Please keep A&E for just that; Accidents and Emergencies

[Happytodayhappytomorrow]

A&E and Urgent Care centres where I live are at crisis point and it is similar all over the country.

It seems that people are going to these places to ensure that they get seen in person, diagnosed and treated all in one go rather than have telephone or zoom appointments with their GPs and perhaps wait for referrals to specialists at the hospitals.

Please, don't be the person who goes to A&E when a trip to the chemist or a phone call with the doctor will suffice.

My local NHS team are racking their brains to put systems and procedures in place to ensure our A&E departments don't crash, as they are needed for some genuine cases.

Of course, if you have an accident or an emergency, you must go to the hospital but if you even think that a chemist might be able to help, please go to the chemist first.
Likewise, try your GP. You might be surprised how quickly you get attended to if your case is urgent.

TIA

@Orf1abc

I have found overzealous 111 staff the reason why I've ended up in A&E

The call centre staff work to an algorithm, if they're telling you to go to A&E it's because that's what the computer has decided. They don't have any discretion to apply common sense, they have to stick to the script for liability reasons.

I know this, but it still doesn't seem fair to place the blame on the public for A&E numbers.

Stop blaming the public, wake up and put the blame where it belongs - with the Conservative Government who have underfunded the NHS for years. If there aren't enough Gps to run an effective service then what else do you expect people to do?

It's not going to happen when the GP tells a 98yo with a history of bowel reconstruction that they have trapped wind & refuse to see them at all. A & E admitted them for gallstones...

@Gullible2021

Try telling that to the receptionists at my GP surgery who refused me appointments to deal with heavy periods and instead said "if it's that heavy go to A&E as it doesn't sound normal."

For five months

And when I refused to go to A&E for a heavy period they put me down in my notes as "refusing medical treatment".

It took another GP who was a relative from another surgery to write to them to say I just needed an appointment with a gynae nurse or GP and that he was reporting the surgery to CQC for abuse of A&E services before I was finally allowed an appointment with a GP, five months later and by this point unable to walk due to terrible anaemia.

My 2019 admissions were for a "heavy period". THe first time I was sent there I thought A&E. would tell me nicely to fuck off. I was admitted. I was given meds the gp couldn't prescribe to stop the bleeding. I was given transfusions and infusions as the iron tablets that the gp could only prescribe weren't touching my anaemia. The coil that the GP could only prescribe would have made the bleeding worse.

My heart was monitored a lot more than the gp would have been able to do as due to the severity of the anaemia it could have been severely damaged.

5 months later an op sorted out the issue.

AS for GP receptionists who demand to know what is wrong I tell them when they have completed med school and become a qualified doctor or nurse I will divulge my medical details to. Until then I want an appointment with the gp. There was one years ago who wouldn't give appointments unless they knew what was wrong when you called in. Show up in person for an appointment and it was like a totally different person. Probably cos they knew make a nuisance of yourself in person and someone else will come along and talk to you to find out the problem,

Thry don't need to rack their brains , make it mandatory for GPS to see patients and I am sure there'll be fewer people turning up at A&E. GPs are using 'covid' as an excuse not to see people whilst a&e have to take on the extra workload.

Nope sorry.

I’m refusing to ration my care or the one of my dcs because some numpty politicians have decided to run it down. And to carry that. On in the middle of a pandemic.

50% of people in the U.K. diagnose themselves with Google. Only 30% in the US.
That tells you everything You need.

I know, right?

It's almost like a system that's free at the point of use abuse, just can't keep up with the demand this creates?!

Our GP surgery is excellent and saw our daughter in person several times at very short notice, even with a cough and fever. Even so we ended up in A&E - it was a bank holiday, and the GP who did an video consultation with us via 111 said she had to be seen ASAP. As it happens, they didn’t even sort her out - we ended up back at the excellent GP two days later and he finally gave her the antibiotics that resolved the issue.
I think one of the issues is that so many minor injuries units were closed down a few years ago, so when GPs are closed there is often no alternative to A&E.
Also, there seems to be a tsunami of sick patients at the moment. Our surgery are great, but seem completely rushed off their feet.

Unless you;
A) happen to fall ill before 8am in a morning
B) have a GP surgery that answer the phone
C) then manage to get one of the gold-dust appointments with a GP (which is usually over the phone and not in person)

then consulting a GP isn’t possible!

My son got progressively worse with an ear infection over the course of the day. By 2pm I rang the GP and was told there was nothing they could do until 8am the following morning when I could attempt to get an appointment. My only option was to go to the walk in centre for the antibiotics he needed.

It’s not people getting it wrong and turning up at A&E. it’s the system that is very wrong and forces people into A&E unnecessarily because there is no-where else for them to go.

GP surgeries need to be sorted out. It’s impossible to get an appointment here. If you ring they say ‘go to the walk in or A&E.’ It is shit in some areas. Absolutely shit.

@canigooutyet I am sorry that was your experience but with me it was all sorted when I did get an appointment with a GP. I only needed tranexamic acid and ferrous gluconate (I can't have infusions anyway due to an autoimmune condition). The practice manager, the GP who saw me, and CQC who I complained to all agreed that the receptionists were very much in the wrong and using A&E inappropriately. Not just in my case either.

I did have to go to A&E as I accidentally overdosed on Cuprofen which I was using as self help to cut blood loss when I couldn't get an appointment. Anaemia brain fog meant I accidentally took double the dose. A&E treated me for the overdose but were very clear that for my heavy periods I needed to get a GP appointment for investigations and then if necessary a referral to gynae. Within 3 weeks of my GP appointment all my bloods and pelvic scans were back - nothing structurally wrong with the pelvic organs but undiagnosed anaemia, b12 deficiency, hypothyroidism and prediabetes. All of which are being treated well under GP services and were neither an accident nor an emergency in my case.

@Happytodayhappytomorrow

Can we have a list of things that are deemed as acceptable Accidents or Emergencies?

Do we have to have X amount of suspected fractures?

Lose how many pints of blood?
How many days to ignore the crippling migraines?
How far open is enough to need stitches?
Ignore the rash and fever in the hopes it goes away?
Wait until it's established that it's a heart attack/stroke?
Despite blood coming out of your eye because something is in there stick with an eye bath?

If we're vomiting and have pain? Stay at home until you've gone how many hours? Stay away if the patient says the pain is under 5?

What if I'm really struggling to piss? Only gone a couple of times in the past 24 hours. It's not burning but there's blood in it and a slight raise in temp?

How long to wait if you're uncontrollably pissing blood? Does the clotting count? Wait until they come out the size of oranges?

How long should we struggle to breath before we say enough?

Have a weird hard lump in your abdomen that's cripplingly painful? Push it back in?

Some of these we would normally see a gp for. But when they aren't seeing anyone what are we to do?

The local surgery FB group is very interesting. Not one person has posted to say woo hoo got an actual appointment.
Instead shame GP refused to see, now in fucking hospital or worse type posts. Occasionally someone from the surgery posts to try and reassure us they are doing everything they can and hope to resume seeing patients soon. They understand our frustrations. Their lines are always open between x and y to discuss referrals, meds etc.

As an a&e nurse I say this - please don't blame patients for going to ED. The government has run the system into the ground so much that many many people feel it's their only option. And don't worry, the triage system ensures that patients who need to be seen first are seen first. So everyone will get seen, but if you arrive with a fairly minor ailment you'll wait for the privilege!

It seems that people are going to these places to ensure that they get seen in person, diagnosed and treated all in one go rather than have telephone or zoom appointments with their GPs and perhaps wait for referrals to specialists at the hospitals

People are going to A and E because it's nigh on impossible to get proper care these days from their GP.

Easily said, but are you also penning a post to all the GPs to tell them to stop sending everyone to a&e?

My gran has been sent repeatedly to a&e, and also had ambulances called etc - complete waste of resources. All because the GP refuses to do home visits or prescribe over the phone. In each case it's been a simple (and quite obvious) UTI which needs antibiotics. The GP is quite happy to waste hospital time and contribute to bed blocking.
She gets prescribed 3 days of antibiotics and told to throw away the rest of the 10 day pack (how wasteful?), so the infection doesn't go away and then guess what? Yes, the GP sends her back to hospital the following week.
Absolutely chuffing useless.

Please, don't be the person who goes to A&E when a trip to the chemist or a phone call with the doctor will suffice.

In theory, sure.

In reality, you can't see or talk to anyone at our GP's without a 5 week wait if you're lucky. And emergency appointments are almost impossible to get as they are completely oversubscribed due to very poor planning around here.

Has op never been to the uk? Or do they work for the government?

Why does everyone seem to think GPs aren't seeing anyone?!

Surely if you can't get an appointment, it's because all those appointments have been booked by other people?

Demand for GP services is through the roof. GPs are working harder than ever.

It's not like they're sat in their comfy offices instructing the receptionists to "just let the first lucky 4 through today, Barbara". No, there are the same number of appointments that there ever were, plus a shit load more stuff being done via email/zoom/e-consult, etc that was never used before, but still demand is outstripping supply.

If you stood at a bus stop and the first 3 buses that went past were completely full, it wouldn't be long before the bus company cottoned on and started running extra buses. They could do this because everyone who gets on has to pay so the extra bus pays for itself. GPs can't do this because there's only a set number of doctors, and only a set amount of finance per patient per year which never changes whether you see each patient once, never, or 50 times that year. Mention the idea of charging to see the GP so that the situation could keep up with demand, and people are up in arms.

It's hardly the GPs fault. It's not even 111 or EDs fault. You need to look to the government who have consistently under funded the whole thing.

The Daily Mail writing stories about lazy, fat-cat GPs hiding behind COVID and using it as an excuse not to do any work, which are widely repeated on Mumsnet, frankly just pisses us all off and doesn't leave us feeling hugely inclined to help improve things for you.

There's also (has anyone mentioned this? I have skimmed and scanned) lots of people with mental health issues (of all types) who are being badly let down in the community.

Community Psychiatric Nurses have been cut so the ones who are left have impossible workloads and can't help everyone who is on their list.

Informal support groups have often had funding cut and have closed down and, of course, since the pandemic started a lot of them have shut anyway out of fears of spreading Covid.

Crisis teams too have a big workload. And you can't possibly be on their list if you are currently experiencing your FIRST mental health episode-you have to be referred by mental health services.

The go-to advice has basically boiled down to "If you are experiencing crisis, phone the Samaritans." The Samaritans are volunteers, they have never claimed to be anything else, and the Samaritans charity was never intended to provide a substitute for professional care.

A and E often isn't the best place for someone undergoing a mental health crisis either (it's too busy, too noisy, too rushed). . . but many people feel there is nowhere else. Because, in lots of situations, there IS nowhere else.

@Pootles34

Yup agree with pp's. We're really lucky - our gps are excellent, and have been throughout. We've family however who have to ring at 8, the line is invariably engaged, by the time you're through, no appointments left.

How is this acceptable? These GPs need sorting out, it really isn't ok.

There's one GP in my area that says "no staff, go to A&E"

I haven't had to try mine yet.

I bloody hate threads like this.

I ended up in A&E a couple of weeks ago. Coincidentally I also had a very obvious ailment that was unrelated.

No one else in the waiting room was aware what I was actually there for, but I was on the receiving end of plenty of passive aggressive snide comments about wasting NHS time with something that wasn't an emergency.

This is yet more divide and rule stuff. Blame the public for breaking the system rather than those responsible for dismantling the system by stealth.

Surely if you can't get an appointment, it's because all those appointments have been booked by other people?

The GPs at my surgery have been home working since last March. The other surgery in the town has one GP in the surgery.

That's for a population of thirty thousand people.

Why does everyone seem to think GPs aren't seeing anyone?!

Because lots still aren’t.

@idontlikealdi cant you buy all those things otc? Or see a pharmacist to make recommendations?

Controversial I realise, but perhaps the GP contract shouldn't be quite so generous that they can all work from home part time.