Accident and emergency (A&E) departments are not meant to be places for extended stays, with patients typically expected to move on to wards within a few hours.
But at the Royal Sussex County Hospital, in Brighton, the hallways around A&E and the cubicles are often overcrowded with patients waiting to be transferred to wards.
From Saturday 18 November until Monday 20 November, I found myself among these patients, under observation and waiting for a bed on a cardiac ward after arriving at A&E in an ambulance, wired up and intubated.
My stay in A&E lasted 41 hours. I started in the resuscitation area, then moved to a cubicle and finally to ambulatory care from where they decided to discharge me – after being convinced that I was not in danger.
This was my second visit to the Royal Sussex in 18 months because of an unidentified anaphylaxis – a severe and potentially life-threatening reaction to a trigger, such as an allergy.
The first time, no ambulance was available. But I was conscious and my family drove me there. I spent eight hours in the cramped waiting room before seeing a doctor and heading home.
Thankfully, this time an ambulance was available because I was, in the words of the resus nurse, “in a terrible state” when the paramedics arrived.
Unconscious, with low oxygen levels and an irregular heartbeat, I regained consciousness as I was being carried out of my home and into the ambulance.
I spent 12 hours in the resuscitation area before I was deemed well enough to be moved to a cubicle – and there I stayed, connected to various wires and cannulas, with my oxygen levels constantly monitored.
By this time, I had received two intravenous drips, two CT scans and a referral to a cardiologist’s clinic. The cardiologist concluded that my symptoms were the result of an anaphylaxis.
The A&E consultant wanted to admit me because she was concerned about the possibility of another anaphylactic reaction.
Given my numerous wires, I was fortunate enough to have the back of the cubicle to myself. But by the end of my stay, there were about eight people in the corridor and about three to four people per cubicle.
The A&E beds were so close together they touched due to the sheer number of patients that medical staff had to monitor.
The nurses and doctors in A&E are incredible. They work tremendously hard, are caring and kind and they kept me informed throughout my stay.
What they cannot do is to conjure up ward beds when none is available. At least three other patients were waiting for a bed in the cardiac ward.
Medical staff are forced to work with too many patients in confined spaces.
I felt that those with more severe heart problems had greater need of a bed on the ward so I was relieved when I was eventually sent home with a referral to an immunologist.
The Care Quality Commission (CQC) inspected urgent and emergency care at the Royal Sussex in April last year. The inspection report described “poor patient flow” throughout the hospital. A lack of available ward beds prevented patients from being moved on from A&E.
The report said: “The use of the environment did not always support keeping people safe. Patients were frequently accommodated in non-clinical areas.
“The use of the environment did not always enable staff to protect the privacy and dignity of patients. The environment of the short-stay areas did not support effective care for patients accommodated there which included patients with mental health illnesses.”
Staff received praise from the CQC for treating patients with “compassion and kindness” – something evident from my experience.
They also have support from their senior managers, as the CQC said: “Staff felt respected, supported and valued by immediate leaders. They were focused on the needs of patients receiving care.”
As we head into winter, the pressure on A&E, the Royal Sussex and social care is increasing.
This year’s “winter plan” focuses on “admission avoidance” – or trying to keep people out of hospital as much as possible so they can recover at home.
Unless the situation is desperate, staying out of hospital is the best advice.
From my experience the main causes of over crowding of the A&E department is people are unable to get a GP appointment (some GP’s wait time for an appointment is 4 weeks). This needs to be addressed which would take some of the pressure off an over stretched hospital. Earlier in the year they announced a £50m redevelopment of the A&E I am sure this can’t come soon enough. Another factor is the lack of staff on the ground, I am aware that all areas of the hospital have been told to make savings on staff frankly this is not the way to help the flow of patients through the hospital.
The NHS was not designed to care for
Every Tom Dick or Harry who decides to come to the U K.
It was designed as a
CONTRIBUTE and use when needed.
Oh yes, in fact as Italian, given the poor level of care and would say knowledge as well of doctors here, I like many other EU are actually quite hesitant to be seen here. We all prefer to have regular checks in our own countries at our own expenses. We pay taxes more than many UK citizens actually. Except when we really need medical care, we pay for travelling and get a proper visit. Oh and plus, our doctors don’t check Google while they are visiting me.
Bebba, some people in this country have tunnel vision and inflated expectations. I feel ashamed of them.
Thank you, Anne. Don’t feel ashamed. These kind of culture is now everywhere. But good people are prevalent. 😉
👏👏👏 💯
As an European, Bebba I agree 💯 with you!
Eric, thank you.
Unfortunately Derek, to have an opinion like that shows your ignorance at how the NHS actually functions, and serves as a warning to others how misinformation by omission or lack of knowledge can be a dangerous thing, leading to bigoted views.
So many seem to be in A&E with very minor injuries, lumps, bumps & cuts sort of thing, others look very healthy and its impossible to guess the cause of visit.
Perhaps its time that A&E had a 3rd area, the 1st the obvious waiting area, 2nd being the hospital main treatment area, perhaps a minor injury unit needs to be opened that on triage those waiting could be split into those that should be seen by a doctor and those that can be treated simply by a nurse practitioner than can issue the usual plasters, bandages & paracetamol as required.
Yes many are those that get told by GP practices that next appointment is 10 days etc (my GP has a system of doctor phone call triaging to reduce the need for many to go into the surgery)and wind up in A&E out of frustration.
The current system is leaving staff short staffed and patients waiting very long times that somehow needs to be redressed.
Personally I cant praise the staff enough. Ive had more than my fair share of visits to A&E all requiring treatment that often needed scans and medications sorting among other things and was shocked this year to still see the A&E so busy away from the sitting waiting areas.
Corridors, now like during the height of covid issues are full of patients on trollies and bed waiting on further treatment/medication/observation and simply a lack of ward beds to admit people.
The RSCH A&E department is over run as is the hospital itself with nursing staff being run ragged while maintaining fantastic levels of respect to incoming and staying patients.
There is also clearly a lack of doctors in the A&E department as a whole adding to the long wait times.
I dont have a solution but someone in parliament needs to find a solution before the whole system breaks down. This should be an issue that every MP no matter where they are aligned should be unified to in getting a working solution to the problem.
Babbling about targets and how much extra this n that has been added (or not) to budgets to sort the NHS needs to stop. In fighting and the bull of not voting on this & that as another party suggested it is verging on criminal.
MP’s need to sort this out or be hounded out of office in every constituency that there is a hospital that is so overloaded they can barely treat people before health conditions kill them !
I recently had anaphylaxis and spent 8 and a half hours in resuscitation unit
Then into the dreaded over crowded corridor
They didn’t even know who I was in the corridor
It was very distressing.
Ambulance drivers weren’t told they were on divert so just kept arriving
Lots of people in distress
The four bed resus bay? For eight hours? Geez you had it bad if that’s the case. Normally they sort you out then pop you for monitoring for a little bit.
There are a lot of people who can afford private health care but choose to use the national health service because it’s free.
Those earning over a certain amount or those with large savings should be forced to go private.
It should be done the same way that the benefit system is done and not everyone should immediately be eligible.
This would cut down on the numbers and help to unclog the system.
Even as a private patient you still get referred back to the NHS for complex conditions. The difference is that the NHS itself receives a portion of the fees involved. As a private patient in this case you still rub shoulders with everyone else. For specialist NHS clinics this can be a fat chunk of their funding. Some consultants run their own private clinics, and the attendees are normally those that have private insurance via work etc.
There is no “private” 999 service, any private ambulance you see is merely transporting a hip op from A to B.
NHS is funded from taxes. And those who earn more, clearly contribute more to NHS than those on minimum wage, so probably they should actually get preferential treatment rather than pushed away.
And that’s how a two tier system starts, Alexander. The American Healthcare system is widely mocked for what you suggest here.
I had the misfortune of being in this place following a fall. 3 beds to a cubicle over spill in the corridor, people in pain, peaple having trouble breathing, people being sick next to you, one guy with a serious broken leg had his foot resting on a pile of boxes as they didn’t have an orthopaedic bed. I could go on…….the bloody place was like a war zone. Medical staff doing everything they can. Management no where to be seen. Useless bunch of waisters, get rid of at least half the management and put the money back into front line medical staff.
LARGE NUMBERS OF THE PISSHEAD COMMUNITY AND DRUGGIES CLOG UP THE A AND E DEPTS UP AND DOWN THE COUNTRY , ESPECIALLY AT WEEKENDS
Usually, they are put into a room with some basic monitoring to sleep it off. You should be compassionate about why they are in there. I know of one gentlemen who always presents the same time of year every year because it is the anniversary of his wife and two children dying in a car accident caused by a speeding driver.
Lesson being, perhaps don’t be so quick to judge Barry.
I can’t moan, went down with a serious cut from an electric saw and was seen within 20 mins then sent to x-ray ect, and fixed up and sent on my way pretty quickly after that. Carpark meter showed me in there less than 2 hours. I was pushed ahead of a lot of people, but most of them looked like they should have just taken some paracetamol…. A&E means accident and emergency. If it’s not an emergency don’t go there.
When the strikes happened, the call volume significantly reduced. And picked up again almost within the hour.ofnit finishing. The data I’ve seen does indeed support the theory that there is an educational aspect needed to using 999.
I have had to be in the Sussex A&E three times in recent weeks following heart attacks. I can not praise staff working there highly enough, with determination they do the best they can for all needing medical attention. Humbled by young med students who are training there because they just want to help people. The best of humanity from around the world are found in such places. The problem is A&E is the only way to access hospital treatment quickly now. GPs if your lucky enough to have one are powerless in getting people needing treatment into Hospital. Private so called specialist clinics are where your GP is instructed to have patents referred to who then make a decision on if your referred to a Hospital. This is the result of the Tory attack on the NHS and their insistence on using private clinics to so call assist. Its a total joke and waste of NHS funding. Don’t blame the NHS A&E do what you should do and get rid of the Westmonster destruction of our NHS backdoor privatisation.
Please do not moan these are over worked angels , yes I waited in the overcrowded cubicles see by great staff for angina.but there were more serious ill people there.this hospital is doing its best in a small area please praise them they are here to help you remember that.
Medical staff are doing an amazing job under very difficult circumstances. My grip is the wasted time and money management bring to the table. I genuinely think we wouldn’t notice if half of them didn’t turn up for work.
Goodwill is a big factor in coping. Lots of people work over their contracted hours, because it isn’t a 9-5 job, and one can’t simply skip out whilst in the middle of treating a patient. Shame junior Doctors, NQ Paramedics and NQ Nurses all get paid only approximately £13ph.
It seems so wrong to me.
Due to various conditions I have had to visit A&E 4 times in 3 years. The 1st(a mon evening) picked up an issue with my kidney and was referred on to a cancer specialist for successful treatment. I went in with chronic gut pains initially thinking a re-occurrence of diverticulitis. Was triaged after 90 mins by time bloods taken and 2+ hr wait on results, then seeing a duty doc I went home 12 hrs later (8.30am) to be called back in for scans that took about an hour.
90% in A&E were people that couldnt get to see a GP, Mondays are notorious for ppl with minor issues wanting to see a GP and told on calling their surgery that soonest Appointment is 10 day! end result many go to A& E when often a chemist could have resolved the issue.
So so many are in A&E waiting areas needlessly causing longer than should be waits.
Ambulance arrivals at the RSCH are constant, and A&E staff have to juggle these arrivals by priority as do the triage staff on the “walking wounded” side.
Another of my visits was again for chronic pain in my side, I arrived @ 9pm and about 4am was finally seen by a doc that admitted me into the bed section for various further tests & then transferred to HHeath hospital as I was under renal care(kidney cancer) and eventually once sorted sent home about 9pm @24hrs through the A&E system.
UTC is a godsend for paramedics.
continued:-
3rd visit was via ambulance that from wife calling it arrived about 30 mins later , Im told thats a good response time considering I’d collapsed about mid-day. major BP crash with blood sugars through the floor(long standing issue thats still to be identified & not diabetes)
from admission to getting home took 5 hours & prob fasted turn around in many years.
4th visit took an 8pm arrive at A&E was well gone midnight b4 Id even seen a doctor and spent the night in observation room and released following day about 1pm
As previous post says the A&E on each visit was rammed, far more than I have ever seen prior. One visit started on a Sat night and expected it to be busy and would have avoided the trip if it was realistic but none were.
the staff up there are very hard pressed and are legally obliged to see everyone that shows up, even minor cuts and headaches.
yes there are some “regulars” that most would call the street dossers that arrive pickled in some way or another and can be quite aggressive and intimidating to staff and those visiting as well.
Granted no one knows the true reason for someone’s visit to an A&E but I suspect like myself those there look around the wait area and wonder why mr X or Miss Y are there as they look fine. Others limp around with obvious injuries while othered temp forget they were previously limping !
Brighton Sussex hospital is the worst hospital going been mistreated and not looked after properly I have learning difficulties and eupd they don’t listen make fun of you the hospital is always dirty they put me on a filthy bed about 2 weeks ago with no sheet on it I have also been threatened by a nurse to snap my fingers off because i was sat on the floor in pain waiting for a taxi i was told to get of the floor which I have proof of on my phone what he said to me the hospital needs further investigating i don’t go to this hospital no more I much rather keep going to Worthing hospital where they treat you better and listen more
Having been taken to A&E by ambulance on Monday I cannot fault the paramedics and medical staff in any way. The corridors were jammed with beds but the staff carried on in a calm and efficient way. It felt like a war zone and I felt almost shell shocked. Why oh why was A&E not upgraded first in the extension of the RSCH. It is a real reflection on the lack of investment in our front line services by this Government which has been in charge for 13 years. Thank you so much A&E staff for dealing with me with courtesy and compassion. Shame on you British Government for allowing our beloved NHS service to be decimated in this way.
It’s very standard affair these days to use that corridor as you enter the queue! Paramedics will typically look after you for the first hour or so whilst they wait to handover to the A&E Team, and if there’s a way we can triage you to something a bit more appropriate, like UTC, we’ll see what we can do to make that happen.
I am glad about the doubling of A&E though, that’s going to make a fair bit of difference!