A&E queues at a 10-year high

MetroThe number of casualty patients waiting too long for treatment at hospital is at its highest level in a decade.

More than 230,000 patients waited in excess of four hours to be seen in accident and emergency departments in the last three months of 2012. The figure is an increase of 38 per cent over the previous quarter.

The number of patients waiting to be admitted to a ward after emergency treatment was also at a ten-year high.

Critics said the figures were a clear sign that NHS cuts were biting. Shadow health secretary Andy Burnham said: ‘A&E departments are suffering their worst winter for a decade.’ The figures come from researchers at the King’s Fund, which also found growing numbers of NHS managers warning that health care had suffered in the past 12 months.

The government’s target that no more than five per cent of patients must wait more than four hours to be seen in A&E is also close to being breached. Dr Peter Carter, general secretary of the Royal College of Nursing, said ‘efficiency savings must not come at the expense of patient care’.

He added: ‘We cannot continue to ignore the warnings about the detrimental effects of increasing financial pressure.’ The Department of Health said it was trying to move away from time targets, and that a four-hour measure was ‘too narrow’. People were spending longer in A&E departments because they were providing a more comprehensive service than in the past, it claimed.

What can be done about this?

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Reply 1

Decerto

Original post by whyumadtho

What can be done about this?

It is the only thing with increasing queues. To see a doctor at my GP surgery, you have to wait in excess of two weeks.

More A+E's, More staff and more awareness of the reasons you should go to A+E. I bet a lot of these people causing these queues are drunk people who have fell over or gotten into a fight.

Reply 2

Fullofsurprises

Original post by Decerto

I wonder if it's also being caused by a large number of unregistered patients who need treatment? Eg, arrivals from abroad. Also the out of hours service offered by NHS Direct is depressingly poor quality in many areas.

Reply 3

Decerto

Original post by Fullofsurprises

Definitely. I have never used NHS Direct. Is it 24 hours?

Reply 4

Fullofsurprises

Original post by Decerto

Definitely. I have never used NHS Direct. Is it 24 hours?

Yes, but out of hours if someone is quite ill, it can be a total pain trying to wade through the stupid scripted call centre approach they use to get some actual help.

Reply 5

Decerto

Original post by Fullofsurprises

Yes, but out of hours if someone is quite ill, it can be a total pain trying to wade through the stupid scripted call centre approach they use to get some actual help.

Scripted call centre - I can tell how bad it is now after hearing that.

Reply 6

n00

Original post by whyumadtho

What can be done about this?

Accept it gracefully keep your mouth shut and die is the government line i believe.

Reply 7

caravaggio2

Its not all one way.
Somebody I know had bowel cancer symptoms and within two weeks of going to the GP he had been given a Sigmoidoscopy (clear) followed by Colonoscopy (also thankfully clear) Going private wouldnt have been much quicker.

Got to smile at people who in the past have been fine with the UK open door immigration policy, telling people to relax about it, now getting worked up about A&E waiting times. As the population grows, infrastructure and services such as this will suffer.

Reply 8

caravaggio2

Original post by Decerto

That's pretty poor. It must be something like a postcode lottery they are always going on about.
If I phone my NHS GP at 8am I can get an appointment that day, more often than not before 10am

Reply 9

Captain Crash

Original post by Fullofsurprises

As an A&E Doctor (for the moment...) my experience seems to be that the bulk of patients are things that they should have seen their GP for, but came to A&E instead (e.g. "My knee has been hurting for 8 months - can you do anything about it?"). Whilst there are drunks and unregistered patients from abroad, they aren't the problem.

Reply 10

Tiger Rag

Original post by Fullofsurprises

Yes, but out of hours if someone is quite ill, it can be a total pain trying to wade through the stupid scripted call centre approach they use to get some actual help.

Sometimes it's just easier to go straight to A&E.

My dad was told by his GP to go to hospital last year after being sent home with pain in his side. After 3 hours, he was seen by a junior doctor and no-one saw him after this. After waiting another 5 hours, he decided he'd had enough and discharged himself and would go back up the next day. Went up at 8am the next day and finally admitted with appendicitis later that evening.

Sometimes it seems that people think A&E is a substitute for seeing your GP.

Reply 11

Fullofsurprises

Original post by Captain Crash

Are you in London? I've read that things are much worse in London, that the NHS is under far more pressure there.

Reply 12

Decerto

Original post by caravaggio2

That's pretty poor. It must be something like a postcode lottery they are always going on about.
If I phone my NHS GP at 8am I can get an appointment that day, more often than not before 10am

Two weeks is a very long time. In my GP surgery, it is joint so there are two GP Surgeries. One of them (mine), you have to wait two weeks and the other one you only have to wait about a day. It's not very good to be honest.

Reply 13

n00

Original post by caravaggio2

2 weeks? How the **** did they pull that one off?

(edited 11 years ago)

Reply 14

littleeggy

Original post by Fullofsurprises

Yes, but out of hours if someone is quite ill, it can be a total pain trying to wade through the stupid scripted call centre approach they use to get some actual help.

Hi there,

I work for NHS Direct but I'm replying to this on a personal level (Disclaimer). I don't have my professional hat on!

The reason why the Health Advisor asks all of those questions is for safety. If they don't they might miss something really life threatening like a heart attack. Having neck pain could mean you've pulled a muscle or it could mean you have meningitits. It's difficult to assess that accurately over the phone without asking questions because you can't physically see the person. I have worked as a health advisor myself so I can tell you that this is the reason but we try to go through the questions as quickly as possible.

NHS Direct uses a lot of Nurses to assess people over the phone. The 0845 46 47 number that NHS Direct runs is soon to be replaced by 111 which doesn't use as many nurses so unfortunately we suspect that more people are going to be directed to A&E and GP but we don't know this yet. This handover from 0845 to 111 is already happening around the country in phases and the trend we are seeing is an increase in A&E attendance.

There have been many cases where a person's life has been saved by calling NHS Direct. The service isn't perfect by no means, so thanks for the feedback we know we can always improve our service.

EDIT: not sure why I got negged? For working for NHS Direct? :frown:

(edited 11 years ago)

Reply 15

Helenia

Argh! This is not a story, nor is it "because of the cuts."

The reason this has happened is because of the abolition (or relaxation at least) of the 4 hour target! Until about 2 years ago, trusts had to see and either admit or discharge >98% of patients within 4 hours of arrival. Unfortunately this led to some people being rushed through, inappropriately admitted or discharged, and led to a skewing of priorities within departments to be based more in the time a patient had spent in the department rather than their clinical need. This was recognised by the new government and the target was relaxed - I think it's now 90%. So of course things are going to change and some people are going to wait longer, because staff are now allowed to prioritise other patients who have been waiting less time but who are more sick. There may be some delays in patients getting to wards if they are understaffed/overfull, but this is only a small part of the picture.

There are problems with people using A&E as a GP service and attending inappropriately, but any fool could see that relaxing the four hour target, for good clinical reasons would lead to an increase in waiting time.

Reply 16

Captain Crash

Original post by Helenia

Argh! This is not a story, nor is it "because of the cuts."

I don't know - at my hospital's A&E we have seen a drastic decrease in nursing staff with between 3 and 5 nurses now staffed for a department that regularly has over 50 patients in the department at the same time. The cuts are affecting A&E services.

Reply 17

Captain Crash

Original post by Fullofsurprises

Are you in London? I've read that things are much worse in London, that the NHS is under far more pressure there.

I'm outside of london, but I'm not going to say where. You don't know who's watching :ninja:

Reply 18

Helenia

Original post by Captain Crash

Hmmm, ok, that does seem pretty crappy. The point about the four hour target is still relevant though.

Reply 19

n00

Original post by Helenia

nor is it "because of the cuts."

Course not, nothing to do with it what so ever, nor will closing A&E wards cos thats just "reorganisation" and nothing to do with cost-cutting. :rolleyes:

The relaxation of the 4 hour target while in practice is obviously a sensible move in reality it will be used as an excuse and taken advantage of for further cost-cutting.