A&E Targets: I see that after the worst... - British Heart Fou...

British Heart Foundation

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A&E Targets

Heythrop51 profile image
19 Replies

I see that after the worst month in over a decade Matt Hancock wants to.scrap the 4 hour target. Surely if he had some backbone he would be striving to improve things? Part of the problem is the difficulty of getting a GP appointment.

This type of action makes me concerned about the future of the NHS!

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Heythrop51 profile image
Heythrop51
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19 Replies
Prada47 profile image
Prada47

Hi

I will reply even though I think this post will be taken down as it is political.

Personally I have only been to A & E once in the last 2 years, I was given an ECG within 5 minutes and I was in a bed in A & E within 15 minutes, and in a ward within an hour, So Waiting times are irrelevant unless you know why someone is at A & E ( Bad Cough ) (Worried Well ) (Sprained Ankle ) It may be better to classify what people are at A & E for rather than just a timing exercise !!

It's all in the name you have had an Accident or you have an Emergency not you need advice on a minor aliment.

My personal opinion and Observation of the News it's Political

Regards

I think your right, in that people can’t access GP’s anymore, so turn to A&E instead. And walk-in centres seem to be closing down daily, which compounds the issue further.

Milkfairy profile image
MilkfairyHeart Star

I have been in the last 7 years to A& E 15 times.

I have been admitted to hospital everytime except on one occasion.

My wait for a Cardiology bed has ranged from 5 hours to 12 hours.

It seems to be reasonable to have a standard that can be measured and audited.

I just tried to make an appointment to see my GP earliest appointment is 20th February!

Prada47 profile image
Prada47 in reply toMilkfairy

I understand what you are saying, but you have something that can't be fixed, or they would have fixed it !! A lot of people going to A & E have been Fixed so come under the ( Worried Well Category ) It's difficult but

A & E is for Acute Emergencies not Anything and Everything.

Best Regards

Heythrop51 profile image
Heythrop51 in reply toMilkfairy

February 20th, that's awful! Is that for a specific MP? With ours you can usually see any GP in a week or two but specific ones can be awkward. This can cause a lack of continuity. All very frustrating!

I agree with Prada47 and HOPE the post will be taken off. However, In the past two years both my wife and I have had to use A&E and the service was just what you would expect: - Prompt, caring, helpful and timely. No waits, to beds in passageways, just good caring medicine. This is possible today if only people would realise that most of what they are suffering from is not an ACCIDENT or an EMERGENCY nor is it a place to go when the doctors have a waiting list and most doctors now have their own minor injury clinic. To be ruthless, fractures and cuts and bruises and a sore tooth or sore throat, when assessed will incur a wait, because they are non urgent - they may hurt, but they are non urgent. Its amazing what one can treat with common sense and a first aid kit. On a controversial topic, an open border system where the whole of Europe has access to this country and its services, where there are not enough houses or school places to go round, how on earth can we expect the NHS to cope? Perhaps this will change, who knows, but I for one hope it will and the sooner the better

Prada47 profile image
Prada47

Thatwasunexpected wrote

" The discomfort finally seems to have passed so, if I had gone to A&E, I would have been one of those malingerers "needlessly" increasing waiting times.

But what if I'd been wrong? "

Does that come under the Worried Well Category ?

When I had a Heart Attack I Knew something was Seriously Wrong, I know we are all different but if you had arrived at A & E having a Heart Attack I doubt you would be one of the Waiting Statistics..

Triage does work in the majority of cases

Heart Attacks have a tendency to come out of the Blue ie Acute.

Non of this is easy or I am sure the NHS/Government would have resolved it, I am sure they don't like being hauled over the coals every time stats are published with regards to waiting times.

A stat I would be interested in

"Is how many people attending A & E are as a consequence admitted to Hospital "

Don't get me wrong A & E are a vital part of our NHS Emergency Care Unit but I am sure it is abused as people say because the GP system is the one letting people down !! I did type " letting us all down," but on reflection our GP surgery is first class and has never let me or my other half down.

When I did go to A & E it was on the advice/instruction of my Heart Failure Nurse, is this the way forward " Specialist Nurse Practitioners, rather than GPs after all there are a lot of well educated Nurses capable of a lot more than Nursing.

Regards

Please note in my posts I endeavour not to use other peoples posts in a disparaging way. I use them to put across my understanding of the system.

Regards

Maisie2014 profile image
Maisie2014

My one and only visit to A&E took 9 hours sitting on a chair, transferred to trolley for another 8 hours then transfer to observation ward for a further 5 hours! I was having a heart attack. If my daughter, a cardiac intensive care nurse, hadn’t spoken to a sister to get me placed on a heart monitor two days later I fear I might not be here now or worse still be sitting on a chair in A&E. It’s not just Government that’s the problem it’s management of resources.

beardy_chris profile image
beardy_chris

It might make sense to change the targets but it is bad politics to suggest the targets should be changed as a response to the worst ever results.

I would always recommend people find out how their GP allocates appointments. My GPs release appointments at around 9 am each day and hold back appointments for urgent cases. Chat up the receptionist and find out how you might be able to access these appointments if needed. Try to work with your doctors, don't just take what they say.

But, undoubtedly, and as agreed by the politicians, we need more GPs and walk-in centres to ease the load on A&Es.

Beith profile image
Beith

Personally, I'd like to be seen within an hour if I visit A&E so why can't the target be one hour? If I put forward that idea, I would anticipate being patted on the head and sent away having been told 'Don't be silly, one hour is obviously impossible".

Fair enough ... but what makes a target of four hours 'possible'? Why not three hours, or two and a half hours? Target setting is largely a game - a game called pick a number ...

A target is meaningless unless there is an associated plan/budget that describes how that target can be achieved.

So where is the plan - budget/resources/equipment/training - that makes four hours a realistic, achievable number?

This morning, my wife received four separate letters from NHS hospitals. She had recently cancelled an appointment and arranged a new date. Two of the letters were about the first appointment - one letter making it and the second one cancelling it ...

The other two both confirmed the new appointment ...

There's a significant amount of money that could be saved if the management/admin was fixed.

in reply toBeith

Your question regarding failure to achieve targets is a very simple one and could be answered in just one short statement VOLUME of PATIENTS.

However then the discussion could grow with further factors that can make a target an impossible achievement: -

WEATHER

POOR MEDICAL KNOWLEDGE - not surgical - just astute first aid

BLOODY MINDEDNESS - If I can't get into the doctors, I will be seen at A&E - and it is no doubt this group that shout the loudest when not seen for ages.

On a more personal note, when I get an appointment for the doctors, I always budget for up to an hours stay there and when they apologise for the wait, I reply that I am grateful to be seen on the same day. BY ANY DOCTOR - the exams are all the same for a GP

On Question Time last night it was stated that the NHS is the envy of the world and has been so since it's inception. It is no wonder that so many come to this country to be treated for free - people that can't even speak the language are given access to a linguist and they are made better. Occasionally relatives swell the waiting rooms and wards to look after the relative that does not speak English or dislikes the food, but they are all accommodated. This must surely be a burden on the NHS not only for the numbers but from a cost point of view too.

Whose fault is this -OURS. This countries! People only want to get well, and will go wherever they know they will get help - just as many UK children are treated in the US for some diseases - the only difference being that the patient will have to pay for the expertise they are going to use. So why don't we adopt a similar process here?

Surely it make sense to charge patients who have not contributed to our health service, at least for a minimum period of 5 years. When we go to the States we know we must carry adequate insurance to be treated there and many other countries we visit. At least that could be considered as fair. Until we can see our NHS as a valuable asset to everyone else in the world and until we begin to put a charge on that worth, there will always be waiting lists at A&E

Another huge factor is drugs and alcohol abuse where treatment is free as is the ambulance to bring them to hospital. There just has to be responsibility for ones actions - self inflicted injury in other words. Councils etc used to think it was a good idea to close cottage hospitals which were a web of care throughout the community - with them mostly all gone, outlying districts have little care facilities. Same story for psychiatric hospitals, how on earth can a medical hospital take up the slack all on the pretense of saving money. There are horrendous problems that for the best part, we let happen.

There are answers but they will be difficult to change. let alone manage however I still thank goodness for the NHS who have NEVER let me down - no matter how long I have had to wait!

Prada47 profile image
Prada47 in reply to

Hi Ticking

You will be told we are a compassionate country and how dare you ever suggest charging people who are ill. These are the same people who stand up in the commons and say not enough is being invested in the NHS or Waiting times are abysmal, the Tories have missed the targets again !! Vested interests are at play within the NHS as well, they have an interest in making people wait.

I don't necessary agree with what I have just wrote I just offer it as a discussion point !!

Regards

Milkfairy profile image
MilkfairyHeart Star in reply toPrada47

The King's Fund is an independent charity working to improve health and care in England. Their vision is that the best possible health and care should be available to all.

They are widely respected by the NHS and their initiatives and research is adopted and implemented by the NHS.

Here is their review of A&E waiting times

kingsfund.org.uk/projects/u...

Prada47 profile image
Prada47 in reply toMilkfairy

Excellent Milkfairy thanks for this

in reply toPrada47

Well there is one thing for sure - something is very wrong somewhere. However, kill us off and they loose in taxes. I can see no good in making people bloody miserable - even when there is a consensus of opinion that the public in general would gladly have an increase in taxes if it went to the betterment of the NHS. What ever is the problem with this land?

Prada47 profile image
Prada47

I have had Heart Attacks along with Open Heart Surgery along with Stents through the by passed Lad. I have a 100% blocked RCA and have Moderate/Severe Heart Failure.

I believe Angina is one of the first symptoms of a problem but should a lump fly off it is really Acute.

I understand for quite a few people any Twinge/Pain after a heart attack is alarming BUT you have to get used to them. As I posted earlier you Know when something is Seriously Wrong because it is Acute otherwise it's Chronic ie Long Term managed by GP Cardiologist or Heart Failure Team not by A & E

Please note my use of the word Tendency

Regards

SpiritoftheFloyd profile image
SpiritoftheFloyd

I've just had a look via PatientAccess, and if I wanted an appointment the earliest one I can book on line is 28th January, which I suspect isn't too bad. When I've gone into the surgery in the past, I've always been able to get an appointment within a few days, so I'd say my GP is fairly good as regards appointments, but I can understand that if your GP is hard to pin down then A&E is the next option.

The only time I've been to A&E was when I had my heart attack, and somehow I had the foresight to pick up my phone before I was put in the ambulance, so my phone has recorded my activity - picked up by ambulance 1.57am , in local A&E 2.03 (diagnosed with heart attack, stabilised) put in ambulance 2.18 and blue lighted to Heart and Chest Hospital Liverpool - arrived 2.44 - so I can't fault that for quick service.

I have no idea what the answer is to this issue, but I have seen the figures for the number of people turning up over a 12 months period in my local A&E, and it suggest that something like 40% of the local population presented at A&E in that period - clearly 40% of us haven't , that's an absurd figure - so presumably this figure must include a number of people who present themselves in A&E multiple times. I assume the NHS has a breakdown of the reasons given for turning up. There's a suggestion that a number of these repeat attendance are people with drink/drug/mental health problems. Merseyside Police has been trailing a system where a paramedic accompanies them in the patrol car, and when someone dials 999 to say that someone lying on the pavement drunk - the police ordinarily have no option but try and get that person to A&E, with a para on board, the para can access them and decide whether they need to go to A&E or not. Maybe we need more approaches like this to try and decrease the stress on A&E?

in reply toSpiritoftheFloyd

Have heard of this before where a type of triage ambulance attends to drunks over a week end. I do believe we are a fair and compassionate people that have come to regret just how fair and compassionate they have been. This sort of forgive and try and understand is wearing very thin especially towards people who could not care less about who saves them, just that its done and they are safe until the next time.

Heythrop51 profile image
Heythrop51

Thank you for the comments. I posted because I am concerned having known a few people who have spent extended periods. In no way was it meant to be political but obviously a few wanted to make it such!

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