A&Es struggle after 'surge' in demand.

[merehazle]

A ''sharp rise'' in demand in A&E units is causing real problems for hospitals, NHS bosses are warning.

The BBC has learnt some NHS trusts have even had to take extreme measures to cope with the ''exceptional'' pressures.

One hospital had to cancel all it's operations, while another considered setting up a temporary treatment area in a tent. Over the past fortnight there have been 45 closures of A&E units - up 50% on the same period last year. And so far this has been the mildest of winters.

We are enlightened that our that our innovation must match the challenge of our ageing population. And our ageing population is often described as a ''burden''. 

Wasn't when they built the wealth of our country. I thought the burden was our leaders not listening to their own people (particularly over the last 20 - years). I thought the idea was for government to plan 'before the horse had bolted. 

Those that are expecting operations might be getting very anxious.  Those that can afford ''private'' care, wont. (hello Cameron, Blair, & Co, ).  

[joe_bloggs*]

Hospitals are being told to shed staff to rescue the NHS from an acute funding crisis, leaving nurses and other frontline medical workers at risk of the sack.

Labour’s Heidi Alexander, the shadow health secretary, said: “At the last election, the Tories promised to ensure hospitals had enough staff to meet patient demand. However, less than a year later they’re asking hospitals to draw up plans to reduce staff numbers.”

http://www.theguardian.com/society/2016/jan/29/hospitals-told-cut-staff-nhs-cash-crisis

"The spiralling cost of employing expensive agency staff, which is set to cost the NHS £4bn this year, is the single biggest reason for the £2.2bn overspend"

[mustard-tree]

The overspend is the billions that go overseas in foreign aid.

Foreign aid should come from a surplus, which we havent got

[joe_bloggs*]

Maybe we should use some of that surplus spent in bombing Syria for the NHS?

[fallen-archie]

That won't solve the crisis. We have too many people, it costs a fortune to run the NHS, we need to use it in a way that reflects what we put in. A&E is full of time wasting hypochondriacs attention seeking, it should be against the law like wasting police time is.

[upthecreekyetagain]

Far too many hospital beds are taken up by people who could be discharged but can't be because care in their own homes or care homes is simply not available.

Budgets for the care system are being squeezed and the simple knock on effect is that the problem is being passed up the chain to the NHS.  It costs just as much to keep a medically healthy person in a hospital bed as it does someone undergoing medical treatment or waiting for an operation.

Then there is the question of NHS facilities and staff being used by the private sector which may provide the NHS with an additional income but has consequential costs often meaning that patients awaiting operations may spend longer in a hospital bed than necessary incurring all the additional costs that go with that.

[fallen-archie]

Agreed but what about the trend of people becoming soft, one sniff a day off makes two and it's off to A&E. The media is full of scare stories as are academics looking for research funding.

[cee-dee]

Has anyone any real facts and figures to support the oft repeated stories about people with very minor "problems" cluttering A & E?

Also, what exactly do they mean by the A & E of which they speak? I've only experience of one A & E so I'm asking, not stating anything of a general nature. The A & E here isn't a place to which you can get easy access. When you go in, there's a reception desk where staff are behind a glass screen and there's a waiting area. You can't get in to the A & E ward because the door's locked.

If you're going in by ambulance, it depends upon what other cases are on-going before you're admitted, if the place is busy, you could be waiting outside in the ambulance for some hours unless you're in severe pain or at risk of pegging it. One person was waiting like that for 5 hours.

When you get in to the A & E ward, you could be in there for a while before being taken to a ward designated for your problem. You'll be looked at, assessed, even treated to a certain extent before you're taken to a ward. One chap told me he'd waited in A & E for 24 hours before being taken to a ward and he'd had a heart attack!

"Waiting" doesn't mean sitting around on seats/chairs waiting, you'd be in a cubicle (defined by curtains) in/on a bed/trolley and would have had and/or be having some intial tests/treatment/observation and have answered numerous questions about you, name, D of B, address etc and been given a wrist tag.

I didn't see any minor or frivolous cases so they must be dealt with in a "minor injuries" area?

[fallen-archie]

Here is your starter for 10.

[cee-dee]

Would you provide a link to that, it's blurred.

[fallen-archie]

http://visual.ly/truth-about-ae-visits-england

[fallen-archie]

This from a medical Forum, The view of one GP.

Everywhere in the NHS there is the concept of appropriateness - except in one place; the holy grail of A/E.

There, because back in distant history a politician had a bad publicity day, there is a politically mandated deadline that EVERYTHING that turns up in A/E departments has to be dealt with within 4 hrs. There is no evidence base for this target, there is no clinical basis for this target, it is a purely politically derived target initially created to avoid embarrassing headlines. As a result if you've had an itchy bottom for 3 weeks and you got to A/E you are garuanteed it will be sorted within 4 hours. If they take longer than 4 hours you can kick off and create hell because Mr Cameron says you're entitled to be seen. If you do kick off a manager will soon appear and placate you and divert a hard pressed junior doctor away from what he's doing to look at your bottom. Now if you rang my surgery and said you'd had an itchy bottom for 3 weeks we'd offer you the next available appointment, we wouldn't squeeze you in as a "fit in" or create an emergency appointment for you, you'd get something within 2-3 working days, something appropriate. So what does Jane Doe choose? Add into the equation that if you go to A/E you're much more likely to get tests and swabs done whereas if you see me I might only look at your bottom and issue a prescription (but one based on 27 years of experience and evidence) and you can rapidly see why patients choose to go to A/E. Garuanteed attention and tests thrown into the bargain.

[cee-dee]

Thank you.

Looking at that, if those figures are true, it surely indicates the need for a better "weeding out" system for "self referrals"?

[upthecreekyetagain]

The A&E at East Surrey Hospital is similar.  Waiting room, receptionists in a glass cubicle.  From there you see a triage nurse who assesses you.

If it is deemed necessary for you to be admitted into the inner sanctum of A&E you are then directed to a further seated waiting area or taken directly to a cubicle.

I have the highest regard for the way in which they manage the apparently large number of people calling on their services - I have been admitted to hospital twice through the A&E walk in system over the last few months and both times it has been absolutely packed out but the triage system seems very effective and on neither occasion did I have to wait more than 30 minutes before being seen by the triage nurse.

The first time I was admitted into A&E I had blood tests, urine tests, X-rays and a couple of ECGs as well as being examined by a junior doctor and a consultant before being admitted to a ward - about 14 hours in all.  On the second occassion it was far more rapid, no more than an hour.  I really couldn't have been treated better.

In 2012 East Surrey was ranked as one of the worst hospitals in the UK for patient satisfaction then they got a new trust manager who imposed new procedures and it is now ranked as one of the top hospitals.  It has the same medical teams as before so I guess management is important.

[cee-dee]

I think that was a "shot himself in the foot" rant.

GPs with that sort of attitude seem to be of the ilk "Hello Mr Archie, how are you today? Enjoy your holiday in Sharm el shiekh? Hot out there was it? What's the problem? Let's have a look then. Oh yes, I see, right, take these, two in the morning, one at lunch time and one at night. How's Mrs Archie and the little ones? Doing well at school? They're going to the right school, soon be end of term and another holiday? I can't wait to go. Glad I'll soon be finished here today and the weekend's coming. Let me know when you're better, bye now".............

They seem to want the money but not the work. Is it any wonder people go to A & E? No.

GPs should eliminate their waiting list by putting some effort in to their job to clear the backlog. They've allowed a backlog to build up and it must be "permanent" otherwise the waiting time would get longer and longer.

[fallen-archie]

GPs were a respected breed for a long time, these day's Money drives the majority and there are few professions that have seen the kind of growth they have. They get funded in part by the volume seen, It is virtually impossibe to get away with a single visit anymore, so A&E does have it's appeal. Add to that my belief that we are all potential Hypochondriacs and the service is Free, i just cannot see things improving anytime soon,

[suzieseaside]

The NHS wouldn't be so strapped if senior administrators hadn't received massive redundancies after the so called 'restructuring'  to save money (oh yeah?) only to be re-employed a short while later.

One couple received about £1 million between them and were then re-employed in the NHS.

http://www.telegraph.co.uk/news/nhs/12092461/NHS-paid-out-more-than-90-million-in-redundancy-to-staf...

Over £90 million paid out in laying off and re-hiring managers

[joe_bloggs*]

http://www.theguardian.com/society/2016/jan/30/gp-surgeries-operating-state-of-emergency-leading-fam...

GP surgeries are operating in a state of emergency because of problems with resources and staffing levels, a leading family doctor has said.

He said GPs were having to deal with complicated cases within 10 minutes, treat a “conveyor belt” of up to 70 patients a day with administration on top of that, while understaffed practices were forced to continue registering new patients.To put it simply, it is not safe to carry on the way we are"...

[023mjc]

There are so many foreigners here now, getting aid, we have every right to keep the money.

[astrologica]

Have a look at this Creeks

http://www.dailymail.co.uk/news/article-3424729/Got-papers-order-welcome-soft-touch-Britain-doctors-...

This is why the NHS has no money.

When Nigel Farage mentioned this is a debate, he was booed and derided by the bleeding heart brigade.