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A dire lack of access to GPs has been blamed for the country’s A&E crisis after video emerged of patients being told they faced waits of up to 13 hours in an emergency department.
A&E services across England are at breaking point as record numbers of patients flood back into the system after years of delays caused by the Covid pandemic, sparking record waits in casualty units.
Campaign groups, MPs and senior medics say desperate patients are turning to emergency and walk-in services because they can’t get a face-to-face appointment with their GP.
The patients’ rights group Silver Voices told MailOnline the situation was ‘completely unacceptable in the 21st century’, adding that by the time patients turn to A&E their conditions have already worsened.
One patient in her sixties from Oxfordshire, who has struggled to get a face-to-face appointment with her doctor told MailOnline GP practices were using A&Es as a ‘triage service’.
Around 60 per cent of appointments with GPs are in-person, with the rest done virtually, compared to more than 80 per cent pre-pandemic.
The average GP in England is responsible for 2,200 patients now – up from 1,900 in 2016. In the areas with poorest access, up to 2,600 patients are fighting over one family doctor.
Tory MP Matthew Offord told MailOnline: ‘The GP surgery should be the first point of contact so that patients can receive the most appropriate treatment in a timely manner. A&E departments across the country are being placed under enormous stress and the Government is not even seeking to understand why this is happening.’
The fury came after a video showed an irate A&E nurse at Princess Alexandra Hospital Trust in Harlow warning patients they faced a 13-hour wait to be seen.
A female NHS worker at the Princess Alexandra Hospital Trust in Harlow warns patients there are no free beds and they face spending the night in the waiting room
NHS data on A&E performance in April shows a record 24,138 people were forced to wait 12 hours or more to be treated, three times longer than the NHS target and the worst figure on record
In the clip, filmed on Monday at around 4pm, a female nurse tells patients they might have to spend the entire night in the waiting room because there are no free beds in the Essex hospital.
She can be heard saying: ‘We’ve got 170 patients in the department, there are 90 patients waiting to be seen at the moment. Our current wait time for a doctor is seven-and-a-half hours.
‘I estimate by the time I go home in the morning at 8 o’clock some of you will still be waiting because the waits will get up to 13 hours.
‘There are currently no beds in the trust, we’re trying to make space if we can but if people are admitted there’s a chance they’ll stay in A&E overnight.
‘We will do our best to make you comfortable but please don’t expect you will be going direct to a ward because that might not happen.’
Relatives of patients at the A&E at Princess Alexandra Hospital Trust were also asked to leave because the emergency department was so busy.
The struggling hospital is now actively encouraging people to stay away unless they have a life-threatening medical emergency due to ‘extremely high demand’.
It comes as latest NHS figures show a record 24,000 people are waiting 12 or more hours in A&E every month before being seen — three times the NHS target.
Dennis Reed, director at Silver Voices, told MailOnline that 13-hour waits ‘was completely unacceptable in the 21st century’.
‘I’ve heard of very long waits before, up to eight hours and the like, but 13 hours? Never.’
He added: ‘There is a lack of access to GPs, it’s very sporadic, so A&Es are taking people who really need a doctor but can’t get one, which is resulting in A&Es being completely overloaded.
‘People only go to A&E if there is something seriously wrong with them, everyone knows the waiting times in hospitals are hours long.
‘Nobody is going to go on A&E on a whim, they are going to A&E because that’s the only place they can finally get help for their condition.’
Mr Reed called on the Government to deliver on its promise to hire 6,000 more GPs, a key pledge in the Conservative Party’s general election manifesto in 2019.
The Royal College of Emergency Medicine (RCEM) has previously warned difficulties in seeing a GP was leading to a crisis in emergency departments. A report in October by the College said a lack of access to family doctors was creating ‘dangerous crowding’ in A&Es.
Tory MP Matthew Offord told MailOnline: ‘A&E departments across the country are being placed under enormous stress and the Government is not even seeking to understand why this is happening.
‘The GP surgery should be the first point of contact so that patients can receive the most appropriate treatment in a timely manner.’
The mother-in-law of a car crash patient patient who was at Harlow A&E on Monday told MailOnline the NHS was ‘clearly on its knees’.
She said: ‘My son-in-law visited A&E on the evening of June 6 2022 at approximately 4pm after being involved in a RTA [road traffic accident].
‘He left in pain after hearing the nurse’s announcement. Others verbally abused her. This is our NHS on its knees after 12 years of underfunding. ‘
She revealed her son-in-law was involved in a three-car crash and was suffering ‘a lot of pain’ in his back, neck and arm.
He decided to go home after hearing that he might have to wait 12 hours and has now been referred for an emergency X-ray.
Stephanie Lawton, chief operating officer at The Princess Alexandra Hospital NHS Trust, said: ‘We are currently experiencing extremely high demand for our emergency care services and have seen a significant increase in attendances in our emergency department.
‘Our teams are working hard to assess and treat patients as quickly and effectively as possible to reduce delays, prioritising those in most clinical need.
‘The public can help us to ease pressures by using the NHS 111 service for healthcare advice in non-urgent cases. As ever, please continue to call 999 or attend the emergency department for urgent and life-threatening emergencies.’
Latest NHS England data shows 2million people in England were treated in A&E departments in April – on par with the highest number ever.
Just 70 per cent of people were seen within the health service’s own four-hour target — the second-lowest rate since records began in 2010.
Ambulance figures for April show waits for paramedics fell compared to March but were higher than nearly all other months since records began. Ambulances took an average of 51 minutes and 22 seconds to respond to category two calls, such as burns, epilepsy and strokes. This is nine minutes and 41 seconds quicker than one month earlier
The number of people waiting for routine hospital treatment in England has soared to another record of 6.36million. NHS data shows one in nine people were in the queue for elective operations such as hip and knee replacements and cataracts surgery by March — up from 6.18m in February
NHS England aims to treat 85 per cent of cancer patients who receive an urgent referral from their GP within two months, but in November 2021, the latest available, only 67.5 per cent of patients received treatment in this time frame. While the problem predates the Covid pandemic, the disruption to services caused by the virus has exacerbated the problem
A total of 131,905 people waited at least four hours from the decision to admit to admission in March.
And 24,138 were forced to wait more than 12 hours – the highest number ever. At the same time a wider crisis is brewing within the health service.
A record one in nine people (6.4million) were waiting for elective operations such as hip and knee replacements and cataracts surgery by March.
There are now 306,000 who have been waiting for more than a year for their operation and 16,796 have been seeking treatment for more than two years.
Ambulance waiting times are also at record low levels, with heart attack patients now waiting more than an hour on average for 999 callouts.
Staffing crises and people delaying coming forward during the pandemic are thought to be the main causes of the unprecedented situation.
But analysis published last month found that millions of visits to hospital accident and emergency units in the past year may have been due to people being unable to see their GP. Patients have also blamed online eConsult services that some GP practices tell patients to fill out in order to get an appointment.
A patient in her 60s from Oxfordshire, who wished to remain anonymous, told MailOnline: ‘The GP surgeries are using A&E as a triage service. You cannot physically see a GP anymore.
‘If you phone the surgery you are put on hold and played a relentless pre-recorded message telling you ‘due to the ongoing pandemic’ appointments are scaled back and telling you to hang up and fill out an eConsult form instead.
‘Then, these tickbox online forms end up redirecting you to seek ‘urgent medical attention’ in most cases anyway. So, what choice do people have when they are in genuine need?
‘If by some miracle you do finally get through on the phone, and all of the ‘appointments’ haven’t gone, they inform you that the doctor won’t see you face-to-face anyway and will call you back instead – and if you need to see someone urgently to go to A&E. It is an endless cycle.
‘I don’t call a doctor unless I need to. No-one in their right mind wants to sit in A&E for 13 hours just to see a doctor, but they are being left with very little choice.
‘No doubt there are many people in A&E who don’t need to be there, but I am fed up with all patients being painted as timewasters.’
Lillian Payne, 66, from Gravesend, told KentOnline that an eConsult form advised her to go to hospital. But when she showed up at A&E, medics said she needed to see her GP. After calling her practice, she was told to complete the eConsult, which told her for a second time to go to hospital.
And doctors have told how the eConsult system has left patients who are unwell and need a ‘quick conversation’ with their GP pushed towards A&E when they didn’t need to be there.
Research by health watchdog the Care Quality Commission (CQC) found almost one in five A&E patients surveyed had resorted to emergency departments because they couldn’t get advice or treatment elsewhere.
Of those, the research found, around one third (35 per cent) said there were no appointments available and 30 per cent said they were not able to get through to or access the service.
In total, 4.7million visits to hospital accident and emergency units were attributed to a lack of access to GPs.
The Royal College of Emergency Medicine (RCEM) said late last year this was causing ‘dangerous crowding’ in A&Es which is ‘unsafe and unconscionable and threatens patient safety’.
Tens of millions of GP appointments were cancelled or done remotely during Covid so doctors could focus on the virus, leading to a post-pandemic boom in demand.
But many patients are still struggling to see a GP as services fail to bounce back, with less than half of appointments being conducted face-to-face.
At the same time there are 1,500 fewer fully qualified family doctors working in England compared to five years ago.
Separate figures show that some areas of the country have just one GP for every 2,500 patients.
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