Author Topic: Accident and Emergency  (Read 4859 times)

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Offline Highlander

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Accident and Emergency
« on: January 06, 2015, 21:36:08 PM »
Are the public more responsible than the Government for the current crisis in A&E Service delivery.



Offline bewva

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Re: Accident and Emergency
« Reply #1 on: January 06, 2015, 22:38:44 PM »
Having used the Chester A & E dept twice in the last week they were absolutely chocker block on both occasions and on nightly visits to the hospital there have been 5 or 6 ambulances in the bays delivering people to the hospital. Waiting times were a joke, 3-4 hours on Friday for non life threatening patients.

I don't know if there is a connection but I would imagine A & E departments are busier now as you have little chance of getting in to see your GP these days, trying to get appointments is a joke. I waited on hold for 17 minutes yesterday to cancel an appointment my wife could not take, then they have signs up in the waiting room telling you how they have so many no shows. Not everyone would have the patience to wait 17 minutes to cancel. Its easier to just not turn up.

Offline kevin3

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Re: Accident and Emergency
« Reply #2 on: January 07, 2015, 10:20:40 AM »
I think uncontrolled immigration has put a huge strain on medical finances and resources, the whole system wasn't prepared.
Then you have binge drinking and anti-social behaviour, that puts a huge strain on A&E.
Then you have far too many managers, and a lot of them cant manage so they employ advisers.
And because they cant manage properly there is an over usage of agency staff. which costs a fortune. 
That is my take on it.

Offline Colwyn

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Re: Accident and Emergency
« Reply #3 on: January 07, 2015, 13:57:35 PM »
 Listening to A&E staff they, almost without exception, say that the vast majority of the public turning up at A&E are in need of treatment and they would not be happy turning them away. Stories about people turning up with broken fingernails are scandalously amusing, and nurses like to tell such anecdotes for a laugh, but they represent only a tiny fraction of A&E attenders. Both GPs and A&E have witnessed a massive increase in patient numbers. This increase that has very little to do with immigrants although such claims will be made since immigration, together with the EU, are currently fashionable scapegoats. Indeed if it were not for the thousands of immigrant doctors and nurses in the NHS (e.g. the 40,000 doctors born overseas) things would be far worse, to the point total collapse.
I find one clear factor in the rise of patient numbers and few other possible factors. The clear one is the rise in numbers of elderly people in the UK (over 65s) who are also living longer (into their 70s. 80s and 90s). These are presenting a wide range of medical conditions that are often compounded into multiple problems (I sometimes feel that I am personally responsible for 5% of the increase of NHS usage). Other possible factors are increased susceptibility to illnesses due to modern lifestyle issues such as working stress, processed foodstuffs, sedentary pursuits; increased expectations and demands for the delivery “health” to the citizen; and increased diagnosis of illnesses that may have been dismissed as “growing pains” or “getting old” in the past.
 
Why is A&E unable to cope with this increase? The simple “vicious circle” explanation is that too few doctors and nurses in A&E create very poor working conditions that deter new doctors and nurses making a career in the service and so on, and so on. Actually there is no great shortage of young doctors entering the A&E service. But many (most?) of them have left after 2 to 3 years experience so there is a thin “middle tier” to go on to become A&E consultants. There are, however, structural issues that underlie the the A&E problem with increasing numbers. The GP service is also understaffed and overworked so they cannot take up many extra patients. The 111 service, as alternative to GP and A&E has been, largely, a failure; it does little more than forward patients to other services – especially GPs and A&E. In my experience the Walk-in Centres have been better but I don’t know how many of these there are and how much “traffic” they deal with. The largest problem, however, seems to be cutbacks in Social Care caused by financial cuts applied to local authorities. Even if there were more doctors and nurses in A&E they might not be able to treat to more patients because of the hospital bed logjam. Thousands of beds are filled with people – prominently the elderly – who don’t require hospital treatment, don’t want to be in hospital, have a home to go to, and could be there if only they had a little support from Social Care. That, of course, would be hell of a lot better and cheaper for all of us; but it isn’t there.
 
What about the responsibility of individual patients? Of course it is easy to point a finger at the drunks (which I do even though I once went to A&E for stitches in my scalp caused by a drunken fall when I was 20) and perhaps town centre medical tents could help some of the demand from this quarter. Or, they could stop getting drunk. But a broken arm from a drunken fall is just as much a broken arm from a rugby match – and, arguably, both are self-inflicted – and both need treatment. We could direct people away from A&E when they don’t need to access it. The 111 service appears to use non-medical staff to lead people through a simple flow chart based on YES/NO before directing on to another service. Perhaps every home in the UK should have one of these to help decide where to go when you are ill or injured – stick it on the onside of one of your kitchen cabinet doors. With a bit of imagination we could think of all sorts of ways to mould the individual into the sort of patient (GP, A&E, Walk-in, Pharmacy, etc) with which the system can deal. Maybe. What I am damned sure about is that politicians, or anyone else, jumping up and saying “People should be more responsible!” will make no bloody difference at all. If “irresponsible” individuals are the "problem" they need to be assisted in becoming a "solution" – not harangued.
 

Offline scorcher

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Re: Accident and Emergency
« Reply #4 on: January 07, 2015, 15:56:25 PM »
Good post Colwyn - fine diagnosis!

Offline bewva

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Re: Accident and Emergency
« Reply #5 on: January 07, 2015, 18:47:03 PM »
As I picked Mrs B up from hospital last night she was told there were 7 available beds and 51 patients waiting for them.

Offline nichola

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Re: Accident and Emergency
« Reply #6 on: January 07, 2015, 20:42:18 PM »
The whole NHS including A&E is being deliberately underfunded and under resourced so that unfounded claims that it isn't working can be made to justify privatisation. Large swathes to the tune of billions of pounds have already been privatized. It may not appear any different because the services that have been sold off operate from the same premises but the fact is that the health service we paid for with tax payers money, that we own is being given away for profit and gain.

In actual fact the NHS is one of the most cost effective and efficient health services on the world recent research has shown but we don't hear this, just the failings of a system that is being deliberately undermined for political and financial gain.

It's an absolute disgrace.

Offline nichola

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Offline Steve A

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Re: Accident and Emergency
« Reply #8 on: January 08, 2015, 09:34:49 AM »
Never been able to cope for years and strangely enough the situation always worsens in election year

Offline nichola

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Re: Accident and Emergency
« Reply #9 on: January 08, 2015, 10:40:31 AM »
Actually at the time of the last election research found that more than 70% of actual users of the NHS were happy with the service, waiting times were radically reduced and models of good practice were being shared around the country.

Anyone who can remember the state of the NHS by the end of the last Conservative government and probably one of the main reasons apart from all the sleaze stories they were booted out of office will know what a huge improvement that was.

I doubt very much now after 5 years of underfunding and selling off what is not theirs to sell anyone can say the same now.




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