A&E Crisis - What's going on

[SwingsitlikeHogan]

Between the four of us in my family we can count on one hand the number of times that we have been to A&E in the last 10 - maybe 15yrs. What's the heck is going on? Who are clogging up A&E and why?

Elephant in room is that many immigrants are not registered with a GP - as registering would make them officially in the country - and clearly many - especially those here illegally are not going to like that! You should go to the end of the queue in A&E and not expect to be seen if the triage nurse classifies you as non-emergency and you are not registered with a GP.

 

[cleanstrike]

Between the four of us in my family we can count on one hand the number of times that we have been to A&E in the last 10 - maybe 15yrs. What's the heck is going on? Who are clogging up A&E and why?

Druggies and drunks is the easy answer.

 

[MegaSteve]

With GPs, in the main, no longer doing home visits or taking night calls invariably means that for any call requesting medical help you are advised to go to A+E...

 

[ger147]

Also, for simple things like an x-ray to double check for a break after a fall for example, certainly in my area there is no option but to attend A&E. Even if you attend your GP during normal Mon-Fri hours, you will be sent to A&E for an x-ray.

 

[CMAC]

There is also a large section of the population who are in jobs that with any time off you lose money, and a whole section particularly within retail that will not go to a GP during the day so go to A&E at night. Combine that with non English speakers who struggle at a GP as there is no interpreter but usually it will be 'managed' at a large A&E hospital.

Add to that the plethora of idiots who visit A&E with a cut finger, sore ear, cold or other minor ailment and the system soon grinds to an inevitable halt as they all must be seen

 

[CMAC]

Also, for simple things like an x-ray to double check for a break after a fall for example, certainly in my area there is no option but to attend A&E. Even if you attend your GP during normal Mon-Fri hours, you will be sent to A&E for an x-ray.

I think you will be sent to the Xray dept of a hospital as opposed to A&E

 

[ger147]

I think you will be sent to the Xray dept of a hospital as opposed to A&E

The x-ray dept is for scheduled appointments e.g. got a sore leg, had it for a while, GP would like an x-ray to decide next course of action = x-ray dept.

Fall and hurt yourself, make it to your GP, he thinks you need an x-ray to see if you've broken anything = A&E Dept.

 

[SwingsitlikeHogan]

Common theme here is that we seem to have a problem with Primary Care - and that is GP practices. Many folk not registered for whetever raeson and when you are you can't get an appointment.

And I'm not sure druggies and drunks are that much more of a problem in A&E today than they were 5 yrs ago.

Bottom line I think is that 'anyone can walk up when you want and be seen and treated for free' primary care has had it's day - the model is broked.

 

[Rooter]

plus GPs add to the problem in my opinion. My daughter has a peanut allergy, last week low and behold my parents give her some weird peanut flavour crisps by accident. it wasn't too bad a reaction, she was sick, then came up in a rash, no breathing probs what so ever. (we didnt need epi pens)

the Mrs was a little worried about the rash and it was quite spread and red, so called our GP just for a chat with a nurse. their suggestion? take her to A&E. 5 frickin hours i was in there to be told yes mr roots, as you thought she is fine, keep giving her piriton....

 

[CMAC]

Common theme here is that we seem to have a problem with Primary Care - and that is GP practices. Many folk not registered for whetever raeson and when you are you can't get an appointment.

And I'm not sure druggies and drunks are that much more of a problem in A&E today than they were 5 yrs ago.

Bottom line I think is that 'anyone can walk up when you want and be seen and treated for free' primary care has had it's day - the model is broked.

with many friends in these areas I assure you its as bad now if not worse than 5 years ago. The weekends at night in A&E are quite scary places and they need more security for the staff than they currently have. The verbal and physical abuse is horrific.

 

[bladeplayer]

A big problem over here is we have Triage nurses who are seemingly qualified to determine who needs seeing 1st etc ..
you go in here & you wait ,
you see the triage nurse and get looked at and wait ,
you get called thru to see the doctor and you wait ..
the doc sees you and sends you for an xray , you wait ,
you get xrayed and sent back and you .. yes wait ..

why oh why cant the triage nurse who is qualified enough to prioratise injuries have enough authority or common sense which ever it is , to see you , oh you need an xray.. we will get that done while you are waiting .. then when you eventualy do get to the doc he is armed with the info he needs ..

Bad Management is one reason , stupid people is the other one , some people will clog up A&E for the simplest of reasons ..

My 82 year old ma got to A&E at 9pm after a fall on sat evening.. she has broken wrist , got cast and discharged .. 5.45 am

 

[Hacker Khan]

Been to A&E a couple of my times with my daughter recently and they were superb. I would have been happy to go to a doctors but ours is not open evenings or weekends. And when I was there there were some people there where you think what accident or emergency do you have. But the majority were obviously badly hurt

There's just been a bit about this on radio 5 and someone did make the same point as has already been said, you ring a doctor and you are lucky to get an appointment within the next 2 days. If you go to A&E you will be seen a lot quicker. So to some as they are in pain, it's a no brainer. They also said that 4 out of 10 people leave A&E having had no treatment whatsoever.

Slightly uncomfortable about bringing illegal immigrants into it and claiming that they are a major contributing factor as I am a wooly liberal. Plus it's veering dangerously into Daily Mail territory, but there you go.

 

[CMAC]

plus GPs add to the problem in my opinion. My daughter has a peanut allergy, last week low and behold my parents give her some weird peanut flavour crisps by accident. it wasn't too bad a reaction, she was sick, then came up in a rash, no breathing probs what so ever. (we didnt need epi pens)

the Mrs was a little worried about the rash and it was quite spread and red, so called our GP just for a chat with a nurse. their suggestion? take her to A&E. 5 frickin hours i was in there to be told yes mr roots, as you thought she is fine, keep giving her piriton....

to be fair Scott with children especially they like to have them there for observation if there is no life threatening problem. We have had to take my wee boy there a few times over the last 2 years- midnight car dash breaking through traffic lights type speeds- and our minimum wait has been 4 hrs, after triage (which I believe happens within 10 mins max) its a good thing if you are not taken through immediately.

Bare in mind what you see in A&E waiting rooms isn't what's coming in the back entrance i.e the serious car crash victims, ambulance emergencies etc etc

P.S Glad your wee girl was ok, the peanut allergy is a frightening one

 

[Foxholer]

Common theme here is that we seem to have a problem with Primary Care - and that is GP practices. Many folk not registered for whetever raeson and when you are you can't get an appointment.

And I'm not sure druggies and drunks are that much more of a problem in A&E today than they were 5 yrs ago.

Bottom line I think is that 'anyone can walk up when you want and be seen and treated for free' primary care has had it's day - the model is broked.

This is my view.

When proper Primary Care is not functioning well - if not disfunctional - then A&E becomes the Primary Care option.

 

[HomerJSimpson]

As someone on the front line of recruting A&E staff we have a twin battle of trying to get sufficient staff, especially those with A&E experience and then trying to keep them. I know from talking to the matron and sisters that morale is through the floor and despite 99% of the staff there trying their guts out to provide a quality service they are being beaten with a government stick in terms of budgets, targets and whatever political hot potato (two tiered A&E according to the papers today) is is flavour of the week

My mum was in and out of A&E many times last year as a result of falls exacerbated by the cancer (and other problems) and the quality of care in several London A&E's was very good. Waiting times were over four hours but the staff were professional and in the end she received the care her situation each time demanded and I don't think at the end of the day you can ask for much more in these time. You should be able to expect more but lest be realists

 

[Doon frae Troon]

Our Local hospital has an out of hours 'Doctors on Call' service joined to the local A&E.
I believe this service is funded out of the GP's budget.
It is brilliant, especially with young children. Most of the time you are seen within minutes and if it is a serious problem you are then referred next door to the A&E team. Many parents of young children just want re-assurance from a doctor, sometimes that can be done with a telephone call.

 

[Rooter]

My 82 year old ma got to A&E at 9pm after a fall on sat evening.. she has broken wrist , got cast and discharged .. 5.45 am

Similar story, but when my daughter fell off the monkey bars (yes peanut girl, who is always in Basingstoke kids ward with other ailments too!! A truly fantastic hospital and kids ward if you ever have the misfortune to have to use their services, anyway) we took her to the out of hours doctors which is based in a non A&E hospital. she was assessed, x-rayed, plastered and cleaned up and home eating a Macdonalds within 2.5 hours from falling, 2 broken wrists plastered up. If we had of gone to A&E it would have been a 6-8 hour maybe more... It does pay to be savvy if you can on where you go. A&E in my head is for heart attacks, car crashes etc, proper "emergencies".

I heard on the radio earlier some guy wanting 2 grades of A&E hospitals, similar to the above, 1 for Ambulance intake only basically, so heart attacks, car crashes etc etc etc... then the rest can form an orderly queue in the emergency ward.

 

[USER1999]

When I tried to amputate my finger with a chisel, I spent about 4 hours in AnE in Watford general. Eventually the wife got the hump, and asked the triage nurse if she had a scooby as to when I might get seen. She said, ah well, if you don't want to wait here, you could try Mount Vernon minor injuries clinic. The mrs phoned up, and they said they weren't that busy. When we got there, there was no one waiting, and two doctors doing zip. They had the right hump that I'd been sent from Watford general though!

So they are going to close it, and send every one to Watford for a nice long wait.

 

[upsidedown]

Simples, lack of money, the GP's have collared it all !!

 

[Hobbit]

I guy I play golf with is a GP. He's doing longer hours than he's ever done but seeing less patients because of the mountain of paperwork and mgt he has to do. As to the "GP's should do more out of hours" argument. When do you suggest they have a break?

The centralising of A&E services into "super hubs" is just an excuse to save money by downsizing the service. 3 A&E's merge into one, and 28 bays(beds) end up being 20.

Triage nurses; if they used nurse practitioners they'd have the authority to send patients for x-rays etc.

But why can't people wait a couple of hours or so if A&E is busy? The fast food mentality is filtering into every aspect of life - "I want it and I want it now!" There's middle ground in this, and a decent triage followed by immediate sending for an X-ray/mri would be a start.