A & E Delays killing up to 500 per week

biglouis

You can order antibiotics on the internet and get them sent by courier next day. Been there, dont it, got the t-shirt. Cost me about the same as a taxi ride and back to my GP.

Not legally, unless you have a prescription.

No wonder we have massive issues with resistance, which will probably kill thousands in a decade or so.

How do you know which antibiotic is suitable for your condition?

Urmstongran

As an article by a journalist in the Telegraph today commented, we are so used to reading horror stories about our broken NHS we’ve almost become immured to it. We read, we are horrified and we shrug.

As he went on to say imagine if there were 500 deaths a week from train accidents. People would be in uproar.

Urmas He's obviously not had to endure the system recently, either as a patient or a member of staff.

You can order antibiotics on the internet and get them sent by courier next day. Been there, dont it, got the t-shirt. Cost me about the same as a taxi ride and back to my GP.

Thank you, Growstuff and Janejudge for the sympathy for my dd.

I think all this is a symptom that the entire system is broken. Dd says they get a lot of ‘social’ cases, as others have mentioned, with people who need pastoral care, not operations or drugs etc. They need to be looked after in the community, not in hospitals, but A&E is the only place where anyone will listen to them.

As well as the ‘strip of paracetamol’ patients, a not infrequent occurrence is people who have seen their GP but aren’t happy with the outcome, either because they disagree with the diagnosis (eg, they want antibiotics for an infection the GP says is viral) or they think they can queue-jump investigations the GP has organised by going to A&E, such as maybe getting a scan to look for gall stones. A&E doctors can’t do anything like that, it’s not within their powers. They have to refer on to the specialist department.

On the other hand, I can see how people end up at A&E. It seems to me there’s such a mishmash of services that it’s hard to know where one should turn in an emergency or when the usual places such as GP are closed. For instance, the other day I went to a part of our town that I’ve never visited before and there, in the middle of a residential area, was a stand-alone Minor Injuries unit! I’ve never heard of it, I have no idea how you access it or why you’d go to it when there’s an A&E maybe half a mile away.

my friend has just called me to say she had seen her gp, she was given a stern talking to for not going to a&e at our local hospital, waiting times are 6 hours or more and ambulance waiting outside can be 6/8 hours, she tried calling nhs 24 but it was 2/3 hours waiting for someone to pick up the phone, she has been told in the past to just present herself at the hospital as she has heart problems and severe asthma. i don't think it is just a matter of getting more beds or using places like the nightingale (probably long gone), they don't have the staff to cope with more beds or patients.

As an article by a journalist in the Telegraph today commented, we are so used to reading horror stories about our broken NHS we’ve almost become immured to it. We read, we are horrified and we shrug.

As he went on to say imagine if there were 500 deaths a week from train accidents. People would be in uproar.

When Tory politicians and hospital consultants and nurses give opposing accounts of the NHS 'crisis/what crisis?' who am I to believe? No brainer - the front line staff of course. The accounts in today's Telegraph of patients waiting and dying confirm this. And that a national newspaper should think it necessary to publish an advisory article by a senior clinical lecturer on what to do if the ambulance does not come is a national disgrace. We have over 10 years of Tory underfunding and micromanagement to blame - the pandemic and flu are Sunaks's alibi for his predecessors' failures. And those who think the NHS is bloated with overpaid managers should bear in mind that only 2% of NHS staff are managers.

Message withdrawn at poster's request.

Hetty58

nanny2507: 'People need to grow up and learn what A&E is for'

It seems that way - but, to me, the usual 'time wasters' would be completely incapable of just growing up. Victim blaming?

There are alcoholics, those with anxiety and MH issues, personality disorders etc. - not just the patients but their panicking carers too.

Underfunding and shortages of staff mean limited access to services elsewhere - along with unreasonable delays. Therefore, in practice, people are being shunted into A&E, through a lack of choice, often time and time again.

There will be far more of them than 'usual' though. A severe lack of carers, MH teams, support for the homeless, alcoholics, ambulance crews, GP support etc. (the whole caboodle) creates that bottleneck. It all falls apart when services are run down for decades. When do we become aware and see it happening? In A&E!

Well put, Hetty.
I'd like to give an example of one Saturday night when I had to call for help for someone with MH stuff: there were just two workers on duty for the whole of my large city, (needed 6) and suicidal people ringing in: what else to but direct them to the relative safety of A and E?

It's also known that life expectation is lower in the same areas.

People living in the most deprived areas in England had a far higher number and rate of attendances at A&E compared to other groups. A&E attendances were twice as high for people in the most deprived areas as in the least deprived.

www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters

Hmm .. I wonder why. It seems to be part of a bigger picture, which needs addressing.

nanny2507: 'People need to grow up and learn what A&E is for'

It seems that way - but, to me, the usual 'time wasters' would be completely incapable of just growing up. Victim blaming?

There are alcoholics, those with anxiety and MH issues, personality disorders etc. - not just the patients but their panicking carers too.

Underfunding and shortages of staff mean limited access to services elsewhere - along with unreasonable delays. Therefore, in practice, people are being shunted into A&E, through a lack of choice, often time and time again.

There will be far more of them than 'usual' though. A severe lack of carers, MH teams, support for the homeless, alcoholics, ambulance crews, GP support etc. (the whole caboodle) creates that bottleneck. It all falls apart when services are run down for decades. When do we become aware and see it happening? In A&E!

Callistemon21

It's not the same system here, growstuff.

Receptionist takes details, including details of the problem, then you wait to be triaged by a nurse, in our experience about 2 hours.
Then back in the waiting room for further assessments - another 9+ hours in our case.

My son was triaged almost immediately. His leg was actually twisted at the knee, so I expect it was obvious that he was in a huge amount of pain. In A&E itself, he was given a painkilling injection and had his obs done within minutes. After about an hour, he had an Xray and then had to wait about another hour or so for somebody to put his leg back in the right position under local anaesthetic.

I wasn't in either waiting room long enough to know what else was going on. My only personal experience of A&E has been as an ambulance emergency, when I was seen immediately without triaging.

I know somebody who works in the department and apparently about 20% of walk-ins are sent elsewhere. The Urgent Treatment Centre is literally next door and is open overnight and at weekends. Apparently, some people are sent off to a pharmacist or dentist.

SueDonim I was sent by the triage nurse from A&E to Minor Injuries Unit miles away.
They could not diagnose the problem at all and I eventually saw a surgeon 5 weeks later - an instant diagnosis and urgent surgery is required.
Still waiting 4 months later.

It's not the same system here, growstuff.

Receptionist takes details, including details of the problem, then you wait to be triaged by a nurse, in our experience about 2 hours.
Then back in the waiting room for further assessments - another 9+ hours in our case.

SueDonim

Oh yes, that’s a regular demand - a strip of painkillers or indigestion tablets. The thing is, all these people still have to be documented and processed, no matter what they’re there for and that all takes time.

That's downright ignorance. There need to be posters all over the place stating that A&E can't hand out medications.

Callistemon21

growstuff

But Callistemon my A&E wouldn't have let people demanding painkillers past the reception desk. Why don't all A&Es have that kind of system?

Are you sure?
Receptionists cannot triage patients.

They have a clinician at the reception desk. What happened with my son is that a receptionist took his details and a clinician (nurse?) took one look at his leg and agreed he needed to be admitted to the main A&E area. That was three years ago, but I think the hospital still has the same system.

SueDonim

Despatches from the front line. My dd has just come off a long shift in adult A&E. The dept had its usual queue of ambulances outside. Inside, they were rammed full as they were unable to admit anyone as there were no beds. They also have staff sickness so at one point there was just one nurse for 30 patients.

Dd said it was a shift from hell.

My sympathies for your daughter.

I expect some of the people had more than just a cold. Something really needs doing about this - long term and short term.

I'm not disputing that some people misuse A&E. Some of them are possibly there from desperation because they can't get a GP appointment or there isn't a local minor injuries unit. However, it's not good enough to blame people for wanting medical treatment because I honestly thing most are genuine. That's why I think there needs to be a big public information campaign and more investment in local community nursing and para-medics, who should be able to keep people out of going to hospital in the first place. I think it's too much to hope that more GPs can be trained in the short term (and anyway, I don't think I'd want to be a GP, if I were a medical student).

If A&Es aren't already triaging, they need to invest in clinicians to do it before patients step inside the building. It also sounds as though they need to invest in security staff.

At the other end of the process, there needs to be more investment in convalescent hospitals with full nursing care, but not necessarily doctor cover. Patients don't always need to be in an expensive acute hospital and could be cared for in a "step-down" unit or even at home, if there were more district nurses.

A&Es should be for people who genuinely need life saving care. There need to be more beds available for admission and more staff in A&E itself. I doubt very much if any private provider would be interested.

The whole process needs to be integrated. At the moment, each trust and GP practice is a cost centre and tries to offload responsibility to others. That's actually costing more than an integrated service would and means patients are being boomeranged from one service to another.

I have no idea how much my suggestions would cost, but I honestly don't think we can afford not to invest in what we already have.

Oh suedonimlove to your daughter

growstuff

But Callistemon my A&E wouldn't have let people demanding painkillers past the reception desk. Why don't all A&Es have that kind of system?

Are you sure?
Receptionists cannot triage patients.

Oh yes, that’s a regular demand - a strip of painkillers or indigestion tablets. The thing is, all these people still have to be documented and processed, no matter what they’re there for and that all takes time.

But Callistemon my A&E wouldn't have let people demanding painkillers past the reception desk. Why don't all A&Es have that kind of system?

SueDonim

Despatches from the front line. My dd has just come off a long shift in adult A&E. The dept had its usual queue of ambulances outside. Inside, they were rammed full as they were unable to admit anyone as there were no beds. They also have staff sickness so at one point there was just one nurse for 30 patients.

Dd said it was a shift from hell.

Dd said it was a shift from hell

Having spent 11 hours in A&E not long ago with DH I can believe that analogy, SueDonim

Yet still the doctor remained cheerful when we saw her. She said some people were there regularly demanding painkillers which their GP would not prescribe for them.

Despatches from the front line. My dd has just come off a long shift in adult A&E. The dept had its usual queue of ambulances outside. Inside, they were rammed full as they were unable to admit anyone as there were no beds. They also have staff sickness so at one point there was just one nurse for 30 patients.

Dd said it was a shift from hell.

btw fleurpepper, I was only talking from our perspective on the social care end.