Idiots who should NOT be going to A&E

Our local A and E has a pre admittance triage in a different building where they check if you really need A and E. Sad sign Of the times.?

Goodness Coolio that is interesting!

If I was in charge {grin]
I would recruit more GPs. The ones we have are overworked and leaving the profession. At least I know 2 who are. They would need incentives. My friend has to put up with foulmouthed, rude and demanding patients at times. She's a locum who stands in for doctors on sick leave for stress!

I would have a triage system in the streets, like there already are in some city centres at weekends or when some big event is happening so that rowdy people could be treated in situ before they have to take up valuable ambulances and space at A&E.

Also, I know it's controversial, but why not charge people for treatment if they are drunk? I know of a doctor at A&E who had to treat a drunk man while he was being restrained.

Absolutely agree Merlotgran, he was out of order. He would have had plenty of time to book a non-urgent appointment well in advance. I have despaired sometimes about inappropriate use of A&E services and there seem to be many factors involved. Changes in GPs working hours with no overnight on-calls, locum out of hours services. While the 111 service is useful for pointing people in the right direction, they will always err on the side of caution. There seems to be a good argument for the development of attached assessment centres to deal with those who do not fit Accident and Emergency criteria. This model has worked very well with Maternity services.

The link below just popped up on my FB feed: Hull Royal Infirmary is tackling exactly this problem. They quote a figure of 46per cent of people attending A&E there could have been seen by other services!!
www.hulldailymail.co.uk/news/health/hull-ae-drastic-action-taken-3651324?fbclid=IwAR2JqffdFI-SAglcl2RN0jDQLWj4NMTRp8Jh3xHhbrLDLSHrUrj3FV3a3dI

Our surgery has a very good system you get seen the same day by a triage paramedic who then decides if you are fine, or ,if you need a simple prescription, or if you need to see a doctor or hospital I would say 90% is dealt with by the prescribing medic or the nurse the other 10% get an appointment straight to a doctor (it may not be your own doctor though)

That is all very well GrannyLaine but if you can't get an appointment elsewhere (the other service) WHAT are you supposed to do?

My previously outstanding practise has introduced the 'keep ringing from 8am' procedure for a doctors appointment. I can't do that! I'm at work. There is now UPWARDS of a 3 week wait, whereas previously it was same week service.

2 months ago, my daughter was vomiting blood. We were sent by 111 to a local walk in centre. Who referred who on to something between a walk-in and A&E, who referred her on to A&E. The whole thing took over 14 hours.

My friend died in Antigua on holiday - if only she had got an A&E check up she would probably be alive today according to a medical professional.

Triage already sorts out the idiots by making them wait the longest.

The closing of NHS drop in centres was another false economy, as was getting rid of trained professionals manning NHS direct with unqualified staff who, of course, are advising more people to go to A andE because they are not confident of giving a correct assessment.

These things happened under the coalition government whose response to a GLOBAL ECONOMIC DOWNTURN was to introduce ideological austerity measures, which have not worked.

That's the trouble with all A&E departments - bloody wimps who shouldn't be there. When I was last there - I gave my sister-in-law a lift, as she'd broken her foot - there was a young woman with a tiny cut on her thumb, which was less than 1cm! She could have put a plaster on it and stayed at home.

There's triage at Addenbrookes. Sometimes the queue snakes for a long way down the road outside so I think he must have conjured up some symptoms to get in. Maybe his past history warranted it but he came across as someone who reckoned he was a bit of a smart cookie to by-pass the wait for an appointment with his GP.

@Gagajo, it would depend on the urgency for an appointment. I'm assuming if you are at work, its not an urgent appointment that's needed. If no appointments are available for the walk-in sessions, most surgeries will arrange a telephone consultation with a GP or nurse practitioner. This works very well at our practice and BlueBelle has outlined a similar arrangement.

Surely though, these people will clog up the system anywhere they go?? - Whether doctor or A&E they always had somewhere to go in the past.

Instead of celebrating their perceived idiocy, and guess-timating their illnesses, why not question the 4 decade steady decline of services through successive Labour, Tory and Liberal colluding?
No xmas compassion...

Merlot- you should have ...

People do not fit into neat little boxes. It is cruel and costly to try to make them do so. Any time I have been near a hospital, I have encountered people with serious and demanding MH issues. The last time I was with a very very elderly relative trying to get her into a taxi, an older woman, inappropriately dressed and confused wanted me to help her. It's so sad.

It'simplistic to think that it's some thoughtless/stupid people, not sensible like us, or the lack of availability of GP appointments causing clogging up busy A&E depts so I looked it up......

Main reason apparently is that many attending are much sicker than in the past and require admission. More investigations are carried out now in A&E but there are simply not enough beds to admit people to, or staff to cope. This causes a huge backlog. ? More elderly with complex conditions.

Another interesting fact is the socio economic factor, ie those from deprived areas are twice as likely to attend A&E than those from affluent areas. Lack of provision in mental health, drug rehabilitation, and social support must be therefore be implicated. ? Austerity.

Most hospitals now have some form of triage where they hive off those who do not need acute care to other ie walk in services.

I can understand your annoyance but isn't it up to the Triage Staff to prioritise patient needs?

I don't see why a hospital, especially A&E dept., should be doing ordinary health checks but they could easily have told him, 'Hard luck, Buddy, see your GP, we have more important cases.'

If people continue to take advantage of the A&E process because they are allowed to, it will always be like this.

I totally agree with your principle BradfordLass72 but we live in a litigious society which makes that approach really difficult for the NHS. I think the media has a part to play with education - I was incensed a bit shocked to watch 24hours in A&E last night to see a guy with basically a cricked neck being given considerable air time

I don't suppose he went in saying he was there for a check before he went on holiday. If he had a heart condition they had to check him if they didn't know the back story. It's called covering their backs. People are ready to complain if they are sent away and return with a deteriorating condition.

It was clearly inappropriate for this guy merlot describes to be seen but how were they to know?

yggdrasil, we would not have been so badly affected by the 2008 disaster, had Gordon Brown read(or had brought to his attention) the warnings that were in the financial and business media about run away unsustainable lending and the economy, especially the housing market, overheating from before 2000 onwards.

The reason Mark Carney was appointed Governor of the Bank of England was because he had held the same position in Canada during the 2008 crisis and Canada had weathered the crisis very well - and they are virtually joined at the hip to the US economy.

Remember the first domino to fall in Britain was Northern Rock, a building society that had been offering borrowers 125% mortgages, that is the whole value of a house plus a quarter more.

To show my impartiality, I would add there have been warnings from several sources in the last two weeks that the amount of private lending, with or without including mortgages is again rising to dangerous levels. It will be intersting to see what BJ does and who he blames it on when the economy is again brought to its knees by excessive poor quality debt.

Exactly my point Greeneyedgirl. The staff would know, they see it day after day after day. We have moved from a culture of endurance to one of complaint.

Yes, sorry GrannyL crossed posts.

GrannyLaine Tue 17-Dec-19 16:35:31
@Gagajo, it would depend on the urgency for an appointment. I'm assuming if you are at work, its not an urgent appointment that's needed. If no appointments are available for the walk-in sessions, most surgeries will arrange a telephone consultation with a GP or nurse practitioner. This works very well at our practice and BlueBelle has outlined a similar arrangement.

Can't take a telephone call in a class full of students. Can't LEAVE the class unattended. It is a sackable offense. GPs won't book a time slot for a GP consultation.

Not to mention, when I found a lump that turned out to be cancer, my first step was a GP appointment. I was at work before and after that. What if I hadn't been able to sit on the phone and wait then? As it was, I used a walk-in centre. But they've been closed now.

No one is off sick from work these days unless they are physically unable to get out of bed. Working conditions are such that if you have any more than 3 episodes (that can be 3 days ) of sickness in one year, you can be put on a disciplinary.

I'm sorry BUT the state GP surgeries are in these days (NOT their fault) it is only those that do not work that can access them.

I haven't been to the GP OR used A&E for years. But IF I had a medical problem and couldn't get into the GP, you bet I'd eventually go to A&E. I pay a LOT of tax and National Insurance. I'm paying for my healthcare. Not my fault the Tories have decimated it.

We also have long waits in ER here in Canada.

My husband had a horrible earache and went to emerg. He was subject to triage, but was kept waiting for hours. His eardrum eventually burst, and was leaking blood.... he had to go up and ask for tissue; was almost in tears with pain. There were people brought in by police, eating hamburgers and socializing on their phones which finally made him lose his temper at the main desk.

I think those brought in by ambulance or police are prioritized, since they have to stay with their patients until they are seen.

When the doctor finally saw him he asked why DH didn't come in sooner.

We live in a fairly remote town and it is hard to recruit doctors here. There is a doctor shortage everywhere in Canada, but more so in smaller towns. I don't know why the government doesn't have a program to help with finances for training doctors, or forgive a part of their student loans if they serve in smaller communities. Anything to help. Most of our doctors are from South Africa, and they do their best to recruit more.

https://www.gransnet.com/uploads/talk/201912/medium-759578-d341111eac2442d2d889df01cd36fc75.jpg https://www.gransnet.com/uploads/talk/201912/medium-678984-fireplace-straight-on.jpg https://www.gransnet.com/uploads/talk/201912/medium-107952-spease-healthcare-19.jpg

This is what a US hospital looks like, a 3 star hotel with 1 star reviews for treatment because as you can see money isn't poured into people's well-being- The flowers on the wall? Chihuly glass-