Doctors "cannot guarantee" patient safety at A&E

Doctors

Doctors "cannot guarantee" patient safety at A&E

First published in Local by

DOCTORS have issued a chilling warning that patient safety can no longer be guaranteed at Worcestershire’s A&E departments.

Top emergency doctors from A&E wards at Worcester and Redditch have written to senior NHS managers labelling the current situation in their departments a “crisis”.

The letter, initially leaked to a national newspaper, warns of “toxic overcrowding”, “institutional exhaustion” and says staff are “frequently operating at the absolute margins of clinical safety”.

It warns: “What is entirely unacceptable is the delivery of unsafe care, but that is now the prospect we find ourselves facing on too frequent a basis.”

The letter has been signed by top doctors from 18 of 21 A&E departments in the West Midlands.

Your Worcester News has learned emergency consultants James France and Chris Hetherington, who are based at Worcestershire Royal and Redditch Alexandra hospitals respectively, were among those to back the letter.

Worcestershire has been one of the areas hardest hit by the overcrowding and delays hitting emergency departments up-and-down the country.

Targets for seeing 95 per cent patients of A&E patients within four hours have been repeatedly missed, dropping as low as 80 per cent during February, although NHS bosses say the situation has now started to improve.

Emergency admissions nationally have risen by 50 per cent.

Mike Farrar, chief executive of the NHS Confederation - the voice of all organisations that commission and provide NHS services - also hit out at the problems.

“The recent headlines do not lie - the pressures are growing and we are getting closer and closer to the cliff edge,” he said.

“If we continue with this trend we will see another extra half a million patients cramming into our A&E departments in the next three years.

“This will be simply impossible for our hospital services to cope with, despite the heroic efforts of staff to date.”

A West Midlands spokesman from NHS England said: “This increase (in demand) reflects a rising demand for emergency care, although nationally over the last three weeks the emergency department target to see 95 per cent of all patients within four hours has been met.

“This has also been reflected in the West Midlands, where performance has greatly improved over recent weeks.”

But they added that peaks in demand are expected to continue, and that local hospital trusts and clinical commissioning groups have been tasked with producing plans to manage these and ensure “robust” systems are in place ahead of time for next winter.

Nationally, NHS England is conducting a wider review into the problems at A&E.

Health Secretary Jeremy Hunt is due to respond to the troubles facing emergency units in a speech on Thursday.

Comments (15)

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5:49pm Tue 21 May 13

Jabbadad says...

This is a very serious situation and not one for politicians to solve since of course we had one after another government thrashing around looking busy and failing again and again.
So now is a testing time for the New system that the doctors are now responsible for.
I recall my thoughts and words about the new Doctor controlled CCG as it could well play into the hands of the Tories for Privatisation with the Doctors shouldering the blame. But I hear you say politicians wouldn't stoop that low would they? You Bet they would.
This is a very serious situation and not one for politicians to solve since of course we had one after another government thrashing around looking busy and failing again and again. So now is a testing time for the New system that the doctors are now responsible for. I recall my thoughts and words about the new Doctor controlled CCG as it could well play into the hands of the Tories for Privatisation with the Doctors shouldering the blame. But I hear you say politicians wouldn't stoop that low would they? You Bet they would. Jabbadad
  • Score: 0

9:28am Wed 22 May 13

Busymum2011 says...

Can I also say that we could save a few million pounds if the hospitals bought the cheapest drugs, and not the most expensive, which do the same job, but happen to be sold by the rep. they've known the longest! Not impressive! Sort it out!
Can I also say that we could save a few million pounds if the hospitals bought the cheapest drugs, and not the most expensive, which do the same job, but happen to be sold by the rep. they've known the longest! Not impressive! Sort it out! Busymum2011
  • Score: 0

10:46am Wed 22 May 13

Sir Smeg says...

Unfortunately yet another direct result of uncontrolled immigration in this country by central government.
Far too many people crammed into a finite space and breading like there's no tomorrow equals overcrowding, not enough housing or jobs, overstretched services and an over-used benefits system.

Recommendations? None that I can see, it's far too late for that!
Unfortunately yet another direct result of uncontrolled immigration in this country by central government. Far too many people crammed into a finite space and breading like there's no tomorrow equals overcrowding, not enough housing or jobs, overstretched services and an over-used benefits system. Recommendations? None that I can see, it's far too late for that! Sir Smeg
  • Score: 0

11:16am Wed 22 May 13

More Tea Vicar says...

No mention in the article of where the extra demand comes from.

A lot of it seems to be around the fact that GP's no longer provide an out-of-hours service, for example.

And as Sir S. says, one of the many negative, but utterly foreseeable, consequences of mass immigration is more people here using services which have not expanded.

More to the point, many immigrants are in low-skill, low-paid work. They will not have contributed the tax that pays for their healthcare, maternity services, schooling for their kids, tax credits etc.
No mention in the article of where the extra demand comes from. A lot of it seems to be around the fact that GP's no longer provide an out-of-hours service, for example. And as Sir S. says, one of the many negative, but utterly foreseeable, consequences of mass immigration is more people here using services which have not expanded. More to the point, many immigrants are in low-skill, low-paid work. They will not have contributed the tax that pays for their healthcare, maternity services, schooling for their kids, tax credits etc. More Tea Vicar
  • Score: 0

12:55pm Wed 22 May 13

Iain Leav says...

We've seen massive increases in housing development and yet hospital places have reduced over the past ten years.

Having spent time in the A&E in Redditch, which does seem particularly outdated and understaffed, it feels more like being in a field hospital than something from a first world country. I am glad this important issue is now receiving some attention.

Also i'm sure not helping the issue is the game you have to play to get a doctors apointment. In trying to make an appointment with the surgery in Bromsgrove I have found it is like playing a game without knowing the rules, 'you can't make an appointment here at the surgery you need to phone us when you get home' or when you do phone 'we can't make appointments now you need to call between 8am and 9am.' And then when you do call you get quizzed as to whether you really need an appointment it small surprise many people go to their local A&E instead.
We've seen massive increases in housing development and yet hospital places have reduced over the past ten years. Having spent time in the A&E in Redditch, which does seem particularly outdated and understaffed, it feels more like being in a field hospital than something from a first world country. I am glad this important issue is now receiving some attention. Also i'm sure not helping the issue is the game you have to play to get a doctors apointment. In trying to make an appointment with the surgery in Bromsgrove I have found it is like playing a game without knowing the rules, 'you can't make an appointment here at the surgery you need to phone us when you get home' or when you do phone 'we can't make appointments now you need to call between 8am and 9am.' And then when you do call you get quizzed as to whether you really need an appointment it small surprise many people go to their local A&E instead. Iain Leav
  • Score: 0

1:12pm Wed 22 May 13

More Tea Vicar says...

Smeg - good points. The thing about immigrants are unskilled, low-wage workers, and many are actually on benefits. In short, they are unlikely to have made much of a contribution to the tax base, before getting full access to medical and other services.

And of course the NHS has been unable to keep up with the population boom. Just like the bulging primary schools....

I'd suggest they have to be here say 10 years before accessing many services for free. Until then, they pay, or go home.

But there are probably genuine issues here which need dealing with. I can imagine doctors bigging up the problems to get more money. If they went back to offering decent out of hours services, it would probably make a big difference.

I understand Labour gave them a huge pay rise, and got less out of them in return.
Smeg - good points. The thing about immigrants are unskilled, low-wage workers, and many are actually on benefits. In short, they are unlikely to have made much of a contribution to the tax base, before getting full access to medical and other services. And of course the NHS has been unable to keep up with the population boom. Just like the bulging primary schools.... I'd suggest they have to be here say 10 years before accessing many services for free. Until then, they pay, or go home. But there are probably genuine issues here which need dealing with. I can imagine doctors bigging up the problems to get more money. If they went back to offering decent out of hours services, it would probably make a big difference. I understand Labour gave them a huge pay rise, and got less out of them in return. More Tea Vicar
  • Score: 0

1:48pm Wed 22 May 13

Sir Smeg says...

I'm not suggesting that ALL immigrants are unskilled or in receipt of benefits, just that the shear volume is a huge contributing factor to a lot of our modern day overcrowding problems.

It's not just a case of the numbers of people entering this country that creates issues either, censors tell us that the average indigenous couple have 1.8 children, a figure that if maintained will see a population DECLINE, on the other hand the average Indian or Pakistani couple have 8.1 children!

It isn't rocket science to work out the inevitable conclusion of the outcome of this asymmetry.

And before it's said, NO I'm not a racist, only a realist.
I'm not suggesting that ALL immigrants are unskilled or in receipt of benefits, just that the shear volume is a huge contributing factor to a lot of our modern day overcrowding problems. It's not just a case of the numbers of people entering this country that creates issues either, censors tell us that the average indigenous couple have 1.8 children, a figure that if maintained will see a population DECLINE, on the other hand the average Indian or Pakistani couple have 8.1 children! It isn't rocket science to work out the inevitable conclusion of the outcome of this asymmetry. And before it's said, NO I'm not a racist, only a realist. Sir Smeg
  • Score: 0

1:52pm Wed 22 May 13

More Tea Vicar says...

Smeg. Mentioning problems caused by immigration is not racist. Making derogatory general comments about them as people based on their race is.

As is saying that they are all wonderful and the natives, by extension, are inferior.
Smeg. Mentioning problems caused by immigration is not racist. Making derogatory general comments about them as people based on their race is. As is saying that they are all wonderful and the natives, by extension, are inferior. More Tea Vicar
  • Score: 0

4:45pm Wed 22 May 13

Sir Smeg says...

MTV, you and I know this but it never ceases to amaze me how many jump to accuse someone of being 'racist' at the slightest mention of immigrants, in whatever context.
MTV, you and I know this but it never ceases to amaze me how many jump to accuse someone of being 'racist' at the slightest mention of immigrants, in whatever context. Sir Smeg
  • Score: 0

5:50pm Wed 22 May 13

Landy44 says...

This situation is ridiculous. Doctors have never been and will never be able to "guarantee" patient safety! All they can do is their best.

The language used today shows how we expect perfect performance and miracles. We need to realise these folks are human too and sometimes, despite best efforts, mistakes are made.

The culture of "cover up" and litigation is one of the things driving up the costs, although as others have quite rightly said so has a growth in population.

As I've said before, the NHS was a nice idea when it was conceived, but unfortunately those that conceived it could not predict the financial and social realities of today. It pains me to say this as there are a lot of hard working people in the NHS who put up with a lot of "meddling" ineffectual politicians, and mediocre management, but this is a service that we can't afford in it's current form anymore. This monolithic organisation when measured against other organisations globally, for our tiny little country is simply unsustainable. We need to rethink the future of healthecare in this country and take appropriate action - swiftly. As others have said - more political interference will simply make matters worse, however management within the NHS can't fix it either - turkeys don't vote for christmas! So who can fix it?
This situation is ridiculous. Doctors have never been and will never be able to "guarantee" patient safety! All they can do is their best. The language used today shows how we expect perfect performance and miracles. We need to realise these folks are human too and sometimes, despite best efforts, mistakes are made. The culture of "cover up" and litigation is one of the things driving up the costs, although as others have quite rightly said so has a growth in population. As I've said before, the NHS was a nice idea when it was conceived, but unfortunately those that conceived it could not predict the financial and social realities of today. It pains me to say this as there are a lot of hard working people in the NHS who put up with a lot of "meddling" ineffectual politicians, and mediocre management, but this is a service that we can't afford in it's current form anymore. This monolithic organisation when measured against other organisations globally, for our tiny little country is simply unsustainable. We need to rethink the future of healthecare in this country and take appropriate action - swiftly. As others have said - more political interference will simply make matters worse, however management within the NHS can't fix it either - turkeys don't vote for christmas! So who can fix it? Landy44
  • Score: 0

6:03pm Wed 22 May 13

Jabbadad says...

The issue of Doctors not providing Out of Hours service comes from when they were under the previous government offered the choice to opt out but by doing so losing a considerable chunk of money.
Many GP'd took the drop in income (remember GP's are self employed) and were then able to sub contract for other agency work if they wished, however the large increase in income they had previously been awarded left them financially OK.
Now I ask you if you were offered the same income for a lot less work (out all hours all weathers plus your day job) would you take it or become a Martyr?
Me neither!!!
The issue of Doctors not providing Out of Hours service comes from when they were under the previous government offered the choice to opt out but by doing so losing a considerable chunk of money. Many GP'd took the drop in income (remember GP's are self employed) and were then able to sub contract for other agency work if they wished, however the large increase in income they had previously been awarded left them financially OK. Now I ask you if you were offered the same income for a lot less work (out all hours all weathers plus your day job) would you take it or become a Martyr? Me neither!!! Jabbadad
  • Score: 0

8:39pm Fri 24 May 13

iamthebinman says...

Sir Smeg wrote:
I'm not suggesting that ALL immigrants are unskilled or in receipt of benefits, just that the shear volume is a huge contributing factor to a lot of our modern day overcrowding problems.

It's not just a case of the numbers of people entering this country that creates issues either, censors tell us that the average indigenous couple have 1.8 children, a figure that if maintained will see a population DECLINE, on the other hand the average Indian or Pakistani couple have 8.1 children!

It isn't rocket science to work out the inevitable conclusion of the outcome of this asymmetry.

And before it's said, NO I'm not a racist, only a realist.
Nearly every time I see an Indian or Pakistani in Worcester they are working. Doctors, nurses, carers, taxi drivers, opticians, cleaners, chefs, pizza delivery, dentists and so on. With that amount of hard work they deserve a family and good health care. Very few of them drink or smoke and many have a healthy vegetarian diet.

What they don't have is 8.1 children.
[quote][p][bold]Sir Smeg[/bold] wrote: I'm not suggesting that ALL immigrants are unskilled or in receipt of benefits, just that the shear volume is a huge contributing factor to a lot of our modern day overcrowding problems. It's not just a case of the numbers of people entering this country that creates issues either, censors tell us that the average indigenous couple have 1.8 children, a figure that if maintained will see a population DECLINE, on the other hand the average Indian or Pakistani couple have 8.1 children! It isn't rocket science to work out the inevitable conclusion of the outcome of this asymmetry. And before it's said, NO I'm not a racist, only a realist.[/p][/quote]Nearly every time I see an Indian or Pakistani in Worcester they are working. Doctors, nurses, carers, taxi drivers, opticians, cleaners, chefs, pizza delivery, dentists and so on. With that amount of hard work they deserve a family and good health care. Very few of them drink or smoke and many have a healthy vegetarian diet. What they don't have is 8.1 children. iamthebinman
  • Score: 0

11:56pm Fri 24 May 13

batchelorboy says...

I think the hospital should complete a substantial and very strict internal review of staff competence.

With a baby on the way, I've been to the hospital with my partner for the usual scans and baby related appointments. They were running an hour behind for the 16 week scan. Receptionist said nothing about the delay and pulled a face when my partner asked how much longer she had to hold her full bladder. We were booked in very first of the day for the 20 week scan and they were still 30 minutes behind! Of course, they may have genuine reasons for both cases but, whilst sitting as patiently as I possibly could, on both occasions, I witnessed a LOT of staff standing around chatting, gossiping about so-and-so down the hall, walking extremely slow like they had no appointments at all for the day, and generally in no rush to see people.

My partner was given an appointment over the phone for an appointment of 25th June for a scan which was meant to be first week in June (exactly four weeks after a checkup). My partner asked the receptionist to politely to double check her notes as the scan should be 4x weeks after the last etc, but the receptionist was just rude simply claimed that 25th June was in four weeks time (well yes, from the date she was calling, but not four weeks from the last apt).

I know this isn't A&E but I wonder if the laziness of staff flows to other departments? Or maybe the general staff in the maternity department need more work to stop them getting bored and miserable?
I think the hospital should complete a substantial and very strict internal review of staff competence. With a baby on the way, I've been to the hospital with my partner for the usual scans and baby related appointments. They were running an hour behind for the 16 week scan. Receptionist said nothing about the delay and pulled a face when my partner asked how much longer she had to hold her full bladder. We were booked in very first of the day for the 20 week scan and they were still 30 minutes behind! Of course, they may have genuine reasons for both cases but, whilst sitting as patiently as I possibly could, on both occasions, I witnessed a LOT of staff standing around chatting, gossiping about so-and-so down the hall, walking extremely slow like they had no appointments at all for the day, and generally in no rush to see people. My partner was given an appointment over the phone for an appointment of 25th June for a scan which was meant to be first week in June (exactly four weeks after a checkup). My partner asked the receptionist to politely to double check her notes as the scan should be 4x weeks after the last etc, but the receptionist was just rude simply claimed that 25th June was in four weeks time (well yes, from the date she was calling, but not four weeks from the last apt). I know this isn't A&E but I wonder if the laziness of staff flows to other departments? Or maybe the general staff in the maternity department need more work to stop them getting bored and miserable? batchelorboy
  • Score: 0

10:10am Mon 27 May 13

pronstar says...

Sir Smeg wrote:
MTV, you and I know this but it never ceases to amaze me how many jump to accuse someone of being 'racist' at the slightest mention of immigrants, in whatever context.
Without immigrants there wouldn't even be an NHS.

Go and blame your pathetic existence on someone or something else. You too MTV.
[quote][p][bold]Sir Smeg[/bold] wrote: MTV, you and I know this but it never ceases to amaze me how many jump to accuse someone of being 'racist' at the slightest mention of immigrants, in whatever context.[/p][/quote]Without immigrants there wouldn't even be an NHS. Go and blame your pathetic existence on someone or something else. You too MTV. pronstar
  • Score: 0

8:41pm Mon 27 May 13

JulianH says...

Good point made by Sir Smeg
Good point made by Sir Smeg JulianH
  • Score: 0

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