Nicola Vincent-Abnett

Nicola Vincent-Abnett
"Savant" for Solaris, Wild's End, Further Associates of Sherlock Holms, more Wild's End

Tuesday 7 October 2014

With thanks to the NHS A&E department Milton Keynes and A&E department Maidstone

A great deal is said about the National Health Service, and let’s face it, not all of that talk is good. 

Under stress, people are inclined to complain. When they are distressed and in pain they want help and they want it fast. I suppose that’s natural enough.

In the UK we have a system that treats patients at the point of need without asking for proof of valid insurance. We are all insured, automatically. There are no upfront costs. We are not charged at the point of need, or invoiced afterwards. If we get sick or injured we are treated.

I had an accident on Sunday night. I was away from home, and the husband drove me to the nearest Accident and Emergency department, which happened to be at Milton Keynes, forty minutes from where we were staying.

I gave my name and address and the nature of my injury. The triage nurse took more details and gave me painkillers. I was supplied with icepacks at intervals during my wait. Yes I had to wait. That’s what triage is about. There were people with a greater need than mine so of course they needed to be seen ahead of me.

One of the patients waiting to be seen had mental health issues that he was clearly aware of, but which made him somewhat disruptive. The staff did what they could to keep the waiting area as calm and quiet as possible for the rest of us. The bathrooms were clean, there was a water fountain, and there were vending machines for snacks and beverages. There was sufficient seating for everyone. The staff were endlessly pleasant and efficient. 

I waited two and a half hours and was seen by a junior doctor. Hannah was lovely. She did what she thought she should do and then had her work checked. Her senior, Edozie advised further checks, which were then completed under his supervision. I was sent home with everything I needed, including extra dressings for my injury, painkillers, antibiotics and the protocols for booking a consultation with an opthalmologist at my local hospital through my GP.

You really didn't want to see a picture of my eye…
On Monday morning, the husband phoned our GP surgery. within an hour our GP had phoned back and set the wheels in motion for my consultation. By the time we’d driven home my GP had also organised a prescription for stronger painkillers, which we were able to pick up by lunchtime. At 5-30 the eye clinic at Maidstone hospital asked me to attend A&E to see the on-call opthalmologist, because they considered my case to be urgent and didn’t want me to wait for the eye clinic to re-open the following day.

I arrived in Maidstone’s A&E department at 6 o’clock. When I arrived the wipe board said that waiting times were an hour. Very quickly, that changed to two and a half hours.

Every A&E department that I have ever been in has been divided into two sections: Major and Minor. It makes sense, doesn’t it? I was a walk-in at Milton Keynes and I’d been invited by Maidstone eye clinic. My injury wasn’t life-threatening. I hadn’t had a stroke or a heart attack and I hadn’t been run over by a bus or stabbed. I hadn’t suffered an overdose or been beaten to a pulp. I wasn’t having a seizure and I hadn’t lost my arm in a chainsaw-related incident.

I had lowered a steak into hot oil and it had spat into my eye. Was it painful? Hell yes. Was my eye and nose secreting a discharge? Absolutely. Was my vision impaired? I couldn’t see a bloody thing. Was any of that going to change if I sat in a chair to wait while someone’s life was actually saved? Of course it bloody wasn’t.

Nothing was going to change for the bloke with the twisted ankle or the woman who’d sliced her thumb on a kitchen knife, or the woman who was ‘achey’ (who knows what that was about) or the bloke with the infected tattoo, or the woman coming down off whatever it was she’d taken, or the homeless man who was clearly a regular. Nothing was going to change for the six year old who whimpered endlessly, but I’m glad they see children quickly. Nothing was going to change for the old bloke I told off either.

It became clear to all of us in Minor that something had happened. Something Major had come into A&E. There wasn’t any fuss, everything remained very calm and professional, but things on our side of the divide slowed down dramatically. We were all fine. We were sitting talking and watching the television. Some of us were reading. The woman who was ‘achey’ talked on her phone and went out for a fag.

We all knew who the opthalmologist was because she’d wheeled a piece of equipment across the waiting area. Anyone who’s ever had a comprehensive eye exam knows what that thing’s for.

I also knew that the eye clinic had called in two patients to be seen by the on-call opthalmologist after clinic hours, because the receptionist had mentioned it to me in case I had to wait. I couldn’t be seen by anyone else. That was fine with me. I’d been given a time of 6-30, but, going through Accident and Emergency, I had no expectation that I would be seen at a specified time.

By about 8-30 my painkillers were wearing off, and I was in some discomfort. My eye and nose were discharging badly, and the dressing over my eye felt as if it needed changing. The opthalmologist walked back across the waiting room. An older man sitting a couple of rows in front of me stopped her and started talking to her. After a couple of minutes he took a letter out of his pocket.

I got up and walked over to him. I put a hand on his shoulder and said, “I’m sorry, but you can’t expect her to consult in the waiting room. She needs to work. We’re all waiting.”

The doctor took the opportunity to walk away. I was calm and polite, and the man said nothing. I guess there wasn’t very much he could say. Half an hour later, the doctor walked across the waiting room again, and the man accosted her again. 

He was a man on a mission, but, and forgive me for saying so, he wasn’t in any obvious pain. He didn’t have pus discharging from his eye or a dribbling nose. He didn’t have a dressing or an eye patch, and he certainly wasn’t alone in waiting for three hours. Some poor sod, in a much worse state than either him or me clearly had come into Major needing an eye specialist, and she was standing in the waiting area having her time wasted by this guy.

I didn’t need to resist the urge to talk to him again, because the lovely doctor simply told him very firmly and very calmly to report to the eye clinic in the morning, and he left.

I was seen at 10 o’clock.

I commiserated with the doctor who admitted that it had been a very tough, very busy shift. She also apologised for my long wait.

She had no need to apologise to me.

A steak spat fat at me, for heavens sake. Within roughly twenty-four hours two hospital doctors, one consultant opthalmologist, one GP, two A&E departments, four receptionists, a triage nurse, a pharmacist and any number of clerical staff had been involved in my care. I had been given dressings, three different painkillers and an antibiotic, supplied with a prescription, and been given numerous different eyedrops to numb my eye and dye it. My vision had been examined twice and I’d undergone a battery of other eye tests. Phone calls had been made, faxes had been sent, forms had been filled in, and the NHS central computer had recognised me at three separate locations.

All of this in clean, calm environments, surrounded by friendly professionals, and all I had to do was supply my name and address and tell someone what was wrong with me. No one asked me for insurance details, and no one asked me how I was going to pay for my treatment.

The National Health Service is bloody wonderful!

I have some damage to my cornea and my vision is impaired, but these things are temporary. I need to keep using the antibiotics for a week to guard against infection, but my eye should mend itself, and my vision should return to normal.

And it’s all my fault, because if I’d been wearing my glasses, or if I’d realised that the oil was a little on the hot side that steak probably wouldn’t have taken offence and that oil probably wouldn’t have jumped out of the pan.

So thank you Milton Keynes A&E department and thank you Maidstone A&E department. You all do fabulous work, and I hope that the NHS gets better funding to do great work in the future.

Can I also say that on a personal note, I hope I won’t be doing too many stupid things that take up valuable NHS resources. I probably did need to go to A&E this time, but I can’t help thinking that with a little good judgement some of us could avoid some of these accidents, and when we have small accidents, some of us might think twice before going to A&E; in some cases, we might do just as well to look after ourselves and each other.


  1. thank you for this! My husband works in our local A&E as a Health Care Assistant and it always brightens his day to hear comments like this. :) Hope you're feeling better soon!

  2. That was a great story to read. I think you would make a good doctor. You read and I've always got the impression you're good with people.

    And regarding financing, from my perspective the government should make the NHS more efficient before increasing funding. Renegotiate Private Finance Initiative contracts that makes hospitals 4 times more expensive than they should be for the taxpayer and directly employ menial staff rather than through expensive agencies. It reduces costs and cleaners etc can get a better wage.

    Anyway, never to late for a career change!


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