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Overloaded A& E Departments


Frederick
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Just a thought after watching the news about Hospital A&E Units being rushed off their feet by none urgent cases because doctors cant give them appointments in less than 24 hours in the UK ...... There are fully trained paramedics sitting in local Ambulance stations  watching the TV waiting to be called out . If people are fit enough to drive to their local hospital and walk in for a sticking plaster.... Perhaps they can use Ambulance Stations  as a drop in for minor treatment instead ? ..............Or is that too simple ? 

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Also doctors don't do callouts, the walk in centers are closing and their replacement service, the 111 one just does not work. The doctors need to do more hours and callouts or alternatively make them do shifts at the local hospitals. The whole thing is a mess because of constant tampering by current and previous governments.
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Well, in my area of the UK there are volunteer First Responders who invariably arrive before the ambulance (I am involved with a group who raises funds for them.

Q doctors were permitted to opt out of out of hours call outs and private companies often provide this service - sometimes employing the doctors for a 'bit more money'.

And you have come over all US with your 'center'.

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[quote user="PaulT"]

And you have come over all US with your 'center'.

[/quote]

I couldn't remember the correct name, sorry. [:(] We used one once and were simply told to walk round the corner to A&E. Could have gone there straight off really. If people can't see a doctor or wait long times on this 111 service they simply give up and go to A&E with the most trivial of things which could in turn blocks it for those that may really need its services.

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[quote user="Quillan"][quote user="PaulT"]

And you have come over all US with your 'center'.

[/quote]

I couldn't remember the correct name, sorry. [:(] We used one once and were simply told to walk round the corner to A&E. Could have gone there straight off really. If people can't see a doctor or wait long times on this 111 service they simply give up and go to A&E with the most trivial of things which could in turn blocks it for those that may really need its services.

[/quote]

I was referring to the spelling - U.S. English (as Microsoft likes to call it) is 'center' but, for want of a better term, English English, it is 'centre'.

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I have seen a GP, more or less immediately in the last few months. As has my father who called his doctor one morning recently and the Dr came out within two hours, incidentally my Dad was not seriously ill.

Around here, it depends on 'why' one needs to see a GP as to how quickly one is seen, 'triage' comes to mind.

Re the walk in centres and 111. Well the walk in centres are as much use a chocolate fireguard  most of the time and 111, may their number  be cut off and I would be wary of employing any of them.

System needs overhauling and someone with basic sense asked to look over any new plans, rather than people who have had years of management and have ended up with their heads stuck so far  up their own backsides that they  have become liabililties and useless in spite of highly inflated salaries.

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We can usually get an appointment with our GP very quickly (same day) if the case warrants it, and our own GP practice, and that of my mother, certainly do visits again when needed.

There is also a walk in centre which I haven't had to use except that it shares a reception with the place my OH had an eye test a couple of years ago.

We have Red doc for emergency call outs

A couple of months ago we tried 111, they said they would get back to us, by that time, an hour or so later I'd already taken the OH to A&E where he was dealt with quickly and efficiently. I suspect thats where he would have ended up anyway....

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http://www.mirror.co.uk/news/uk-news/new-111-line-to-replace-nhs-267355

From Tesco check out to trained 111 call center staff....................three weeks !

The sooner its shut down the better......its not going to work people have lost confidence in it already .

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The method that 111 are using could be made available on the Internet. It is just a series of screen showing different responses to a question that then leads to another screen and question until it finally comes to one that shows what course of action needs to be taken, i.e. phone undertaker.
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It was available on the internet: as NHS Direct. And yes, it did exactly that. I used it once, on a Sunday, after I'd had a chest pain for 3 or 4 days. Quite funny, really. I knew it wasn't anything life-threatening, but after a few days it was nonetheless annoying as it clearly wasn't heartburn or indigestion. After several screens of questions I arrived at "STOP! PHONE AN AMBULANCE IMMEDIATELY!"

I am quite sure  (and, given that I'm still alive and suffering no ill effects) that I would have been as popular as a pork chop at a Bar-Mitzvah if I'd done as suggested.

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I had to ring 111 a few weeks ago, when my husband's condition deteriorated after being discharged from a private hospital. I was very concerned about it, as I'd read and heard such horror stories. However, I wasn't bombarded with a long series of questions unconnected with my husband's condition as I'd feared.

I explained the problem, was asked about 3 questions and was told that a doctor would ring within an hour; she actually rang 10 minutes later. I was told that someone would arrive at the house, but no exact time frame was given, or we could take him to our local hospital at a time of my choosing. I nominated an appointment time, allowing 10 minutes for my son to get to our house to help get my husband to the car, then the drive to hospital, another few minutes - then he was seen immediately by a doctor and then admitted to hospital. It's exactly the same system we had before 111 came in, but with that extra phone call added in. It was a great relief to find it all worked exactly the same. A wonderful service, we thought.

A & E, which we passed through, was crowded, but there were plenty of seats available, and several surgeons were actually in A&E, not on the wards or off duty, which seemed a good idea to speed things up.

Although not my husband's problem this time, it's worth noting that our local hospital aims to get patients suffering from suspected heart attacks sorted out within 90 minutes, including any stents needed etc. Staff are on duty 24 hours a day in the Jim Shahi unit, named for one of the cardiac staff who died very young, after helping to set up Reading's excellent cardiac care centre.

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[quote user="Frederick"]There are fully trained paramedics sitting in local Ambulance stations  watching the TV waiting to be called out . [/quote]

Simple idea but there is the problem that if ione goes to an ambulance station there is not certain that a crew will be there. They could be out on a call already and goodness only knows when they will be back. When I was on the road (probably the same now) eacch station had outise a telephone that when you picked it up would put you through to the ambulance control (or did you have to dial 999 . . .  a few years ago now).

Another downside a crew is treating someone on station and a call comes in for an asthma attack . . . . . . . they'd have to stop dealing with the 'minor injury \ illness' to go on that call, Or, they would tell control they are dealing on station with someone and they'll be shown off the road . . .. .  what happens to the asthma attack then? Next nearest staion has to deal with it perhaps.

 

An idea that would be unworkable. The crews are on the stations for a reason (sitting watching TV waiting to be called out  . . . no . . . . . ) or out on EA cover or out working.

[quote user="You can call me Betty"]Postcodes[/quote]   

Usually health matter are runs on geographical boundaries, not postal. As an example (albrit obscure) from 1948 to 1965 Ealing was covered by the Middlesex ambulance service because despite being W5 and W13 it was geographically in Middlesex. In 1965 it became part of London so the borders of the ambulances service changed to match London from 1965 on. Wimbledon was another, SW19 but was in Surrey so had Surrey Ambulance Service until 1965.  People sem to have a thing about postcodes.

 

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[quote user="You can call me Betty"]Postcodes again.[/quote]

Usually health matter are runs on geographical boundaries, not postal. As an example (albrit obscure) from 1948 to 1965 Ealing was covered by the Middlesex ambulance service because despite being W5 and W13 it was geographically in Middlesex. In 1965 it became part of London so the borders of the ambulances service changed to match London from 1965 on. Wimbledon was another, SW19 but was in Surrey so had Surrey Ambulance Service until 1965.  People sem to have a thing about postcodes.

 

Can't seem to be able to copy bit to put the two posts together . . .

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When I was in the NHS one of the hospitals A&E was refurbished. Instead of walk in patients and patients arriving by ambulance there is now an entrance for walk in patients and another for patients arriving by ambulance. The staff are not happy about this.

Before the walk in patients, i.e. less serious could see the serious cases arriving by ambulance and bided their time until they were seen. Now, the walk in patients do not see the urgent cases arriving by ambulance and now moan about having to wait.

Thinking about it now perhaps a monitor showing ambulance arrivals in the walk in waiting area might help...

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At my local Urgences in France, there was a separate entrance for the sapeur pompier/ambulances cases. Truthfully, they would not have been able to get near the main entrance, bordellic parking would have put pay to that.

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[quote user="idun"]At my local Urgences in France, there was a separate entrance for the sapeur pompier/ambulances cases. Truthfully, they would not have been able to get near the main entrance, bordellic parking would have put pay to that. [/quote]

Hereabouts the queues of potential patients waiting to be registered into the system would certainly put paid to ambulance access if the pompiers/ambulances did not have their own entrance.

Sue

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Sad news that this should happen. If ones calls for help then one should get it.

 

Sadly the EMD was following the protocol that was set down by the powers that be. Have a go at them rather than the EMD. Years ago an EMD* (or then a CAII*) would have more freedom in questioning a patient and calls were not prioritised by a computer. CAIIs were well trained to answer the calls and deal with them and had the knowledge required for the job. Now a days more and more rules and regulations are piled on people that work in the ambulance serivces . Too many protocols perhaps taking away the common sense approach. Everything has to fit into to a rule, be covered by a regulation or something.

 

It is the national guidelines that should be brought into question.

 "The call was assessed using national guidelines based on the information provided by the caller".

 

 

 

 

 

 

*Various grades in the service.

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