The new A&E at King's

[tomskip]

I just thought I'd start this thread to see if people more knowledgeable than me can explain about the new A&E set up at King's. I was there recently and it doesn't seem like an improvement in any way, but then I am just an average punter and don't understand NHS systems and thinking so it would be great to have an insight from someone in the know.

The "old" set up had large seating area with padded blue seats (at least I think they were padded) in rows in front of the large reception desk, and a separate A&E for children to the right just as you went in through the main entrance doors. This was the arrangement when King's was featured on 24 hours in A&E. It was also like that when I had to go in in 2017.

I'm not sure when it was rearranged but I had to go to A&E in the middle of the night recently. There were two stages to signing in at two separate desks and then the waiting area was tiny, more like a corridor with two rows of hard metal seats (like on a railway platform) facing each other. It couldn't have been a less comfortable place for someone in considerable pain to be left waiting for 3.5 hours. The jovial doctor who saw me in the end told me I should be grateful it wasn't a 7 hour wait like it had been a few nights previously.

Of course I understand the concept of waiting in A&E - there will always be someone more acutely ill and other emergencies coming in that take priority. But since we are expected to wait many hours - why does it have to be in a place as miserable and uncomfortable as you could imagine? The old waiting room was definitely a notch or two up.

[Jennys]

I am pretty sure the hard uncomfortable metal seating was in use under the previous layout of A and E. There was also a machine which dispensed fizzy drinks and unhealthy snacks and sweets. Presumably this was a big source of revenue. I am not sure if it still there. However I agree, the new layout is really dreadful. And the entrance on foot is less easy to find.

[ab29]

Agree with what is said here. Plus it's not possible to tell a nurse why you came to A&E without everyone around listening - most embarrassing. The King's seems even more depressing after seeing the A&E at St Thomas'- so much better.

[RichH]

I'd guess it's designed to be just uncomfortable enough to discourage people who aren't really ill from wasting the medical staff's time trying to get in when there are people with genuine medical emergencies who need to be seen.

I was there in 2017 (definitely all hard metal seating in the main waiting area and not at all welcoming) and, after progressing through the two reception stages, was examined by a nurse who gave a wry chuckle and said it made a change to see someone who actually had something wrong with them.

[evilmanic]

The first area you wait is counted for their "Admitted into A&E" stat, the second area you wait you're counted as admitted so it doesn't affect their stats.

[Penguin68]

I believe that when you are triaged in the first room you may be sent to a number of different second staging posts. If you were in one with a long waiting time that suggests that your problem was (probably) - (1) not life threatening and (2) would not lead to rapid deterioration (however bad it was it wasn't likely to get much worse). A simple break for instance, however painful, will be as treatable in 4 or 7 hours as it would be immediately. That makes it no better for you, of course, particularly if in pain, but at least you won't be with people who will be treated before you because of the severity of their problem.

This may be a better way to allocate ER resources, where clearly the acutely ill (those whose lives may be at risk, or whose condition is likely to deteriorate quickly) should be being treated first.

The downside is that you can enter the first room of the ER system thinking that it looks like there will be only a few ahead of you, only to enter a crowded 'second stage' room, which is dispiriting.

[Penguin68]

The first area you wait is counted for their "Admitted into A&E" stat, the second area you wait you're counted as admitted so it doesn't affect their stats.

But as the count-down to the magical 4 hour target wait is triggered from the 'admitted to A&E' time this actually does them no favours. Indeed forcing people to wait a longer time for first triage (which starts the clock) would be a better bet, if they wanted to fiddle their figures.

[Bob Buzzard]

There are other medical facilities available instead of the Emergency Department - for example an urgent care centre, a walk-in Centre, an out-of-hours service, or a same day appointment at a general practice clinic.