A and E waiting times

[Ethan]

This is the problem. My brother used to be a Team Leader and Paramedic for the London Ambulance service, but he has given it up as he got so fed up with the time wasters and imbeciles. The problem is if someone insists on going to hospital or calling an ambulance, they have to take them. If they don't and they miss something the consequences would be a nightmare. Even if that means taking someone to hospital in an ambulance because they have a pain in their toe or decided to call the ambulance because they have a cough (which they've had for a week).

The same applies to A&E, people going when they really don't need to. Personally I think the following needs to happen.

1. More out of hours GPs and an advertising campaign that the GPs should be the first port of call.
2. Drunk tanks away from A&E for drinking / drug related injuries / issues away from central A&E
3. Better management of repeat offenders, be it education, fining, social support. You get a lot of people simply going to A&E / calling an ambulance so they have someone to speak to. An alternative for "non-emergency" cases is required.
4. Charging those that can afford it to receive treatment that is later proven to have been a non-emergency - this could be complex and difficult to implement though.

It doesn't help that 112 will call an ambulance if you call in complaining of almost anything because they have no clinical training and rely only on an algorithm which is ultra-conservative.

I know of cases where people have called looking for advice on finding an all-night pharmacy or on whether they should go to GP out of hours and have had an ambulance sent despite saying they neither wanted one, needed one or would even accept one.

 

[Slicer30]

It doesn't help that 112 will call an ambulance if you call in complaining of almost anything because they have no clinical training and rely only on an algorithm which is ultra-conservative.

I know of cases where people have called looking for advice on finding an all-night pharmacy or on whether they should go to GP out of hours and have had an ambulance sent despite saying they neither wanted one, needed one or would even accept one.

that happened me once when I got an electric shock at home - called the NHS direct for advice and they insisted on sending an ambulance. Sirens, lights the whole lot and had to go through all the motions to then tell me I was fine.

While waiting for some results, the Ambulance team said the exact same thing. The NHS direct people cover the behinds with the ambulance teams so they get sent on lots of silly errands. Like eejits giving themselves shocks trying to repair a TV

 

[MegaSteve]

Can only say for around these parts but despite an explosion in population they've been shutting down A+E departments... Doesn't really compute with me...

 

[SwingsitlikeHogan]

that happened me once when I got an electric shock at home - called the NHS direct for advice and they insisted on sending an ambulance. Sirens, lights the whole lot and had to go through all the motions to then tell me I was fine.

While waiting for some results, the Ambulance team said the exact same thing. The NHS direct people cover the behinds with the ambulance teams so they get sent on lots of silly errands. Like eejits giving themselves shocks trying to repair a TV

..and the compensation culture is in my view a direct consequence of the huge feelings of entitlement I have mentioned - and so that if things don't go as well as hoped (or expected - another problem - unreasonable expectations of the NHS) or if a service isn't provided as quickly or to fit with the specific circumstances and preferences of the individual - then ping! - letter of complaint sent to Trust CEO and risk of litigation against the trust.

The amount of time senior nurses have to spend providing their responses to complaints being raised is 'not good' - when many if not most of the complaints will be kicked out.

 

[bladeplayer]

Surely triage nurse can weed the important from the trivial ,

From my experience at my local A&E the problem lies with the management & triage ,


NOT the doctors & nurses

 

[MegaSteve]

..and the compensation culture is in my view a direct consequence of the huge feelings of entitlement I have mentioned - and so that if things don't go as well as hoped (or expected - another problem - unreasonable expectations of the NHS) or if a service isn't provided as quickly or to fit with the specific circumstances and preferences of the individual - then ping! - letter of complaint sent to Trust CEO and risk of litigation against the trust.

The amount of time senior nurses have to spend providing their responses to complaints being raised is 'not good' - when many if not most of the complaints will be kicked out.

I suspect this balances out somewhat with many, who have been let down, [genuinely] by the NHS not wishing to cause a fuss...

 

[SwingsitlikeHogan]

I suspect this balances out somewhat with many, who have been let down, [genuinely] by the NHS not wishing to cause a fuss...

probably - but many will be let down as a direct result of the pressure being put on the NHS by the others for whom nothing is good enough unless it fits precisely with their expectations; what they want for themselves, and when they should get it - and to heck with the needs of all other patients and the medical teams.

 

[SocketRocket]

...and too many with a massive sense of 'entitlement' - IMO a major factor in what is bringing the NHS down.

Borne out of a society that today has too many folk having bought the Tory line that they are paying too much tax and it is being squandered and misspent - and always it is someone else who is benefitting.

Too many of our fellows are frustrated, angry, fearful and hugely resentful - emotions fomented by the right wing media. And so when we may need some help or support these emotions create a feeling of entitlement for that help or support - and when it is not immediately forthcoming our anger and resentments increase and the vicious cycle continues.

As a country of individuals we have really got to have a good look at ourselves.

In your opinion all problems these days are the fault of the Nasty Tories and right wing media. Do you honestly believe if we had a Labour Government and everyone read the Guardian we would be living the life of Riley?

 

[Hobbit]

..and the compensation culture is in my view a direct consequence of the huge feelings of entitlement I have mentioned - and so that if things don't go as well as hoped (or expected - another problem - unreasonable expectations of the NHS) or if a service isn't provided as quickly or to fit with the specific circumstances and preferences of the individual - then ping! - letter of complaint sent to Trust CEO and risk of litigation against the trust.

The amount of time senior nurses have to spend providing their responses to complaints being raised is 'not good' - when many if not most of the complaints will be kicked out.

The NHS Litigation Authority makes it very clear that it fully supports a patient and their families to take up claims against the NHS if they feel they have experienced poor care. The NHS LA has also saved over £38billion in resolving negilgence claims last year alone. A significant saving has also been made in the way claims are paid out, i.e. rather than pay one lump sum, payments are now staggered to provide cover for ongoing costs to those seriously affected by negligence.

Without a doubt the cost of claims has gone up, as the NHS LA's own figures show but the numbers of claims hasn't. And just to add a few facts to your inaccuracies, the number of claims has gone from 0.04% of all NHS activity to 0.01%... a drop of 0.03% against projection. And when viewed against a 26% growth in NHS activity, it clearly shows that claims, as actual incidents rather than as a %, have dropped significantly.

As for Senior staff getting more embroiled with responding to negligence claims, the NHS LA now bears the brunt of the work in responding to negligence claims. And in putting better reporting structures in place, the time spent has dropped further. Unsurprisingly, its the legal costs that have risen disproportionately, i.e. in the last 10yrs those costs have risen from 32% of monies paid to 52% of monies paid.

But hey, there's nowt like a bit of unsubstantiated waffle to embelish a good story.

 

[SwingsitlikeHogan]

The NHS Litigation Authority makes it very clear that it fully supports a patient and their families to take up claims against the NHS if they feel they have experienced poor care. The NHS LA has also saved over £38billion in resolving negilgence claims last year alone. A significant saving has also been made in the way claims are paid out, i.e. rather than pay one lump sum, payments are now staggered to provide cover for ongoing costs to those seriously affected by negligence.

Without a doubt the cost of claims has gone up, as the NHS LA's own figures show but the numbers of claims hasn't. And just to add a few facts to your inaccuracies, the number of claims has gone from 0.04% of all NHS activity to 0.01%... a drop of 0.03% against projection. And when viewed against a 26% growth in NHS activity, it clearly shows that claims, as actual incidents rather than as a %, have dropped significantly.

As for Senior staff getting more embroiled with responding to negligence claims, the NHS LA now bears the brunt of the work in responding to negligence claims. And in putting better reporting structures in place, the time spent has dropped further. Unsurprisingly, its the legal costs that have risen disproportionately, i.e. in the last 10yrs those costs have risen from 32% of monies paid to 52% of monies paid.

But hey, there's nowt like a bit of unsubstantiated waffle to embelish a good story.

Sorry - but my wife and her boss waste quite a bit of time responding to complaints - some stupid, but some valid and often brought about by her team having to deal with those that shout loudest.

 

[alexbrownmp]

Surely triage nurse can weed the important from the trivial ,

From my experience at my local A&E the problem lies with the management & triage ,


NOT the doctors & nurses

Triage are there to ensure someone is seen within 10 mins of arriving to assess the level of priority. They are usually nurses and are not qualified to send someone away without a Dr first examining them.

There are a large number of people, usually foreign who never go to a GP and even if they could they dont as it doesnt fit with their work/family hours whereas A&E is open 24/7.

The staff are exceptional though and they dont get paid enough for that role.

 

[hors limite]

Some months ago there was a short report on the BBC's Look North regional news programme that a survey at Barnsley General Hospital had revealed that 60% of the people turning up at A & E should not have been there. I waited in vain for a more comprehensive follow up by the BBC .Can't help feeling that this sort of fact doesn't sit comfortably with their preferred narrative - the NHS needs more money,doctors and nurses. Oh and, of course, any shortcomings in the NHS should be blamed on the nasty old Tories.

 

[SocketRocket]

Some months ago there was a short report on the BBC's Look North regional news programme that a survey at Barnsley General Hospital had revealed that 60% of the people turning up at A & E should not have been there. I waited in vain for a more comprehensive follow up by the BBC .Can't help feeling that this sort of fact doesn't sit comfortably with their preferred narrative - the NHS needs more money,doctors and nurses. Oh and, of course, any shortcomings in the NHS should be blamed on the nasty old Tories.

And the right wing press!