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?

Last time I went to A&E I was fine. But there just wasn't any other way to get a referral in time. I had gone to a private clinic or a check up and labs (wasn't planning to use public healthcare services). The lab results came and the private lab is not as extensive and they can only see if the result is positive or negative. So the doctor called and said I need more accurate results and told me to go to an A&E cause getting a GP and then getting a referral to specialist, then getting referral to a lab and then getting results would take too long.

If employee needs a doctors note and you can't get a GP and they won't sign it over the phone, A&E you go.

Ah we must be spoilt here as we have a fab one that does and has its own xray and ultrasound and phlebotomy team.

The problem isn’t the people. It’s the NHS.

We don’t have enough GPs or the ones we have don’t have the ability to do anything or don’t want the responsibility, waits to see consultants are disgusting so people become even more ill when their issues could have been found and treated had they been seen sooner , mental heath care is non existent so people become suicidal and are told “go to A and E”.

There was a post the other day from a parent whose child had a weird patch on their tongue. GP prescribed treatment but told her if it didn’t work “go to A and E. WTF she was baffled.

It’s the snowball effect of not having proper primary care. I’ve said it before and I’ll say it again. We need a system like the French AND we would then need to actually hire more consultant, GPs and Nental heal th professionals but no one has the balls to enact it.

That's what happened with my son too except he had septic shock and went downhill all of a sudden after looking seemingly fine after some anti sickness medicine. His organs were shutting down and initially, he only went in because he was dehydrated due to what we thought was a tummy bug but he actually had a bowel obstruction.

Children especially can go downhill so quickly despite looking fine. Sepsis is terrifying too, there's a reason why it is called the silent killer.

It’s strange that people expect to be able to access healthcare that they pay for in one of the wealthiest countries in the world isn’t it? The entitlement(!)

Can they?
Others have said their GPs don't refer to x-ray. I have no idea whether ours does.
Anyway, you are triaged in 15-20 mins, referred to minor injuries and then to x-ray if needed, so out of the A&E queue quickly.

Generally because the most experienced doctor is busy trying to stop the actually really sick patients from dying.

For comparison, I now live in Europe, where there is also a national healthcare service, paid for through employee and employer contributions deducted at source - so basically a compulsory tax exactly like income tax paid in the UK, and charged at a rate only a little higher than in the UK.

My GP surgery has the usual GP services found in the UK, but there is also an x-ray facility, ultrasound, and a small lab for blood and urine tests. It also opens early in the morning, on a couple of evenings and at weekends, so it is the first port of call for anyone with minor illness, minor injuries and for regular tests. There's no need to go to A&E with a cut hand - the GP can look at it, x-ray it if necessary and a nurse can stitch it up (and look at it a week later when it's healed). Small injuries like a broken wrist can also be x-rayed and plastered. Anyone requiring more extensive treatment is sent on to A&E at the district hospital.

I've had to go to this A&E department on a few occasions, either for myself or for neighbours. I've never waited more than 30 minutes - on more than one occasion there has been no wait at all.

I went to the walk in centre/minor injuries a couple of years ago with what turned out to be a Bartholin's cyst. I'd never had one before so didn't know what it was and couldn't get a GP appointment. I was triaged and told I had to go to A&E as I needed blood tests and they couldn't do them at the walk in centre. I got to A&E, explained what was wrong and got asked why I thought I needed A&E! I explained what had happed and the nurse said the walk in centre was always sending people across when it was unnecessary. I was then sent to ambulatory care and saw a doctor and was sent on my way with antibiotics.

There doesn't seem to be any joined up thinking. My GP surgery is a lot better now and it's much easier to get an appointment thankfully but the walk in centre is still useless so I get why people would give it a miss and go to A&E.

Some areas have a lack of options. The option in my area being: wait 3 weeks for a doctors appointment, pharmacies that are only open until 5 pm, or A&E.
Both Primary Care and the local Walk In Centre were shut down years ago here.

I agree there needs to be a rethink on GP care. In my practice there are 20 GPs. Well, that’s impressive, you might think. But they all work one half day each!! The admin for that must be huge, apart from the palaver of, say, trying to reach a particular one. I was prescribed a new drug by consultant, but it had to be issued by GP and the wait for her to sign it was at least a week.

This is exactly what we need.

Did you let this fart rip in A and E?

Plus sometimes they are the ones who actually get it wrong.

My son who had septic shock caused by a bowel obstruction deteriorated so quickly in the end because a senior surgeon ignored nurses concerns and insisted that he wasn't a surgical case, he also decided that the sepsis protocol didn't apply to my son because he was certain it was just a tummy bug.

What puzzles me is that it's incredibly difficult to get an appointment at my GP surgery, yet there are big signs in the waiting room saying they 'welcome new patients' with instructions on registering. They can't cope with the patients they already have!

I think 111 does over-send to A&E. And I think the lack of access to other parts of the NHS does mean that people are there who shouldn’t be. The last time I was at A&E, DD had concussion. She looked fine. Other people who might look fine might be a suspected blood clot, chest pains, even a broken wrist can pass the “casual witness” test I would think

😂

She genuinely was unbothered by it, and I don’t actually know how long it was up there as I found it because I wiped her nose and it was blue 😐 it was way up there and she’d not had access to crayons for days that I could remember.

But like, once you know there’s something there you can’t just leave it and I definitely couldn’t get it out, they actually weren’t sure they were going to be able to, they were planning on putting her under a GA and flushing it at one point

But she was completely fine, no breathing issues no infection or inflammation, just having a nice day out at the hospital 🤦‍♀️

I was in A&E with DH looking completely well last week, following a TIA. I was told that if I could drive DH to A&E it would be faster than an ambulance. 999 told A&E reception to expect us, and on arrival he was immediately triaged, sent back to A&E waiting room looking very healthy, then given a bed in the A&E ward, still looking very healthy, but actually classified as being in "hypertensive crisis." (MAP 151) Monitored all day, CT scan, ECG, medications, follow up appointment at Stroke Clinic.

Kids were worried sick so I sent them a photo of their Dad in A&E looking very well and grinning and giving a "thumbs-up." I can imagine what you'd have been thinking, OP, if you'd seen him posing for that photo!

A&E is the correct place to go following a TIA, even if it does put you in the category of people who look perfectly fine and are chatting away. Given that his blood pressure was sky-high, and he'd had a "warning" TIA, if he'd been sent home and told to see his GP, I'd probably be a widow by now.

One of the things my GP practice does well is triage. None of the receptionists do unqualified triage by numbers, if there isn’t a convenient appointment or you are a possible urgent the triage doctor rings back. They say it saves the practice and patients great many unnecessary trips to the surgery and reaches the “quiet but need seeing” for exactly this reason. Everyone wins.

The origin of formal triage in most A&Es was to meet targets not patient benefit. It enabled hospitals to say that all patients had been seen within X hours even if they had waited far longer to actually be treated or dispatched home. Its ironic that the more patient centred approach could also have been more cost effective.

I was recently in a&e in the early hours after an accident. There were several "frequent fliers" as the nurses called them, literally a dozen or so homeless people, who apparently go to a&e frequently to try and get a prescription for something, or just to hang out somewhere warm/dry.

Popping in and out for vape/smoke, chatting and laughing. Plus a multitude of people giving nurses pure abuse for no reason which is disgraceful.

I dont think everyone needs to look like they have been in a car accident to qualify for a&e, but I do think people wasting time should be dealt with somehow.

People won't like this, but if you had to pay for treatment, waiting times would rapidly decline. The Swiss model works well.

Imagine assuming you can diagnose and identify medical conditions with no training just by looking at them.

There are conditions that people are not dying from but waiting medical intervention for two months can still be very detrimental.

Do you have any data on how many of these “repeat offenders” there actually are and the extent to which they clog up the system? I would be surprised if they make even the smallest dent to be honest.

My dad was chatting to me in the waiting room when I took him to A&E. He died a few days later in the hospital.

I think you're generally correct though. Most people could at least go to the drop in centers. We have a couple of them that are for fairly urgent but not life-threatening stuff.