A & E Delays killing up to 500 per week

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.

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.

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.

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.

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?

It's not to be recommended biglouis!

This is seriously worrying. People will be sicker for longer, people will have fewer options to get better, and the cost of care will increase. In the future, more people may also die from secondary bacterial infections that are resistant to antibiotics.

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

And viruses do not respond to antibiotics anyway.

I have 2 friends currently in hospital due to long term staph infection resistant to anti-biotics. They will probably not come out alive.

SueDonim

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.

On the subject of minor injuries units, they are an unsung hero of the NHS, and treats:
Broken bones
Dislocations, sprains and strains
Assaults
Wounds and minor burns
Insect stings
Rib injuries (if there is no coughing up blood or chest infection)
Insect, animal and human bites
Foreign bodies to eyes, ears and nose
Head or face injuries (if there is no loss or change in level of consciousness)
Non-penetrating eye and ear injuries
Minor neck injuries
Minor back injuries

It’s nurse led, with access to X Ray, and is co-located with the GP out of hours service. They refer complex cases on to Accident and Emergency, but reduce the A&E load very considerably - and the waiting times are much shorter.

Casdon, sadly many of these Minor Injuuries Units have been closed now in our area.
There is still one across the border in England but we're not really supposed to attend there.

There is a Minor Injuries Unit at a central hospital, staffed with nurses, doctors and a consultant, but the waits there are just as bad as in A&E which is in a different hospital.

Sent by a friend who works in A&E (he did not write the article btw)

Posted anonymously by an A&E doctor:
"I'm writing this because I’m angry. Actually more than that, I’m fu*king livid.
I’m an A&E reg with 9+ years experience in A&E both here and overseas. This morning was the first time EVER that I cried in my car after a shift.
I was on nights over this New Years period, but New Year was not the issue, every shift is like this now.
Where 5 years ago we had 50 patients in the department on handover at night, we now have 180. It used to be around 20 patients to see with a 1-2 hour wait for clinician, it’s now 60-70 with a 10 hour wait.
People used to lose their minds if patients were coming up to 4 hour breaches. Last night 60% of the patients in A&E had been there for more than 12 hours, some for more than 40. Many I saw the night before, still in the same place when I came on.
No triage or obs after 2 hours of arrival, no bloods or ECGs or gas for 4 hours. Regularly finding people in the waiting room after 4 hours with initial gases showing hyperkalamia or severe acidosis or hypoglycaemia.
87 year olds coming in after falls sitting on chairs for 18 hours. Other elderly patients lying in their own urine for hours because there’s no staff, or even room to change them into something dry. As the reg in charge of the shift, Ive had (on multiple occasions) to help the sole nurse in the area change patients by holding a sheet around the bed because we have to do it in the middle of a corridor. People lying on the floor because there’s no chairs left, trolleys parked literally wherever we can put them.
Things have been getting even worse for the last 3 months. 5 weeks I came home raging to my wife that people are sitting in their own piss for hours and it’s so inhumane. Now we’ve got to the point where people are actually dying. People who’ve been in A&E for 2-3 days,
The media and public might blame the A&E nurses and doctors for this, but honestly what the fu*k are we meant to do with 180 people in a department built for 50. With 8 nurses rather than the MINIMUM staffing of 12. 1 or 2 nurses per area, giving meds, doing obs, trying to provide basic cares to 25-30 people, an absolute impossibility. And there’s less nurses every week, because honestly why would you put yourself through this day after day?
Resus patients are quickly assessed and stepped down to make room for the next pre-alert, going to the area with those same poor nurses, already overstretched, now inheriting an severely unwell patient.
We need to accept the truth, the NHS isn’t breaking, it’s broken. And the same bastards who broke it are doing reality TV shows and writing books about how they saved the NHS whilst refusing to increase nursing pay. We try and shovel shit with spoons whilst they pour it in with dump trucks
The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.
The public have no idea, they don’t really know how dangerous this all is. When they come in they’re horrified, but most of the population don’t know how bad it is. This could be their mum on a trolley for 17 hours, or their wife or son or daughter.
I genuinely feel it’s now our responsibility to speak out. We don’t for fear that it will make our hospital look bad or harm our careers. But it’s not a hospital problem, it’s a national problem, and it’s a problem brought about by the politics of the people in power.
We need to shine a light on what they’ve done, make the public so angry that they demand a change. Massive recruitment of nurses through a proper wage/paid uni/free parking/free Nando’s if that’s what it takes would be a start.
If anyone has any idea how we could coordinate some kind of campaign to show the state of emergency departments in the UK right now please write a response, because I can’t work in this much longer, and more importantly I’m not sure the patients can survive it."

It seems to differ so much from area to area.

My post was to Casdon

Callistemon21

*Casdon*, sadly many of these Minor Injuuries Units have been closed now in our area.
There is still one across the border in England but we're not really supposed to attend there.

There is a Minor Injuries Unit at a central hospital, staffed with nurses, doctors and a consultant, but the waits there are just as bad as in A&E which is in a different hospital.

It’s rural where I am Callistemon21, a minimum of 20 miles to Accident and Emergency in any direction, and they are a godsend, as they are throughout Powys. I also took my very elderly mum, who had cut her leg getting into the car to one in the midlands ( it was Tamworth). - we drove 30 miles to get there, and the service she had was so good, and quick.
I think even if an MIU is not that close from peoples homes it’s worth considering going there instead of an A&E Department if you have one of the conditions listed.

We mustn't forget that, as well as A&E there are Surgical and Medical Assessment Units where some patients can sit for days, having been assessed but are still waiting for an 'urgent' bed.

It's the same for us, Casdon, and Minor Injuries are about the same distance too.

It's quite frightening.
Before anyone thinks we should live somewhere near such important facilities - yes, we did once. The facilities closed down.

I've just read our local news and they are looking into 8 deaths in 20 days because the patients weren't categorised properly. Patients are sitting in there own urine for hours as there is no one to take them to the toilet and a man sat for four and a half days in A&E waiting on a bed.
When is this government going to realise how bad it is, these poor people deserve better care than this.

Fleurpepper that article by the A&E registrar is so good. It probably won't help much, but would it be okay to share it on Facebook?

Fleur pepper - thank you for sharing the A&E Registrar's experience. It should be required reading for all Tory MPs.

choughdancer

Fleurpepper that article by the A&E registrar is so good. It probably won't help much, but would it be okay to share it on Facebook?

Of course, a freind sent it to me but it is public.

choughdancer

Fleurpepper that article by the A&E registrar is so good. It probably won't help much, but would it be okay to share it on Facebook?

It's being shared widely on social media already, I think.

Sunak's speech today about cutting waiting lists was a diversion from the immediate problems of acute care and A&E. For God's sake, people are dying and enduring pain and disgusting experiences while waiting on trolleys, in chairs and on the floor while the Tories claim there is no crisis. What has this nation come to?

An article in today's Guardian by a palliative care doctor explains that the Tories have taken a political decision to let people die in the NHS. It's appalling. What has this country come to? Please

www.theguardian.com/commentisfree/2023/jan/06/patients-dying-nhs-hospital-corridors-avoidable-deaths?CMP=Share_AndroidApp_Other

Grantanow

An article in today's Guardian by a palliative care doctor explains that the Tories have taken a political decision to let people die in the NHS. It's appalling. What has this country come to? Please

www.theguardian.com/commentisfree/2023/jan/06/patients-dying-nhs-hospital-corridors-avoidable-deaths?CMP=Share_AndroidApp_Other

Exactly. Emergency Action Plan needs to be implemented now. How are we as a county, standing by without doing SOMETHING??