Improving Accident and Emergency

A few hospitals this winter have had to put a temporary stop to some non urgent work in order to cope with the large numbers of people arriving at A and E. Fortunately this has not happened to our local hospitals.
There are, however, pressures on the A and E departments of most hospitals. Demand is surging for a variety of reasons. Some find it difficult to get an appointment with their GP, so they think it is easier to admit themselves to A and E who have to look at them when they turn up, and treat them if necessary. Some are not well informed about their GP and his or her arrangements, but know the local hospital. Some want to go out of hours or at the week-end, when A and E might be the most obvious available option. Some visitors or illegal migrants to the UK may go to A and E because they are not normally asked about their entitlement, but might well be if they tried to get on a doctor’s list.
Each of these cases requires a different solution to reduce numbers sensibly. In an ideal world only people with a clear need for emergency treatment would turn up at A and E. If you have been in an accident then of course A and E is the place for you if you have anything other than a minor injury. If you are suddenly stricken by an unknown condition that seem serious, which may include a stroke , or heart attack, then again A and E is for you as quickly as possible.
The government is examining what it can do to relieve pressures. Can some GPs be attached to the local hospital to handle some of the cases? Can GP surgeries be strengthened to offer more hours of service? Can more use be made of the walk in centres?


  1. BobE
    January 19, 2015

    If you get a prescription at an A&E it is free. If you get a prescription from a GP it is £8+ for each item. If you are prescribed several items this soon adds up. So another reason to visit A&E is to save money.

  2. Tony Houghton
    January 19, 2015

    My feeling is that GPs should be tasked with doing more to filter patients to reduce the load on A&E. They received a very good deal a few years ago and now receive pay of over 6 figures. They could provide a shift system to cover the weekends.

    January 19, 2015

    Some time ago a man detected a tiny splinter in the sole of his foot which he took to be a slither from perhaps a metal brush. He was elderly, living alone and try as he might he could not apply tweezers to it. He was too embarrassed to ask a neighbour: too responsible to trouble a doctor. So he thought to ask the nurse at his local doctor’s surgery to perform the 10 second removal as it was painful.

    Upon his arrival the nurse refused to even look at his foot. She explained it had been decided at a higher level that patients in ALL instances involving such had to be sent to hospital for an X-Ray and examination. She smiled wryly.

    The point is, doctors and people in the medical field are not beyond playing politics in the widest sense. Politicians of all hues seemingly only ever heap praise on medical staff, teachers and one of two other professions , ( excluding long-term serving police officers most notably ).

    But the strain on A & E could partially be a self-inflicted wound by medical personnel themselves and with their own agenda in ways it is hard for those not ” in the know ” to fathom.
    Yes, I am in the know.

    1. alan jutson
      January 20, 2015


      Are yes, being in the know both to speed things up, slow things down, and all things political.

      Last year one of our family members needed a CT scan to investigate further a shadow on the lung shown up by X Ray.

      Local hospital has two such machines, but one had broken down, another local hospital (same Heath Trust) has one that is grossly underused (lack of staff given as the reason)

      Instead of transferring staff from the broken down unit to the other local hospital for a period until the original was fixed, they sent all waiting patients to a local private hospital for a scan.

      When the consultant was eventually seen for the results I asked the question, why pay for private scans when another machine at another local NHS Hospital was under used (in fact used only one day per week) I was told, internal politics, ask no more.

      No wonder the NHS needs more money if this is how things are managed.

      How sad that patients are being used as pawns for some sort of political gain.

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