1 in 5 patients now wait longer than 4 hours to be seen in A & E

But no-one is saying how many of us go there because a wait in A & E is perceived to be quicker than waiting to see our GP. No-one is adding up the figures, and seeing exactly why non-emergency cases end up in A & E.  The Minister just complains and tells us we should see a GP.

For those of us who have an accident – as long as we are dealt with competently and made comfortable in A & E, we are not going anywhere and understand we will be kept waiting. As long as pain is dealt with immediately, and we aren’t told “you will get pain relief later – we will put up with a long wait. But when the Minister shouts about ‘targets’, no-one has asked us what OUR target is.
Like many, I go to A & E when I have something wrong medically, and know that waiting to see a GP for the condition for weeks is an unacceptable option.  I take myself off to hospital with my lap top, expecting to be there for half a day, knowing that my problem will usually be sorted, won’t get worse whilst waiting to see my GP, and I can work whilst waiting.  My local surgery does now offer the option of seeing ‘any’ GP particularly at weekends. But this is a Locum, wet behind the ears, and as I found out, with suspect diagnostic skills. 
In many areas, it’s easier to see the Queen than your GP.  Clunky phone systems, not enough appointments, unhelpful receptionists, inconvenient hours for commuters, etc.
So, you have a ‘lightbulb’ moment and go to A&E; it’s open, you can park, and even if you do have to wait, you’ll still get to see a doctor in a few hours, rather than waiting days.
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Normal procedure
From experience, if you walk in to A & E you will wait 3 hrs and 50 minutes to be called (thus ticking the box for being seen in under 4 hours), shown into a cubicle – and there you wait, and wait, and wait.  No tick box to identify how much of our time is wasted by NHS.  But you have been ‘seen’ within the 4 hour slot, so the box can be ticked and the hospital isn’t fined.
There must be a better way, although this weekend I blessed the time when I had made full use of being left alone, and ‘borrowed’ tape, dressings etc. from the dressings trolley whilst bored out of my mind; I was grateful I had these dressings at home when some fell off afters my last hospital procedure.
The old dears in other cubicles are often dozing away, warm and kept happy by older nurses who dish out TLC; and pop in every so often to smile so they know they aren’t forgotten.  ‘Targets’ mean nothing in this scenario  – it’s human empathy that counts when you are a patient.
Why is there such a mess when it comes to dealing with life’s ordinary health problems?
Primary care cannot cope with demand and STPs have barmy ideas about closing beds, making the whole situation worse. People who have to hang around waiting for treatment are vulnerable, and more likely to fall sick.
To the public, the NHS looks after our health. But the NHS complicates the system.
The NHS is split up into lots of divisions, and believe it or not, they are all competing for our money.  You may think the NHS is there to serve the patient.  WRONG.  In its own mind it is there to get as much of the NHS funding pot as it can for its own sector, and doesn’t think the service should work for common good.
What plans does Whitehall have?
As usual, the enormously over-staffed Dept. Health has been beavering away;  these are latest pronouncements:
1. Hospital occupancy levels should be monitored; currently bed occupancy in hospitals is running at 100%, so when Gran slips and breaks a leg, her broken bone needing another bed creates a crisis. Other countries expect 80 – 90 % bed occupancy and the Royal College of Surgeons says 82% is a safe level.  
2. Latest ‘plan’ is to Free-up 2,500 acute beds by getting people home faster. Sounds like another magic number.  It can take 6 weeks to sort out sort out some discharges.
3. However, there is yet another brilliant plan festering in Whitehall, Collect better primary care data to figure out what’s going on.  Good, but how?  My guess is by spreadsheet and a weekly return.  Or the NHS could buy some software from other countries to see how it could work – but NHS IT system couldn’t cope.
4. Work with councils to ensure 7 day working; in most parts of the country social care doesn’t open at the weekends. So if Gran could go home, but it’s Friday, she ain’t going to be moved until Monday, or Tuesday, or …
5. Drive to implement best practice.  Yawn, yawn.  Yes we’ve all heard this – again.
6. Specific action to address staff shortages in key areasThere are about 30,000 nurse vacancies, we can’t get any more from Europe, the bursary has created a dead-cat-bounce, return to work is about as difficult as it could be and HEE look dumbstruck.  It’s a big job for someone who is in charge of systems wide HR.  By the way, if you see a district nurse, take a picture and frame it.  They are an endangered species. 
7.    Plan earlier than in previous years.
Love this!  Shall we start three weeks ago?
8.    NHSE and all other quangos should be more aligned.
9.   NHS should work to reduce reporting burdens.
If private hospitals can work far better with less paperwork, COPY.
10.  Implement wider system reforms.
Roy Lilley says he thinks this means close beds, move stuff and stir up a row with the residents, councillors, MPs, lawyers and judicial review.
It looks to me like we are in for a bad winter.  Take my advice; take a holiday to avoid A & E, or take your EHIC card and try to get in to a European A & E.  If you have to go to A & E here ensure you have a good support system on alert if you are taken in by ambulance. (Not forgetting a pillow – my local Foundation hospital can’t afford these for A & E).  if you’re going there under your own steam, take supplies to tide you over.  



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