My experience of A&E

Cyclizine

As someone who allegedly was an NHS manager for 25 years, you do not appear to understand how patients are admitted to a hospital bed in the UK. You can only (outwith a few unusual situations) be admitted via a referral from your GP or via the Emergency Department. Both are performing the initial assessment and triage and will decide where best to refer you on. Despite what you think, your GP was on the telephone arranging your admission. If you had waited in the ED, to be seen by a doctor (who would also potentially be a trainee GP; almost certainly a trainee, anyway) this is likely to be what would have happened also.

Cyclizine

Loanranger wrote: »

All this discussion of what is wrong with the NHS and the elephant in the room is this: how can we admit 260,000 people from overseas every year and not expect that the infrastructure will break down?
In recent years the net immigration has been double that number. This is net, so the number of people leaving are deducted to arrive at the figure of 260k. This is a city the size of Wolverhampton every year.
We cannot build enough hospitals and train enough staff to keep pace with demand.

I am not passing judgement on whether this increase in the population from abroad is a good or a bad thing, it is simply presenting the fact of it and suggesting that it is a factor in the stress upon the NHS.

It is not, but it is a useful scapegoat. Migrants are as a rule young and healthy with little demand on the NHS compared to your average 'homegrown' Brit. Given migrants cause a net gain to the Treasury, ask yourself why this extra money isn't spent on increasing NHS capacity.

Our aging population, with complex chronic conditions and decades of underfunding of social care are the main reasons for the increasing demand.

Manxman_in_exile

Cyclizine wrote: »

As someone who allegedly was an NHS manager for 25 years, you do not appear to understand how patients are admitted to a hospital bed in the UK. [I didn't need to. I didn't work in the Acute sector. I worked in Mental Health and had nothing to do with the clinical side].


You can only (outwith a few unusual situations) be admitted via a referral from your GP or via the Emergency Department. [Thank God it's not just down to A&E]...


Despite what you think, your GP was on the telephone arranging your admission. ["Despite what I think..."? I know she was on the 'phone - I was there!]


If you had waited in the ED, to be seen by a doctor (who would also potentially be a trainee GP; almost certainly a trainee, anyway) this is likely to be what would have happened also. [Likely is not good enough. I needed to be admitted to hospital. Let's get the crystal ball out.][/QUOTE]


I've got no problem with trainees. Nearly 20 years ago I was responsible for managing nursing, OT/PT and a clinical psychology doctorate with two universities. I fully understand the significance of trainee healthcare professionals - and of them gaining appropriate clinical experience during training. Our GP practice is a training practice for our local medical school and I'm quite happy for medical students to sit in on consultations with my GP. Got to think of the future.


Nice user name!

fred246

I think the OPs real complaint is probably that he was discharged too early. He has been showing clear signs of confusion for the last 48 hours. Went to hospital and discharged himself before he saw the doctor because he was too ill to wait and then goes on a forum to moan. I do worry about the quality of NHS management.

Manxman_in_exile

fred246 wrote: »

I think the OPs real complaint is probably that he was discharged too early. He has been showing clear signs of confusion for the last 48 hours. Went to hospital and discharged himself before he saw the doctor because he was too ill to wait and then goes on a forum to moan. I do worry about the quality of NHS management.

Oh - thank you very much! That made me laugh out loud! I feel much better for that.


Actually I did think I was probably discharged a couple of days early as I was still quite wobbly. If I lived on my own I think they would have kept me in for a couple of days more. I was still a bit confused on discharge but I'm OK now. (Honest!)

Loanranger

Cyclizine wrote: »

It is not, but it is a useful scapegoat. Migrants are as a rule young and healthy with little demand on the NHS compared to your average 'homegrown' Brit. Given migrants cause a net gain to the Treasury, ask yourself why this extra money isn't spent on increasing NHS capacity.

Our aging population, with complex chronic conditions and decades of underfunding of social care are the main reasons for the increasing demand.

You are in denial, seriously in denial.

Cyclizine

Loanranger wrote: »

You are in denial, seriously in denial.

You are blinkered, seriously blinkered.

HTH

Cyclizine

Manxman_in_exile wrote: »

Cyclizine wrote: »

As someone who allegedly was an NHS manager for 25 years, you do not appear to understand how patients are admitted to a hospital bed in the UK. [I didn't need to. I didn't work in the Acute sector. I worked in Mental Health and had nothing to do with the clinical side].


You can only (outwith a few unusual situations) be admitted via a referral from your GP or via the Emergency Department. [Thank God it's not just down to A&E]...


Despite what you think, your GP was on the telephone arranging your admission. ["Despite what I think..."? I know she was on the 'phone - I was there!]


If you had waited in the ED, to be seen by a doctor (who would also potentially be a trainee GP; almost certainly a trainee, anyway) this is likely to be what would have happened also. [Likely is not good enough. I needed to be admitted to hospital. Let's get the crystal ball out.][/QUOTE]


I've got no problem with trainees. Nearly 20 years ago I was responsible for managing nursing, OT/PT and a clinical psychology doctorate with two universities. I fully understand the significance of trainee healthcare professionals - and of them gaining appropriate clinical experience during training. Our GP practice is a training practice for our local medical school and I'm quite happy for medical students to sit in on consultations with my GP. Got to think of the future.


Nice user name!

You're still missing the point - yes, you probably did need admission when you attended the ED however, you left before you were seen by a doctor! You attended another doctor the next day and were admitted. I struggle to see what you're venting about, other than you had a long wait in the ED (and then a longer one overnight before seeing your GP). The way triage works has already been explained to you - patients are seen in order of priority in the ED, not in order of attendance. There is more going on behind the cubicles...

humptydumptybits

Manxman_in_exile wrote: »

Several posters seem to think that this was my fault because I left A&E voluntarily. This seems to be based on two questionable premises.


First, that I was still alive the following day, therefore I must have been correctly triaged in A&E. Well that may or not be correct. It may be that if this were to happen ten times that I would actually die nine times and that I was extremely fortunate that this happened to be the tenth time and I survived until the following day. Who is to say? I don't know and neither does anybody else posting here. All I really know is that two GPs were sufficiently concerned to get me admitted immediately the following day.


Second, that because I wasn't seen more quickly by a doctor in Emergency, that I obviously didn't need to be seen by a doctor more quickly. This assumes that the "process" works (near) perfectly and there simply can't be any mistakes


Both of the above seem to me to be pretty good examples of the logical fallacy "begging the question". That is where you assume the conclusion of your argument at the outset and then argue in such a way as to support the pre-assumed conclusion. (It is not a fancy way of saying "this raises the question" which most people seem to think it means). eg "You were still alive the following day, therefore you were processed correctly in A&E" and "You didn't see a doctor more quickly because you obviously didn't need to".


Additionally, the assumption by one poster that because I'm being critical of my experience in A&E that I expect "special treatment". As a logical fallacy I would say that's a "non sequitur". Nothing could be further from the truth. I'm starting to feel guilty now as I must have jumped the A&E queue and taken somebody's bed away from them.


I'm sure that those who say "it's all your own fault because A&E don't get things wrong" won't be persuaded otherwise, so let's just agree to differ.

You don't know what decision the nurse made when you were triaged, all you know is that the wait for your particular level of need was longer than you were prepared to wait. It doesn't mean she was wrong.


There was lots of talk about the Birmingham Pub Bombings on TV last week. That night in 1974 saw 21 people die, loads more injured. I know a nurse who was working in A&E in Birmingham, off duty staff rushed in but they were still struggling to cope. How long do you think people were waiting in A & E that night, how could the hospital have prepared for that night to ensure no one had to wait for 3 or 4 hours? A&E is unpredictable, it is pretty obvious if you think about it. Expecting there to always be short waits in A&E is as logical as the NHS asking you to get sick at a quiet time.


Of course it is annoying to wait, horrible when you are feeling rotten but you were successfully treated so maybe focus on that.

humptydumptybits

Loanranger wrote: »

All this discussion of what is wrong with the NHS and the elephant in the room is this: how can we admit 260,000 people from overseas every year and not expect that the infrastructure will break down?
In recent years the net immigration has been double that number. This is net, so the number of people leaving are deducted to arrive at the figure of 260k. This is a city the size of Wolverhampton every year.
We cannot build enough hospitals and train enough staff to keep pace with demand.

I am not passing judgement on whether this increase in the population from abroad is a good or a bad thing, it is simply presenting the fact of it and suggesting that it is a factor in the stress upon the NHS.

When I was last in hospital my named nurse was from the Philippines, the Registrar was Italian and my Consultant was from India. Not sure that cutting down on immigration is the answer.