Another A&E fiasco

Perhaps what the NHS could do with is a proper initial triage. Too many people go to A&E with pathetic "illnesses" that can be treated with basic 1st aid kit at home or should be seen by gp.

Perhaps NHS should start charging people for wasting their time.

David Anderson Photography said

Perhaps what the NHS could do with is a proper initial triage. Too many people go to A&E with pathetic "illnesses" that can be treated with basic 1st aid kit at home or should be seen by gp.

Perhaps NHS should start charging people for wasting their time.

Hear hear!

Northampton General Hospital now have a tiered A&E whereby a patient is seen almost straight away by a nurse who points them in the right direction. ie, pharmacy, non emergency walk-in, or GP. I've seen people in A&E with cut fingers and grazed knees. Admittedly they're usually also pissed or off their tits on some substance or other. Waiting time has gone from an average 4-6 hours down to 1-2 at most.

Surely A&E is all about those that need immediate emergency care?

Charge all the alcohol and drug reated cases fees for their treatment. Also charge all those folk that love to go walking up the mountains in winter in a pair of flip-flops, a crop top and hotpants then call out the rescue services when it all goes Pete Tong. It's hard enough for those of us with genuine medical needs to get appointments and/or treatments without these fools draining the little money that is allocated to the NHS by their foolishness.

In a world where footballers are paid multiple millions and nurses are paid worse than retail staff, i can't help feeling that things have gone wrong somewhere.

Edited by StrictlyFunPhotography

StrictlyFunPhotography said

Surely A&E is all about those that need immediate emergency care?

Charge all the alcohol and drug reated cases fees for their treatment.

Sorry, but my brother in law is currently dying in hospital from alcohol releated disease - who are you going to charge? His Mother, his Sister, me? Should they have refused to admit him to A&E?

And someone mentioned triage. Don't all A&E depts operate a triage system anyway. Minor injuries etc are dealt with, eventually, by specialist nursing staff.

Half of the reason people with minor ailments go to A&E is because they can't get a GP appointment - or in the areas where GP surgeries are in rapid decline - can't even get a GP!

It takes a week to see a GP. 

BTW What happens if you think your child has contracted meningitis where every minute counts? Er yes...silly me.....you let it die. 

A lot of A&E visits are down to cuts in social care and unavailability of GPs. Hunt is an incompetent @£*^

Edited by vanBrighouse

What's required is a change in attitude whereby people don't call an ambulance for a sprained toe-nail and stop clogging what is meant to be an emergency service with trivial ailments which could be treated at home by someone with a Band-Aid and two working brain cells.

I say this with the benefit of years of Acute Medical work behind me....Jeremy Hunt couldn't find his arse with a map and tourguide. He is not fit to hold office, any of his crackpipe induced ideas should be thrown in the bin with the rest of his crayon drawings.

He is an odious little shit with a god complex.

In other news, the Tories know this and have decided that they don't care because the quicker it gets worse the quicker they can flog it off to Virgin Care.

The solution is to start chasing the tax evasion specialists and put that money back into front line services like Ambulances and walk-in centres for minor injuries. It is too easy to dismiss the cause of most backlogs in Acute care. It is often caused by lack of beds, lack of beds is caused by delayed discharges, delayed discharges are caused by lack of social care in the community and this is caused by lack of funding.

Since 2010 waiting lists are longer.

Trolley waits in A&E are longer.

Waiting times for Cancer care from diagnosis to treatment times are longer.

The Tories re-Organisation of the NHS was the cause of this.

And while I agree that some form of charges should be given to those who waste valuable resources for Drink and Drug admissions we should also be looking closer at other areas of wastages too.

AndyWilson said

StrictlyFunPhotography said

Surely A&E is all about those that need immediate emergency care?

Charge all the alcohol and drug reated cases fees for their treatment.

Sorry, but my brother in law is currently dying in hospital from alcohol releated disease - who are you going to charge? His Mother, his Sister, me? Should they have refused to admit him to A&E?

And someone mentioned triage. Don't all A&E depts operate a triage system anyway. Minor injuries etc are dealt with, eventually, by specialist nursing staff.

Half of the reason people with minor ailments go to A&E is because they can't get a GP appointment - or in the areas where GP surgeries are in rapid decline - can't even get a GP!

This year a student on my course had a patient that called an ambulance because he was told he couldn't get an emergency appointment at the gp for a cold. The ambulance got him an emergency appointment with a nurse, the nurse told him to take paracetamol for his cold and expressed the cost of calling an ambulance.

People calling ambulances & turning up at a&e for minor ailments is the fault of those people not just the fault of GP surgeries.

Minor injuries units are perfectly able to deal with your minor injuries, a&e isn't really the place.

AndyWilson said

StrictlyFunPhotography said

Surely A&E is all about those that need immediate emergency care?

Charge all the alcohol and drug reated cases fees for their treatment.

Sorry, but my brother in law is currently dying in hospital from alcohol releated disease - who are you going to charge? His Mother, his Sister, me? Should they have refused to admit him to A&E?

And someone mentioned triage. Don't all A&E depts operate a triage system anyway. Minor injuries etc are dealt with, eventually, by specialist nursing staff.

Half of the reason people with minor ailments go to A&E is because they can't get a GP appointment - or in the areas where GP surgeries are in rapid decline - can't even get a GP!

Sorry to hear about your brother in-law. 

Yes there is a triage system in place at A&E, those with silly complaints get put to the bottom of the queue. And rightly so.

For the drunks, etc, Booze Bus seems a logical option. Such innovations should be more wide-spread. Cases of serious alcohol illness is not really the same. And if we want to help pay for self inflicted care, stick some tax on fags, booze, McDonalds, Sweets, etc, etc. Oh we already do that!

I think It's a simple fix for some of the stuff, my idea is. very much like a driver awareness course, so if you abuse the emergency services, and this works with them all, you are then issued with equirememt to attend an emergency service awareness course, at a cost of say £50, failure to go is a £200 fine, then ramp the fees up for persistent t offenders.

So if you think it's ok to ring the police because your cat is missing, the you clearly need education, or if you think an ambulance is a taxi, same applies, it's all about education.

AndyWilson said

StrictlyFunPhotography said

Surely A&E is all about those that need immediate emergency care?

Charge all the alcohol and drug reated cases fees for their treatment.

Sorry, but my brother in law is currently dying in hospital from alcohol releated disease - who are you going to charge? His Mother, his Sister, me? Should they have refused to admit him to A&E?

And someone mentioned triage. Don't all A&E depts operate a triage system anyway. Minor injuries etc are dealt with, eventually, by specialist nursing staff.

Half of the reason people with minor ailments go to A&E is because they can't get a GP appointment - or in the areas where GP surgeries are in rapid decline - can't even get a GP!

Idiots turning up after a piss up and hurting themselves is a very different case than longer term Alcoholism. In my 17yrs people I have looked after with Alcoholism have had something more going on with them, they are vulnerable adults with often deep pyschological issues to deal with. Emergency departments are not the best place for them unless they are injured. I think more research is needed to find the best way to deal with them.

D_evil_Red said

I say this with the benefit of years of Acute Medical work behind me....Jeremy Hunt couldn't find his arse with a map and tourguide. He is not fit to hold office, any of his crackpipe induced ideas should be thrown in the bin with the rest of his crayon drawings.

He is an odious little shit with a god complex.

In other news, the Tories know this and have decided that they don't care because the quicker it gets worse the quicker they can flog it off to Virgin Care.

The solution is to start chasing the tax evasion specialists and put that money back into front line services like Ambulances and walk-in centres for minor injuries. It is too easy to dismiss the cause of most backlogs in Acute care. It is often caused by lack of beds, lack of beds is caused by delayed discharges, delayed discharges are caused by lack of social care in the community and this is caused by lack of funding.

Since 2010 waiting lists are longer.

Trolley waits in A&E are longer.

Waiting times for Cancer care from diagnosis to treatment times are longer.

The Tories re-Organisation of the NHS was the cause of this.

And while I agree that some form of charges should be given to those who waste valuable resources for Drink and Drug admissions we should also be looking closer at other areas of wastages too.

^100%

I think there are quite a few good ideas for restricting demand to the limits originally envisaged for a&e units i.e. Emergencies.

We seem to forget that the NHS is the only health service in the world where no charge is made to keep demand sensible.  In VBs 'meningitis' example what do other countries do? In Australia you could go to a free HP or call an ambulance for which you (or technically your insurance) would be charged.  In Ireland it would cost you 80 euros to see your gp don't know the a&we system. In France you would be charged and then be able to claim back 90 pic of your cost.  In Norway you would pay up to £250 per year for your health service usage whatever it was after which everything would be free.

No one can be arrogant enough to say that these countries don't care anboutbtheir citizens health but they do require a bit of 'personal responsibility' that we seem increasingly to omit.

We are unique in everything being free.  And in my experience everything free is abused eventually.  Even a small charge gives a service 'value' in the eyes of the user and abuse is reduced disproportionately.

You only have to watch bbc's 'Ambulance' to see the levels of abuse of the system that exists.....and the corporation are hardly a bastion of Tory propaganda.  Some form of cost must be  applied to abusers at some point but maybe we could start by sending the miscreants details of what cost they have had the NHS incur on their behalf.  This would be for education not penalty.  However if behaviour didn't change then the invoices would become real....and payable

By the way is everyone aware that insurance companies are charged for ambulance, a&e, other medical costs and fire brigade expenses of car accidents, via the insured involved.  This forms part of the costs of  our car insurance.  So maybe pub chains or council licensing committees or brewery/ distillery companies should be charged for the 'booze buses'...

Btw......both my beloved and I have worked for the NHS in various front line capacities...land have experience of various foreign health services as good as or better than NHS ...but for which there was a charge of some sort ranging from symbolic to substantial.

Just sayin

StrictlyFunPhotography said

Surely A&E is all about those that need immediate emergency care?

Charge all the alcohol and drug reated cases fees for their treatment. Also charge all those folk that love to go walking up the mountains in winter in a pair of flip-flops, a crop top and hotpants then call out the rescue services when it all goes Pete Tong. It's hard enough for those of us with genuine medical needs to get appointments and/or treatments without these fools draining the little money that is allocated to the NHS by their foolishness.

In a world where footballers are paid multiple millions and nurses are paid worse than retail staff, i can't help feeling that things have gone wrong somewhere.

Edited by StrictlyFunPhotography

According to published NHS pay scales for 2017/18, NHS nurses can earn anything between £15K to over £100K per annum, so I’m not sure where the comparison with retail staff comes in. What are the median salaries?

Individuals need to be more responsible as well. So many of the cases over the weekend tends to be from overuse of alcohol.