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Wednesday, 20 February, 2002, 23:38 GMT
Accident and emergency services: Tell us your experiences
Often, this can be a long wait in the modern health service.
There are also fears that lives are being lost because ambulances are struggling to get to seriously-ill patients in time.
What are your experiences of "casualty"? What will it take to improve these overstretched parts of the service?
This debate is now closed. Read a selection of your comments below.
At 7am yesterday my 90-year-old mum fell and broke her hip. The paramedics were wonderful and they soon had her safe and sound at the A&E, a 15 mile trip in an ambulance. A surgeon was available but an aftercare bed was not. Several hours later a bed was found, so back into another ambulance and a 20 mile journey to the county hospital. They put her on the orthopaedic ward ready for a hip replacement operation at 9am today. I have visited her to be told that she was taken off the operating list because of emergencies. What bigger emergency is there than a 90-year-old with a broken hip and in serious pain? When I left her this evening she looked much, much worse than when I found her laying on the floor, cold and in pain. The word that I am searching for is appalled. If I were to treat my pet dog in such an appalling manner, I would be, and rightly so, prosecuted. I just feel so useless at not being able to help my dear old Mum in her hour of desperate need and the NHS not even bothering about her. It's just awful!
A few years ago I came off my push-bike and dislocated my shoulder rather badly. A&E was very busy, but because of the severity of my injury I was hurried into the assessment bay and given gas and air. I was seen by a doctor about 45 minutes later and treated about 15 minutes after that. It was my birthday and the accident happened at around 5pm in Coventry. By 9pm I was enjoying a night out in Birmingham. If our A&E was not superb I would have missed that night out. I fully realise that my injury was severe enough to bump me up the queue and I would not deny the same privilege to anyone else - less severely injured people will see their waiting time increase as a result. They know when the busy times are and so should increase the numbers of staff at these times. I believe Dr Goodman is right about the NHS running on goodwill, this is wrong, but at least the service is superb.
Dr Z Goodman, Leeds, UK
Unfortunately I have a condition that requires emergency admission to hospital on occasion. It really annoys me when I am waiting in agony to be triaged or waiting for a trolley, when there are people in front of me who could have gone to their GP.
Yesterday I attended my GP surgery in town with symptoms of gastro-intestinal complaint. My GP fast-tracked me to the Medical Assessment Unit (MAU) at Broomfield Hospital Chelmsford where I underwent a full 'MOT' including heart monitor, X-rays and blood tests. All results were back by 4 p.m. and I was lucky to be discharged home by 6 p.m. with various outpatient appointments to follow up a more chronic complaint. My doctor acted immediately on the information as I gave it to him and because I was fast-tracked by him I bypassed the A&E consultation and went straight to the MAU.
Unfortunately, I believe that users of the NHS have to be more informed about their problems in order to get a decent diagnosis as Doctors are less informed and updated on recent treatments.
I have had to use A&E on two or three occasions the last being a few weeks ago when my 2 year old son was suffering dangerously high temperatures. On this and previous occasions I was impressed with the level of care, service and attention received. I have never waited for longer than half an hour.
Mrs I Wilson, High Wycombe, Bucks
The biggest problem in my local A&E is the lack of doctors. While we have sufficient nurses on duty to cope with the number of exam rooms, there is only one doctor to cover the whole department of 6 rooms plus the Crash room. If that single doctor has to spend, say, an hour in the Crash room, no other patients can be seen. No wonder the waiting times build up.
When in Salisbury recently my 20 month old daughter dislocated her elbow. We went to Salisbury A&E and a very experienced nurse popped the elbow back into place. Brilliant, quick service from an experienced triage nurse. My wife and I were expecting a 4 or 5 hour wait as we are used to in London. We were in and out in 20 minutes. It would have been shorter but the nurse wanted to watch my daughter play for 10 minutes to ensure the joint was OK. Brilliant nursing!
A Mullan, Dundrum, UK
We hear a great deal in the media criticising the NHS every time the system fails an individual. What is not taken into account is the amount of time staff in A & E depths spend dealing with problems which are not accidents or emergencies. Old accidents that occured over 24 hours beforehand should go to the GP and there should be a better system of dealing with the social problems. How about a media campaign highlighting when A & E departments should be used?
In this area we need more beds to cope with large population. We have many bed blockers. Nurses can't afford to live in this area - we should pay them a decent salary. Why do we criticise all the time? Let's emphasise all the good that's done - often under very difficult circumstances. Let's also have less government interference.
My wife was admitted to hospital in Hull at around 12 a.m. on Saturday with severe fever, pain and vomiting. At 9 pm she was moved to the acute assessment unit. In the end I had to phone the duty manager to inform him of the situation. The nurse who gave me the phone was only too pleased to do so as she informed me that there were only two of them looking after over 25 very ill patients. Within three minutes a posse of nurses and doctors arrived and my wife was diagnosed with septicaemia, a life threatening condition. Up until this time no help was given to my wife and I dread to think what may have happened if I had not been there. I believe that treatment of her condition requires intravenous antibiotics ASAP. She had had to wait over nine hours to get the necessary drugs. I cannot praise the nursing staff enough. They are working under severe pressure with what seems like no back up from management. More than one of them told us that they are leaving the N.H.S. .
Thank you NHS for putting emergencies before the routine. Thank you for operating brilliantly to save my son's hand even though this meant you had to cancel a routine patient scheduled for that day. Thank you for the biopsy on a lump that you gave my other son, just 13 days after I took him to our GP. Performance management in our schools has given us teachers who meet targets by excluding anyone with emergency needs. Please don't force our doctors and nurses onto the same immoral ground by reporting just the bad news.
Having worked in an A&E dept. for over 13 yrs, I have come to the conclusion that the general public have no idea what really happens in A&E departments all over the country. Hundreds of people attend A&E when really they should be seeing their GP. Nurses and doctors are constantly verbally abused, there are not enough beds for patients because too many wards have been shut down and lots of staff have left the NHS because of the appalling conditions. The NHS is dying, I hope it is not too late to save it....
Anouska Biggin, UK
A large number of people present themselves at A & E departments because GP surgeries are appointments only instead of first come first served, as it was when I was a child. I feel the need to see a doctor within 24 hours of becoming ill so the temptation is to go to the local hospital instead of making an appointment with the GP which may not be for two or three days.
Could a partial solution to the problem be to employ GP doctors at A & E departments or even to attach a large GP practice to hospital grounds?
I also think that its silly that people have to go the A&E when they don't need to. Most people probably don't know who there GP is. People should be encouraged to go there instead. Also people should be grateful that they can see a doctor on the same day even if its not there own. A doctor is a doctor. People should get to know there surgeries better.
I worked as a Junior Doctor (Senior House Officer) in Leicester A&E three years ago. It was the hardest job I have ever had and it nearly destroyed my marriage. I did gain an awful lot professionally though and noticed that the staff work incredibly hard. In the 6 months I was there, we saw around 65-70,000 patients. Thanks for doing this report today. It is important that all sides of the NHS story.
I am amazed by the number of people who complain about waiting four to five hours in A&E. Don't they realise that if they are waiting it is because there is someone with more urgent injuries being treated before them? I also wonder whether people would complain so much if they could remember what things were like before the NHS and the Welfare State was formed.
I had a car accident two years ago. I can't remember much about the accident or the two days following an operation required to repair my injuries. However I do know I received the best care available both from the Lister Hospital where I was initially taken and then subsequently at Stanmore, NOH where I was operated on. This was followed up by excellent medical and rehabilitation care to get me back to good health. My injuries required a subsequent operation and again Stanmore provided the best medical care for me. My view is in time of crisis the NHS looked after me and provided the best service possible. I am very grateful for all the support I have received from the NHS.
I am amazed by the number of people who complain about waiting 4 - 5 hours in A&E . Don't they realise that if they are waiting it is because there is someone with more urgent injuries being treated before them.
I also wonder if more people could remember what things were like before the NHS & the Welfare State was formed would they complain so much.
A&E needs to be outsourced to our local health centres manned by doctor group practices
Hospital A&E departments are being swamped with cases requiring urgent attention many of which are of a less serious nature.
The hospital staffing levels are unable to cope with such an influx
Pre-Screening is required before treatment is initiated. i.e. Proper First Aid needs to be applied.
In the last two years Iżve been to A+E at the William Harvey Hospital (Ashford) twice and Iżve waited no longer than 75 mines before going to a ward.
Whilst I was in A+E I was seen by a doctor within 30 mins and given food and drink.
The treatment I received in the Cambridge wards was excellent, the nurses dedicated and hard working, the choice and quality of food was VERY good, considering the amount of patients to cater for, and the wards were clean and warm.
If I had to score out of 10 then I would give 10.
WELL DONE NHS!
Mrs Ursula Arnold. RGN DipN.
I have worked for the London ambulance service since June 01 and would never have expected to be going on blue lights (which in it self can be dangerous for us and other road users) to patients with colds or who have had a headache. It is clear these calls could have been prevented had these people considered other forms of treatment rather then expecting a 999 service.
If these patients insist on having an ambulance, we have to respond. The sad thing with this is that it takes an ambulance off the road for one hour - meaning someone who needs an ambulance has to wait longer for a response. And if these patients insist on going to A&E this adds another person to the waiting room, causing longer delays for all waiting. (at least 40% of people waiting in A&E could have found alternative treatment rather then hospital)
When you try to suggest to these patients they could have got adequate treatment or advice from either a chemist, NHS Direct etc they seem to feel they are entitled to an ambulance regardless how minor their condition. Perhaps if the government were to get tough on this abuse of the service, those that need help will get it with less delays.
I have just had surgery in St. Mary's Hospital, London, W2, and separately
was in their A&E after a car crash.
I received the most wonderful attention and treatment at all times, by staff
who were clearly extremely competent, caring and dedicated. The hospital
ward was spotless.
Last November I called an ambulance (the first time ever) and they came within about ten mins and they were marvellous. I was taken to Old Church Hospital. I arrived about 10.15 in the evening. I eventually saw a doctor at 5am. He told me I could go home but as I was in so much pain and could not move I was unable to go home in a car as I had to lie flat. I had to wait for an ambulance to take me home which came about 10am in the morning. We was told that there was only one doctor and two nurses working that night (Wednesday 21 Nov 2001) and there were 200 patients waiting to be seen. Why can't we have more staff on in the A&E department at all times.
R Knight, UK
About a year ago I a passenger on a bus that was involved in an accident and I received cuts all over my face from flying glass. While I waited for 3 1/2 hours in casualty waiting to be stitched up, holding a pad to my head to stop the blood, two people came in wearing football gear, with pulled muscles. Both of them were seen and were in and out within ten minutes.
Is that really the priorities of A&E?
I was recently involved in a car accident and the paramedics that attended me were extremely pleasant. They were friendly, compassionate and made me feel secure and comfortable. Nothing was too much trouble for them. This was followed by the same treatment from the nurses at the hospital. What I cannot understand is why people doing such a wonderful job should be exposed to abuses suffered from drunks and obnoxious patients.
Will Davies, London England
My husband was knocked off his motorcycle in January. He was taken to hospital by ambulance. He lie in casualty for five hours in a neck brace with a dislocated shoulder, a fractured shoulder and cut knee before the Orthopaedic surgeon saw him. Whilst he was waiting, he was shovelled full of morphine and other pain killers. My question would be - why was there no Orthopaedic surgeon available for 5 hours? He was taken to a ward about 10 hours after he arrived in A&E. The nurses treated the patients like prisoners. They did not respect their privacy or dignity. The nurses moaned about one patient who had badly broken both legs because he wanted to use the phone to contact his partner and couldn't get out to the payphone in the corridor. They let patients smoke in the ward instead of providing them with an area and helping them get there. They even complained about patients closing the curtains around the bed. My experience, which isn't just based on my husband's stay in hospitals that both patients and visitors lose all rights to behave like normal humans. People are expected to sit around on their bed all day waiting for a nurse or consultant that inevitably turns up 2 hours later than expected. I think a change in attitude is needed.
My mother is a nurse and within accident and emergency she has been verbally, and seen other nurses physically abused by drunk, ignorant, arrogant patients. I think that those who attack nurses or cause trouble within accident and emergency should be electronically tagged and lose their right to health care.
About a year ago I was a passenger on a bus that was involved in an accident and I received cuts all over my face from flying glass. While I waited for 3 1/2 hours in casualty to be stitched up, holding a pad to my head to stop the blood, two people came in wearing football gear, with pulled muscles. Both of them were seen and were in and out within ten minutes. Is that really the priorities of A&E?
Amanda Bowden, England
I was recently referred to the rapid access clinic at our local hospital due to severe chest pains. It took four weeks before I could be seen. My doctor thought I would be seen the following day but was unable to help any further once referred. Thankfully I am still alive to complain.
My little boy has difficulty controlling his seizures and has been admitted to A&E four times via emergency ambulance. He has always required urgent medical attention and to date has always received it. The staff have been generally kind and efficient. Unfortunately we have not received the same standard of care from the outpatients department.
I've had two experiences of A&E which taught me it is a place you only go as a last resort or if you are very near death. In both cases the ambulance crews were excellent in every way but were totally let down on arrival at the hospital by the pitiful performance of the A&E department. I simply don't believe these places were that busy. They were just badly organised and prioritised.
Children should be given separate waiting facilities from adults, particularly when the adults are under the influence of drugs or drink. It is distressing enough if you have to take a child to casualty without having to protect them from a situation that they otherwise would not encounter.
I have had first-hand experience of incompetent doctors in the NHS. Two years ago my husband had a rare disease that took three trips to the A+E department before he was admitted to the hospital for live-saving treatment. On each visit the doctors were more interested in the rugby results than seeing patients. How is this putting peoples' minds at rest that the hospitals are up to the standards defined by the government?
I work for the London Ambulance Service, and have for the last five years. I have seen and heard big promises being made. However, none of them have ever come to anything other than empty promises. When ministers do a surprise visit to an A+E department, the powers that be gloss over the cracks in the system. Furthermore, we do on average of 3000 to 4000 emergency calls a day, but sadly we are mostly used as a taxi service. This is very frustrating, and does not allow us to attend the calls where patients really need us. Moreover, we are verbally abused or even physical abused as a daily routine. We are being pushed to reach eight minute targets. Sadly we are never going to reach these targets unless we get more funding, and educate the public what an ambulance is really for.
On a visit to England last September, I was called upon to convey my 86-year-old aunt to Milton Keynes General Hospital emergency department, as she had broken her ankle. They left my Aunt waiting for four and a half hours with no painkillers and in great distress before they even X-rayed her foot. When finally they got around to putting it in a solid fibreglass cast and sending her home we'd been in the hospital a full six and a half hours. Is this disgusting and pathetically inadequate system what my Aunt fought the second world war to suffer?
Kate Potter, UK
I was recently involved in a car accident and the paramedics that attended me were extremely pleasant. They were friendly, compassionate and made me feel secure and comfortable. This was followed by the same treatment from the nurses at the hospital. What I cannot understand is why people doing such a wonderful job should be exposed to abuse from drunks and obnoxious patients.
I was admitted to and A&E department in January with a fractured elbow and had excellent treatment there. I think perhaps a charge for visiting A&E services when it is clearly not an emergency may also be an idea - it stops people abusing the service. Basically, though, there needs to be more money invested in the NHS, from both public and private sectors, and as an NHS employee, I would appreciate more positive press from the media too!
I had to take my wife to A&E on a Saturday night. The staff were great, but we had to wait 2 hours for an ambulance, because they were all out bringing in drunks who had been involved in fights. The A&E soon filled up with drunks shouting at the nurses and causing trouble. The police had to be called to restore order. The nurses told me that this was a regular weekend occurrence, and that ambulances ended up being called out as it was a free ride to A&E. Why not charge £20 for calling out an ambulance? It would take the pressure off the ambulance service and it could be claimed back off insurance or paid for by the Benefits Agency if the person was unemployed or a pensioner.
Children should be given separate waiting facilities to adults, particularly when the adults are under the influence of drugs or drink when they can be loud, abusive and even violent. It is distressing enough if you have to take a child to casualty without having to protect them from a situation that they otherwise would not encounter.
A&E units should be staffed by registrar grade doctors. Only pure accidents and emergencies should be seen in A&E.
I have had several first hand experiences of A&E because I used to suffer from heart palpitations. I had to go to Wigan Royal Albert Infirmary, where the nursing staff had to assess my condition. They saw me straight away and nothing was too much trouble for them. The nursing staff were always busy and short staffed. More staff are needed and I have even e-mailed the government regarding this. Where is the money going? I think we should have a people's committee to say where we think money should be spent in the NHS. Luckily for me I now have a pacemaker, which has corrected my condition.
07 Jun 01 | Health
Faster 999 response 'cuts heart deaths'
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