Ambulances/patients, parked outside A&E

[Harry Bloomfield]

I keep hearing on the news, ambulances containing patients, brought to A&E, then the ambulance is unable to unload, so they have to sit outside A&E, sometimes for hours. An expensive ambulance, and crew, sat there, and burning fuel waiting, while calls for ambulance attendance just stack up, due to shortage of ambulances.

Wouldn't it be more sensible, for the ambulances to be unloaded, the patients all moved into a reception area, where they can be attended by fewer staff, able to look after more patients? The ambulance could then be got back to doing the job it was designed for.

 

[Brigadier]

Depends what they're being ambulanced in for, but I suspect at least some of them aren't sitting in the ambulance with a magazine in hand.

Ambulances are equipped with life-saving and life-sustaining equipment, that reception areas just aren't.

And if you put that equipment into the existing reception, you'd then have to create another reception area, to serve that purpose.

Plus, the frontline staff shortage is still going to be there.............

 

[JohnD]

I keep hearing on the news, ambulances containing patients, brought to A&E, then the ambulance is unable to unload, so they have to sit outside A&E, sometimes for hours. An expensive ambulance, and crew, sat there, and burning fuel waiting, while calls for ambulance attendance just stack up, due to shortage of ambulances.

Wouldn't it be more sensible, for the ambulances to be unloaded, the patients all moved into a reception area, where they can be attended by fewer staff, able to look after more patients? The ambulance could then be got back to doing the job it was designed for.

I am told it because the hospital does not categorise the patients as "waiting" until they are brought inside.

This enables them to falsify waiting times.

It is wasteful of ambulance and paramedic resource, adds costs, and does nothing to help the patients.

An unintended consequence of measurements and targets being gamed by the people who performance was supposed to be measured.

Politicians love "targets."

 

[MNW67]

I have just been reading an A&E doctors group on Reddit.

Main problems are:

A&E physically too small
Not enough A&E staff
Exit blocks from general wards meaning patients back up in A&E

 

[Notch7]

I suspect that this is about safeguarding.

Ambulances have to do a handover, so ensure the patient is safeguarded at all times.


I did read about London Ambulance service adopting a drop and go after 45 minutes

Ambulances 'drop and go' in London works well, says health minister despite warnings

But a senior A&E doctor has raised concerns about the controversial system

www.standard.co.uk

 

[Notch7]

I was in A & E last year a few times and the other thing I saw was police waiting in A&E reception…..it’s almost always people who have had a mental health breakdown and the police have to take them to A&E and wait until they are seen by medics.

I saw police, and it’s always 2 waiting 3 / 4 hours like that

 

[Murdochcat]

The root of the problem is that too many people rock up at A&E rather than using their brains

Charge them

Then this will free up capacity for ambulances to off load patients

 

[MNW67]

The root of the problem is that too many people rock up at A&E rather than using their brains

Charge them

Then this will free up capacity for ambulances to off load patients

Not according to the A&E doctors group on Reddit I was reading earlier.

 

[Murdochcat]

Not according to the A&E doctors group on Reddit I was reading earlier.

Hum ….. do you consider that a reliable source of quality information?

 

[MNW67]

Hum ….. do you consider that a reliable source of quality information?

They seemed to know their stuff. Lots of detailed discussion of the systemic problems. Certainly not going for an easy answer from a Daily Mail headline.

 

[MNW67]

An interesting factsheet from the King's Fund which covers similar ground in more detail:

https://www.kingsfund.org.uk/insight-and-analysis/long-reads/whats-going-on-with-ae-waiting-times

A useful snippet:

However, the increased pressure on A&E departments is more closely associated with rising numbers of emergency admissions to hospital rather than the increase in A&E attendances. In recent years, as demand for hospital inpatient care has increased, the capacity to meet this demand has come under increasing pressure due to an insufficient number of hospital beds and severe staff shortages (see our explainer on NHS hospital bed numbers for more information).

 

[Old Salt]

My son used to work for the ambulance service. There are generally a lack of resources and hospitals pay a “fine” if ambulances are stacked up for hours. This “fine” helps to fund the ambulance service.

There are lots of reasons ambulances stack up, bed blocking as well as a lack of A&E resources, However some of these problems are due to the nhs organisation. We have a local hospital that closes at 5’ish other than emergency GP appointments. They do day clinics but all that resource CT scanners, x-ray, mri etc sits idle outside day hours.

We also have another hospital with a minor injuries unit that closes at 9pm but has to rely on the main hospital to review x rays, set plaster casts etc.

The main hospital regularly has 18 ambulances stacked up. My wife waited 8 hours for treatment having been sent there by 111. My grandson waited 4 hours, my GD partner waited 6 hours. All of these visits needed medical intervention but were not life threatening.

The A&E is supposed to be for emergencies RTA’s, heart attacks, strokes etc. But if its the only place to go that’s where people will seek help. The nhs needs to get its act together (managers) and the government need to stop placing adverts telling us to see our GP.

You have to fight the Rottweilers on the front desk to talk to a GP on the phone let alone see one in the flesh. Its time for a proper walk in 24/7 hour service for minor injuries.

If you dont believe me go and sit in A&E from when the schools kick out till the pubs kick out. Sprains, twists, bloody noses etc from kids clubs, football training, karate, etc One woman turned up 24 hours after being rear ended complaining of whiplash!

 

[Mottie]

People with no allocated GP go to A&E to get seen to. I’ll let you decide who they are.

 

[Harry Bloomfield]

The A&E is supposed to be for emergencies RTA’s, heart attacks, strokes etc. But if its the only place to go that’s where people will seek help. The nhs needs to get its act together (managers) and the government need to stop placing adverts telling us to see our GP.

No, GP's/ the surgeries ought to be what they used to be - the first line of medical help, rather than what they have become, a place to get a prescription, or a sick note.

You have to fight the Rottweilers on the front desk to talk to a GP on the phone let alone see one in the flesh. Its time for a proper walk in 24/7 hour service for minor injuries.

Yep, they have turned it into a very commercial business. The more patients they have on their books, the more funding they get, they less they seem willing to do for each. We do have a 24/7 walkin service, which I've used twice. Each time it has been in a different location, 10 miles from home, and not easy to actually find, and in an unsavoury area.

The 111 service, is likewise useless, or so I've found. The only advice I've had from them, is to visit the 24/7 walkin service. One time I rang them, because I urgently needed an injection, whilst away from home. I made an appointed with a local to where I would be on the day needed, with a surgery, on the day, the surgery just cancelled it without explanation, or offering an alternative. I rang 101 in the morning, explained the situation I was in, that it was just a simple injection that needed doing, ten minutes, and I even had the injection with me. I then spent most of that day, struggling on a poor mobile, before they finally found me an appointment at a local hospital, who were willing to do the injection.

It's actually easier to get help for a sick animal, than medical help for a sick human.

 

[JohnD]

Hum ….. do you consider that a reliable source of quality information?

Much more reliable than your unthinking bias.