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CAMHS won't see you now

GPs told to avoid referring patients to A&E after hospital placed on 'black alert'

GPs in Cambridge have been warned against sending patients to A&E, after one of the country’s most renowned teaching hospitals announced that it had been placed on black alert.

Cambridge University Hospitals wrote to GPs, ambulance services and four other nearby hospitals on 10 July to warn them that Addenbrooke’s Hospital was facing ‘severe’ capacity issues.

GPs have been asked to consider whether patients they would usually send to A&E can instead be assessed through an ambulatory care service and all referrals must now first be discussed with an on-call doctor, the hospital said.

The hospital has been on black alert, which indicates the highest possible level of capacity crisis, since early July.

It had been placed on the black alert several times in recent years - for 190 days in 2012-13 alone. Though figures for 2013-14 are not yet available, it is understood that they are expected to rise.

The letter, seen by Pulse, said that the trust was experiencing ‘severe’ capacity issues across all areas. CUH’s on call director, Amanda Kahn, wrote: ‘We have planned admissions on hold. We have contingency areas open. We are no longer able to place patients from the Emergency Department. We have critical staffing levels.

She added: ‘If you do phone GP liaison to refer a patient, please be proactive to considering whether your patient can be assessed on EAU3 (ambulatory care) rather than simply sent to the Emergency Department.’


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Readers' comments (10)

  • So a hospital with current, and multiple past, capacity problems wants GPs not to refer to AEU. Sorry my stock of medical goodwill ran out many, many years ago and if my patient needs to go the AEU they go. End of discussion.

    Why has the hospital not solved their capacity problems? Just why should GPs help those who would not help themselves?

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  • Our local hospital had black alerts last year, then they turned into rainbow alerts with spots on it, as they had hours of waits for ambulances to drop off new patients!

    Demand management from the DOH is the only way to stop the flood of morons turning up to A&E with coughs and sore throats, drunks need to be fined for wasting NHS time - less money to pour alcohol down their gullets.

    Close the doors to A&E for minor non accident and non emergency care - simple decommission them so they aren't paid to see it. See how soon it is all sent back to where it belongs.

    Coughs and colds - even in small children belong at home in bed with parental care and Calpol.

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  • and what about general practice capacity issues.....

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  • ........and winter?

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  • Ok today I won't send in any patients that don't need to there. It's common practice for GP's to refer patients to A&E for the hell of it but we'll stop that when hospitals need us to. So sorry for all the inconvenience of you having to see patients at all let alone the ones we send in for fun.

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  • Great news when this becomes a Major Urgent Care Centre. Heaven help us.

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  • I never refer patients to AE. If I see someone who needs secondary care I refer them to the appropriate team. Where they choose to see them is not my concern. Equally I have no ability to stop patients attending at their own discretion .

    So the warning to GPs is completely spurious and designed to pass the political heat to us. Cue Hunt.....

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  • I have just reviewed 100 patients at risk of re-admission / a and e attendance as per the national des - there are about 1% of ' possibles' to not attend and I consider myself ruthless after 30 yrs since qualification
    - who ever advised this government on potential savings needs to be sacked as clearly mentally Ill and no handle on reality whatsoever - and similarly the current government - pie in the sky comes to mind - the only solution appears to be mass euthanasia - starting with the front bench !! Hand over the syringe - whilst not keen - for the good of the country - bring it on x

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  • FAILING HOSPITALS everywhere!! WHY ? Just lack of funding. Prof. Anastole? report showed Guys and St Thomas has 125 Consultants per 100 beds and are doing nicely thank you while in Nottingham a hospital has 44 Consultants per 100 and is failing.
    Mid - Staffs was a 5* hospital in 1999. When they cut 300 staff the place collapsed and is now closed !! Christine Hancock predicted, as any child could, that if you chop staff, patients will suffer. Proper staff ratios are crucial and core to patient care.
    Enter Francis and a 13 million pound report with 300+ recommendations!! If they had not cut staff, there would be no Francis !!
    This is not cosmological constants, modified theory of gravity or quantum entanglement. There is no special place in the NHS where staff are so superior that their hospital succeeds whereas another fails. It is just a matter of funding and staff patient ratios. That is all. A hundred more inquiries will not solve anything till we can compare like with like. How many beds. consultants, junior doctors, nurses per 1000 patients ?

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  • Admitting a patient, or sending them to A&E is not an easy thing to do. The patient does not like it unless obviously necessary. They know they will be seen by a nurse after 1 minute and them be in a corridor for 3 hours and 59 minutes before admission. It will also take me at least 15 minutes on the phone, quite apart from arranging ambulance and letter. Does anyone in secondary care really feel admissions are an easy option? What are we going to do with patients that need admitting - leave them at home?
    The same alert thing happens with our local hospital. They built the hospital they could afford under PFI, so it is too small and the car parking is very expensive. Everyone told them it would be too small and yes, surprise; it is. Our local population did not go younger, and chronic illness did not become less of a burden. Now we get regular letters with "red alert" "purple alert" etc. We get them so often, they go in the round filing bin immediately, unless I get really miffed which is when I send them back a fax. "dear hospital our practice is on black alert with bells on and red stars. Please do not discharge any of our patients as our surgery has now reached full capacity". I am certain my missive will be treated with as much consideration as it deserves.

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