A&Es face collapse without overhaul – doctors
Hospitals’ casualty departments are close to breaking point because of “unsustainable workloads,” says a report by emergency doctors, which calls for GPs to take on more patients.
The College of Emergency Medicine, which represents the UK’s emergency doctors, said that a lack of staff and increased workload have led to basic, preventable mistakes in emergency departments.
The college put forward a series of recommendations for the government, based on research at 131 emergency departments, which include GPs and other non-emergency services taking some of their workload: the college said that between 15 and 30 per cent of patients treated at A&E do not need emergency care.
The college pointed out serious failings in emergency care because of understaffing and an unsustainable workload. From 2011 to 2012, 6 per cent of departments reported a “never event”, which include surgical instruments being left inside patients or operations being carried out on the wrong body part.
A&E services have been under huge pressure…there is a danger the system will fall over in six months’ time unless we plan effectively. Chris Hopson, Foundation Trust Network
The report comes as the Foundation Trust Network, which represents hospital managers, highlighted problems with the funding system for emergency departments, saying that they are unfairly penalised.
Chris Hopson, chief executive of the Foundation Trust Network said: “A&E services have been under huge pressure and although performance is now stabilising, there is a danger the system will fall over in six months’ time unless we plan effectively for next winter.”
Health Secretary Jeremy Hunt said that he agreed with Mr Hobson: “over the last three years a million more people going into A&E every year, and that does create pressure”. Mr Hunt pledged to look at both the short term and long term reasons behind this, but singled out the “disastrous” reform of GP contracts in 2004 which had removed the responsibility for out-of-hours care from GPs which he said had resulted in the public losing confidence in out-of-hours provision.
Hospitals have reported a 50 per cent increase in emergency patients in the last decade, and last winter the NHS in England started missing its four-hour waiting time target.
Among its recommendations for the government and health officials, the college recommended setting minimum consultant numbers in emergency wards.
‘Urgent action’ needed
At present, the average ward has seven full-time consultants but the College recommended that there be at least 10 on normal wards and 16 on large wards to provide “sustainable cover”.
Taj Hassan, vice president of the College of Emergency Medicine, said: “It is clear that working environments for them (consultants and middle grad doctors) at times are intolerable, associated with risk for them and their patients and that action is required to stabilise our systems.
“The report has come at a timely juncture where our regulatory bodies and policy makers have also recognised this to be a crisis and suggested urgent action is merited.”
Norman Williams, president of the Royal College of Surgeons, said there are “relentless pressures” on A&E departments.
“We hear from our members that the current crisis in emergency departments in parts of the country is hampering access to emergency theatres and intensive care facilities and preventing consistent access to consultant-led care,” he said.