s a pretty sweeping statement. I agree that the system is broken but you don’t have to be pissing out blood or vomiting on the floor to qualify for the A&E waiting area.

Yeah and then it takes a week to get X ray appointment and another week to get the results. Kind of doesn’t work with suspected broken bones.

my daughter needed a blood test to exclude lime disease after a tick bite gone red. GP gave me the form for a blood test at the hospital, sure. They only had availability in a week’s time 🤣
so off to A&E we had to go

why It’s not possible to have facilities for quick blood tests and x rays is beyond me, it isn’t difficult to do at all

Hmmm... I'm not entirely sure I agree OP. I mean, can you tell just by looking at someone as to how ill they really are or whether they had made the decision to go to A & E without going to their GP first?

A few weeks ago, I took my son to A&E (on the advice of our GP). He had a niggling pain in his leg with some redness, we were sat in the waiting room chatting away to each other and to an uninformed bystander, it could have been assumed that there was nothing wrong with him.

45 mins later he was being prepped for emergency surgery.

It’s not for me to judge why people are at A&E! However, I’ve recently had to go twice with my elderly dad because it was a weekend and the GP insisted, even though we absolutely knew his problem could have been solved by a district nurse.
On one other occasion he had a temperature and needed antibiotics but because of his previous medical history, the GP wanted him to go to A&E. Spent 10 hours there on a corridor trolley and sure enough, got sent home with oral antibiotics.

I’m not complaining as we’re grateful to have healthcare but from what I can see, the lack of an army ‘on the ground’ of GPs and district nurses means that going to A&E is sometimes people’s only means of seeing a doctor.

I’ve now paid £15 a month for Bupa’s GP service so that we can easily get dad antibiotics if he needs them at a weekend.

I have never seen this, and I've been to A&E a few times for my own health issues and those of family members. Just because some patients don't look obviously ill, it doesn't mean they can wait until the following Monday to see a doctor. For example, one weekend, DD needed antibiotics for scarlet fever. It's an infection which can lead to life-threatening complications, such as rheumatic heart disease.

I can't imagine that spending hours in A&E would be anyone's idea of a fun day out. I've hated it every time.

it depends what you mean by “shouldn’t”. For example, you can’t call our GP on the day, they open the e-consult maybe once a week, appointments are often “we can see you in 4 weeks” at best…if you call 111 or go to a walk in centre (if you’re lucky enough to have one nearby) they often send you to A&E. A lot of the time it’s literally the only way to get seen by a medical professional.

That attitude isnt great either. A lot of admissions could be prevented if people (could) see a GP sooner and start oral antibiotics or treatments for their conditions.

Actually virtual queuing might be a good idea

I think you’re being slightly judgemental you have zero idea why people are in there. Not every emergency is a screaming one. For example, I was with a friend in A and E a few weeks ago- she was having an ectopic pregnancy. We were sat talking etc but she had emergency surgery 6 hours later.

Minor injuries might have been better

My partner went to A&E recently with excruciating headaches that the GP kept dismissing as anxiety. He was straight to a CT scanner and was told he did the right thing in attending. He probably looked ‘fine’ but what else can you do when you’re constantly dismissed?!

My ex was in A&E a couple of weeks ago with headache and double vision, seemed otherwise fine and then while there had a massive stroke. You really can't triage people with your eyes!

Also loads of people are in A&E because the GP or 111 has told them to go there.

I don't know how you can tell whether someone should be in A&E from looking at them sitting in a waiting room. I've been to A&E precisely 3 times in my life (all for my DH). We chatted while waiting. Two times he had a pulmonary embolism and the third time was when he'd cracked his head open (you could see his skull) and needed stitches but we'd cleaned his head up at home and he was wearing a cap so he looked perfectly fine. Until he took the cap off 🤕
We wouldn't even have gone to A&E for the stitches if there were any walk in centres available.

What qualifies you to make this judgement - are you a doctor? Have you assessed them all?

Just because you think people don't "look" sick, doesn't mean they aren't.

You are generally correct, but a lot of people in the waiting room may actually have been relatives not patients. Most of my time spent in ED waiting areas has been whilst a relative was being seen.

I had a pulmonary embolism when I was 22, had a bit of chest pain but felt fine. Was sat happily gabbing away in A&E.
Because of this history, whenever I cough up any blood and get a bad chest infection, the GP usually sends me to A&E to have a D Dimer which is a blood test that the GP can not do and can only be done at the hospital. Again, I usually just have a bit of a cold, should I put on a sick voice and a sad face to save being judged?

Oh, I agree, what I'm proposing is if you change the way certain people are addressed by primary health care, by having a separate route for the repeat offenders (sorry, cant think of a better expression, not meaning offence), then it frees up the normal route for everyone else.
There isn't a magic wand to wave, but I certainly think that adding different routes to access primary care would free up the bottle neck, which at the moment is GP access

The way the NHS is structured means that A&E is often the only option. Also, the whole point of a health care system in a developed country is that people should be able to get urgent medical assistance when they need it.

e.g. if you get chest pains and feel breathless one evening, what are you supposed to do?

or you bang your head and have a large bleeding cut?

or you suddenly notice a weird rash near a small infection site (this actually happened to me - extremely lucky I did google it and go to A&E - I had to be put on an antibiotic IV immediately)

Drug addicts collecting methadone are genuine people in need of their medication.

There aren’t any minor injuries centres that accept kids nearby and it required specialist blood tests so the GP told us to go to A&E