A&E charges

Mint Sauce

recently had to go to A&E, was treated and discharged, but was told to come back if symtoms continued or worsened after a few days

question is, would i have to pay a second A&E fee if went back

eth0_

Of course. It's a separate consultation.

Mint Sauce

even if it was for a follow up regarding the same problem

ergo

No, you definitely would not have to pay for a re-presentation if it concerns the original presenting problem. I have worked in several A+E's and that's how it works.

Presuming it is within a reasonably close time period and not, say, 7 months later or something!

Looby_Loo

If its about the same issue and couldnt be dealt with elsewhere I shouldnt think that you will have to pay

Mint Sauce

ergo wrote: »

No, you definitely would not have to pay for a re-presentation if it concerns the original presenting problem. I have worked in several A+E's and that's how it works.

Presuming it is within a reasonably close time period and not, say, 7 months later or something!

if i was to re present, whoes attention would i bring it to, would it be registrations, the CNM in charge...

and who makes the decision

dont think i'll have to go back, but it would be handy to know if i did

ergo

irish-stew wrote: »

if i was to re present, whoes attention would i bring it to, would it be registrations, the CNM in charge...

and who makes the decision

dont think i'll have to go back, but it would be handy to know if i did

You would say it initially when checking in at reception so they woudln't charge you again. And then say it again to the triage nurse (the nurse you meet initially who finds out quickly the problem and quickly assesses you etc)

they will usually (depending on the hospital) then print out the medical note from the previous recent encounter and bundle it with your new note. It happens all the time. I suppose the triage nurse ultimately makes the decision.

Traumadoc

The charges were introduced to try to get people to see their GPs before coming to the A&E it does not work and is a PITA to administer. However it does pull in over 3k a day for most departments or 1 million a year. so its unlikely to go.
You will have to pay even if its for the same problem.

ergo

Traumadoc wrote: »

You will have to pay even if its for the same problem.

I've never been involved in the administration of these fees but always thought if it was a re-presentaton involving the same complaint within a short enough period of time there's no further charge

Traumadoc

No , often people will present with chronic conditions - back problems or Psychiatric conditions. They do not go to their GPs first so are charged. I believe there is a maximum number of times they can be charged.

DrIndy

I work in A&E now and i know how frustrating it is when people with relatively minor issues which can be dealt with by GP's cause huge waits for people in need of our services. however - i do sympathise with people who sometimes just don't know whether they should come to us or not.

A&E is about trauma and emergency medicine and rapidly and effectively dealing with both. When people attend for other medical conditions then can result in people with minor trauma such as broken fingers and tendon tears having to wait a very long time to be seen - even though they are the appropriate patients to attend!

A&E also cannot deal with chronic illnesses - the department are not designed for that - we are supposed to deal with and stabilise emergencies quickly and efficiently - anything which requires followup is inappropriate for A&E

Mint Sauce

DrIndy wrote: »

I work in A&E now and i know how frustrating it is when people with relatively minor issues which can be dealt with by GP's cause huge waits for people in need of our services. however - i do sympathise with people who sometimes just don't know whether they should come to us or not.

A&E is about trauma and emergency medicine and rapidly and effectively dealing with both. When people attend for other medical conditions then can result in people with minor trauma such as broken fingers and tendon tears having to wait a very long time to be seen - even though they are the appropriate patients to attend!

A&E also cannot deal with chronic illnesses - the department are not designed for that - we are supposed to deal with and stabilise emergencies quickly and efficiently - anything which requires followup is inappropriate for A&E

very good arguement, and partly reason for my original question, have only ever, including last weeks visit, attended an A&E about 4 times in my memory, one of them being a GP referral, so would not be to up to date on charges and follow up procedure, had originally planned to vist my GP this time, could not get an appointment, and when described my complant was adviced to attend A&E

mine was a minor injury (describtion given by one of the nurses when she showed me and a few other to examination room) away from the main waiting room, and ended up being there for about 4 to 5 hrs, had a hand injury, x rays taken, final impression was ligament and soft tissue damage, was bandaged up, given exercise advice, and told to come back for furhter xrays if problem persisted

so arcording to your aguement, and apolagies if read it wrong, i imagine i should have really been given a refferal to out patients clinic for a proper follow up, so if i was to re present to A&E, is it considered an appropraite visit, even if some or all original symptoms persist

Traumadoc

DrIndy wrote: »

I work in A&E now and i know how frustrating it is when people with relatively minor issues which can be dealt with by GP's cause huge waits for people in need of our services. however - i do sympathise with people who sometimes just don't know whether they should come to us or not.

A&E is about trauma and emergency medicine and rapidly and effectively dealing with both. When people attend for other medical conditions then can result in people with minor trauma such as broken fingers and tendon tears having to wait a very long time to be seen - even though they are the appropriate patients to attend!

A&E also cannot deal with chronic illnesses - the department are not designed for that - we are supposed to deal with and stabilise emergencies quickly and efficiently - anything which requires followup is inappropriate for A&E

Some injuries may not be apparent on xray at time of presentation, Scaphoid fracture being a classical example, due to the lack of access to radiology by GPs these injuries may have to be followed up in A&E.

nesf

Traumadoc wrote: »

Some injuries may not be apparent on xray at time of presentation, Scaphoid fracture being a classical example, due to the lack of access to radiology by GPs these injuries may have to be followed up in A&E.

Out of curiosity, why would these be followed up in A&E and not through GP or appointment with an out patient clinic or whatever? Is it a lack of a suitable channel for such cases that's the problem? I ask simply because it is my understanding that A&E would be the kind of pressure point in the system that would benefit from people not having follow up treatment there.

Traumadoc

Unfortunatly there is a lack of access for basic radiology services for primary care in this country. So if someone has a suspected fracture they have to be sent to A&E to get an xray- if the xray is nondiagnostic, to be rexrayed in a few days when some fractures become more apparent, the patient has to reattend the hospital.

It will be interesting to see what happens when community radiology services get off the ground- the xrays are sent electronically to other countries for reporting. Then the whole problem of accreditation becomes an issue- but thats a whole different can of worms

DrIndy

some A&E's do a one-visit follow up clinic for things like scaphoid fractures. If there is a fracture and you get a cast - then they refer you to orthopaedics OPD for follow. They can also refer to medical departments for followup.

We are not designed though to be an alternative GP service though which is where people get confused. Just because there are doctors there is not a reason to visit unless you have had either an accident or an emergency problem.

Irish-stew correctly attended but others incorrectly attending resulted in delays.

Traumadoc

Strictly speaking they are not ment to refer to outptients, the medical council issued a warning about cross referral few years ago. It was pointed out that this was stupid as most A&Es refer 60 patients week to the fracture clinics.

Most departments have review clinics.

Mint Sauce

Traumadoc wrote: »

Strictly speaking they are not ment to refer to outptients, the medical council issued a warning about cross referral few years ago. It was pointed out that this was stupid as most A&Es refer 60 patients week to the fracture clinics.

Most departments have review clinics.

so if its a reveiw clinic, i'd asume you would not be liable the 2nd consult fee as a public patient

ps, hands fine now, took off banageing/support as advised by the reg/nurse yesterday, almost full movement has returned, still a bit of discomfort at times, no where near the pain i had before though,

thanks for the input guys/gals