The Truth about A & E Waiting Times

So A & E depts. up and down the land are getting it in the neck because too many patients (although actually, fewer than 1 in 10) breach 'the 4 hour rule'. The govt. is giving the impression that frontline staff in A & E depts are disorganised or lazy or both. Otherwise, why can't they get through all the patients faster?

This is pernicious twaddle. The reasons so many patients have to wait longer in A & E than is deemed 'reasonable' are:

1. Too many people turning up in A & E who should not be there (i.e. they do not need urgent treatment). They have period pains, or a headache, or they have stubbed their toe, or they have a cough. Perhaps they have cut their finger and have no plasters at home. Perhaps they have vomited once or twice that day, but feel OK otherwise. Perhaps they have lost their contraceptive pills. They might have an itchy eye, or a sore throat. None of these is an accident or emergency requiring a trip to A & E, but they come anyway.

2. When someone is brought into A & E drunk (as is often the case), they cannot be turned away, but nor can they be assessed clinically because in that condition, an accurate diagnosis is well nigh impossible. You have to wait until they sober up, then assess them. That often means that they 'breach'. That is clearly not the fault of the doctors and other healthcare staff, but it makes the statistics look worse than they are.

3. If the police arrest someone who is drunk and disorderly, with the intention of taking them to a cell, all the drunk person has to do is say that they will harm/kill themself if they are locked up, and the police are obliged to take them to A & E for a psychiatric assessment (when they have sobered up, so longer waiting time).

I wonder how many A & E doctors were consulted before the govt came out with their stupid declarations about breaches, and I wonder how they expect to recruit more A & E staff when the ones we have are being told they are failing?

I agree with everything apart the 'headache'. Headaches if unusual and har different symptoms and are sudden and you arent a migraine suffer can and rightfully warrant a trip to a&e.

Pretty much spot on there, Alice.

So A & E depts. up and down the land are getting it in the neck because too many patients (although actually, fewer than 1 in 10) breach 'the 4 hour rule'. The govt. is giving the impression that frontline staff in A & E depts are disorganised or lazy or both. Otherwise, why can't they get through all the patients faster?

 

This is pernicious twaddle. The reasons so many patients have to wait longer in A & E than is deemed 'reasonable' are:

 

1. Too many people turning up in A & E who should not be there (i.e. they do not need urgent treatment). They have period pains, or a headache, or they have stubbed their toe, or they have a cough. Perhaps they have cut their finger and have no plasters at home. Perhaps they have vomited once or twice that day, but feel OK otherwise. Perhaps they have lost their contraceptive pills. They might have an itchy eye, or a sore throat. None of these is an accident or emergency requiring a trip to A & E, but they come anyway.

 

2. When someone is brought into A & E drunk (as is often the case), they cannot be turned away, but nor can they be assessed clinically because in that condition, an accurate diagnosis is well nigh impossible. You have to wait until they sober up, then assess them. That often means that they 'breach'. That is clearly not the fault of the doctors and other healthcare staff, but it makes the statistics look worse than they are.

 

3. If the police arrest someone who is drunk and disorderly, with the intention of taking them to a cell, all the drunk person has to do is say that they will harm/kill themself if they are locked up, and the police are obliged to take them to A & E for a psychiatric assessment (when they have sobered up, so longer waiting time).

 

I wonder how many A & E doctors were consulted before the govt came out with their stupid declarations about breaches, and I wonder how they expect to recruit more A & E staff when the ones we have are being told they are failing?

I totally agree with you.

I would also add the amount of NHS staff milking the system.

 

I would also add the amount of NHS staff milking the system.

Which is what, exactly? And how?

Charge them 20/30 quid .They'll soon get the idea.

Which is what, exactly? And how?

Heard it quite often from friends i know who work in the NHS.

Also this extract from a personal letter in the paper today.

Why the NHS is failing.

Next month I will retire after 35 years in the NHS, 30 of them coordinating teams of outworkers. And over the years two of the biggest problems have been maternity leave and sickness.

Because of their skills,99% of my teams are women and because of maternity leave and sickness (either personal or family), I consider myself lucky if I have a staff level of 75%. Many abide by the rules, but there's an increasing number who milk the system for all it's worth.

I stopped being surprised years ago by just how many regularly call in sick a couple of weeks before the school holidays. It's also not unknown for new recruits to inform me, sometimes before they've completed their induction period, that they're pregnant. It's later revealed that they knew at the interview but said nothing.

Another ploy, used to extend maternity leave, is to return to work after the expiration of the allotted time then announce after a few weeks that they're taking up the holiday days they accrued while on leave or, once they're back in their new period of entitlement, go off suffering stress.

In the worst cases, I've known of further children being conceived while the woman was on holiday or off 'sick' so the maternity leave continues ad infinitum. Unless the NHS comes down hard on those who abuse maternity and sickness leave, it will never resolve it's staffing problems.

My partners sister is a teacher and her husband is a principle English teacher, they say exactly the same goes on in schools.

Heard it quite often from friends i know who work in the NHS.

 

Also this extract from a personal letter in the paper today.

 

Why the NHS is failing.

 

Next month I will retire after 35 years in the NHS, 30 of them coordinating teams of outworkers. And over the years two of the biggest problems have been maternity leave and sickness.

 

Because of their skills,99% of my teams are women and because of maternity leave and sickness (either personal or family), I consider myself lucky if I have a staff level of 75%. Many abide by the rules, but there's an increasing number who milk the system for all it's worth.

 

I stopped being surprised years ago by just how many regularly call in sick a couple of weeks before the school holidays. It's also not unknown for new recruits to inform me, sometimes before they've completed their induction period, that they're pregnant. It's later revealed that they knew at the interview but said nothing.

 

Another ploy, used to extend maternity leave, is to return to work after the expiration of the allotted time then announce after a few weeks that they're taking up the holiday days they accrued while on leave or, once they're back in their new period of entitlement, go off suffering stress.

 

In the worst cases, I've known of further children being conceived while the woman was on holiday or off 'sick' so the maternity leave continues ad infinitum. Unless the NHS comes down hard on those who abuse maternity and sickness leave, it will never resolve it's staffing problems.

 

 

 

My partners sister is a teacher and her husband is a principle English teacher, they say exactly the same goes on in schools.

I taught for 30+ years and saw no evidence of what you describe.

Besides which, maternity leave is a right for female workers in most jobs. The fact that there are not enough supply staff to cover is not the fault of the employee who is pregnant. Nor is it is what is making A & E departments breach.

Charge them 20/30 quid .They'll soon get the idea.

I totally agree with this. The issue with A&E is that it is free, people have no natural inhibition because a lot of people have no loyalty to the NHS.

I taught for 30+ years and saw no evidence of what you describe.

 

Besides which, maternity leave is a right for female workers in most jobs. The fact that there are not enough supply staff to cover is not the fault of the employee who is pregnant. Nor is it is what is making A & E departments breach.

My ex is a teacher and one of her colleagues cancelled a major operation because it fell in the 6 week holidays. She managed to re-arrange it just after the 6 weeks holidays. Post op she needed another 6 weeks off to recover (fair enough) This woman put her holidays before her health! What an idiot!

I agree with your comment regarding the NHS, but abuse is rife if the incentives are there.

I know of people who work in local government who literally decide amongst themselves which part of the year they will go off on a sickie.

---------- Post added 12-12-2014 at 22:54 ----------

I totally agree with this. The issue with A&E is that it is free, people have no natural inhibition because a lot of people have no loyalty to the NHS.

I will also agree with this.

Heard it quite often from friends i know who work in the NHS.

 

Also this extract from a personal letter in the paper today.

 

Why the NHS is failing.

 

Next month I will retire after 35 years in the NHS, 30 of them coordinating teams of outworkers. And over the years two of the biggest problems have been maternity leave and sickness.

 

Because of their skills,99% of my teams are women and because of maternity leave and sickness (either personal or family), I consider myself lucky if I have a staff level of 75%. Many abide by the rules, but there's an increasing number who milk the system for all it's worth.

 

I stopped being surprised years ago by just how many regularly call in sick a couple of weeks before the school holidays. It's also not unknown for new recruits to inform me, sometimes before they've completed their induction period, that they're pregnant. It's later revealed that they knew at the interview but said nothing.

 

Another ploy, used to extend maternity leave, is to return to work after the expiration of the allotted time then announce after a few weeks that they're taking up the holiday days they accrued while on leave or, once they're back in their new period of entitlement, go off suffering stress.

 

In the worst cases, I've known of further children being conceived while the woman was on holiday or off 'sick' so the maternity leave continues ad infinitum. Unless the NHS comes down hard on those who abuse maternity and sickness leave, it will never resolve it's staffing problems.

 

 

 

My partners sister is a teacher and her husband is a principle English teacher, they say exactly the same goes on in schools.

Was someone actually complaining that NHS staff were using their annual leave that they've accrued.

The issue about statutory leave is a distraction. People are entitled to a certain number of days' leave - when they take those days is often non-negotiable. In any case, research suggests that fewer teachers and NHS workers throw 'sickies' than the working population generally.

Perhaps we can get back on topic.

The bottom line is that there are too few NHS staff and resources (beds etc) for the number of patients coming through the doors, and that the way doctors' 'performance' is measured is ludicrous and unfair. It seems to me that there are various solutions:

(a) employ more frontline staff and have efficient provision for cover if necessary. Stop putting young doctors off from wanting to specialise in Emergency Care. Make it possible for them to do the job professionally and well, and stop rubbishing and demoralisng the workforce. My daughter is a doctor and loved many aspects of A & E work. What she didn't appreciate (and what put her off doing it as her speciality) were the ridiculous shifts (often extended for hours when the next doctor rang in ill/exhausted/stressed), being abused by patients (spat at, sworn at and threatened with a knife, on one occasion), too few security staff, working your hardest for 10-15 hours without a meal break, only to be told that too many patients had breached during your shift (mainly drunks). Until those issues are addressed, the NHS will continue to have to pay over the odds for agency doctors and nurses in A & E.

(b) roll out a public information/education campaign about the kinds of illness/accident which justify calling an ambulance or turning up at A & E and which do not

© do not count drunks in the numbers of patients who breach the 4 hour rule

(d) charge people for their care after an accident (and let them claim it back from their personal accident insurance?) The problem with this is that it would probably cost more to implement than they would collect in revenue. And we do arguably pay for NHS care through National Insurance, which most people have contributed to. It seems unfair to penalise legitimate A & E patients because of the idiots. We need to stop the idiots turning up in the first place.

---------- Post added 13-12-2014 at 10:01 ----------

I agree with everything apart the 'headache'. Headaches if unusual and har different symptoms and are sudden and you arent a migraine suffer can and rightfully warrant a trip to a&e.

I agree about sudden unexplained severe headaches, and to a lesser exent migraines (although migraine sufferers often have the requisite medication to hand and don't need to go to A & E if they take it early enough), but you would not believe the number of people who turn up in A & E with mild headaches which are not bad enough to have stopped them going out drinking that evening, or which have gone now, 'but I thought I had better get it checked out anyway'.

Or just hangover/dehydration headaches, which are avoidable in any case.