An inspection at Northern Ireland's biggest hospital emergency department has found evidence of a dysfunctional system plagued by shortages of medics and allegations of staff bullying, the Health Minister has revealed.
Edwin Poots outlined the initial findings of a review of care in A&E at Belfast's Royal Victoria Hospital.
The inspection by the Regulation and Quality Improvement Authority (RQIA) was commissioned by the minister in the wake of a major incident being declared at the hospital last month over a huge patient backlog.
Mr Poots said aspects of the feedback from RQIA were "cause for concern". The inspectors spoke to more than 100 staff across a range of roles and functions
"The inspection has confirmed concerns about staffing levels in key areas, allegations of bullying, staff under intolerable pressure and a system of care that does not function fully as it was set up to do," he said.
"The concerns relate to the emergency department itself, to the acute medical unit, which is a 60-bed unit for the assessment and treatment of admitted patients, including many admitted through the ED, and to some aspects of the wider hospital and trust functions.
"There are genuine and heartfelt concerns from clinicians about the impact that this difficult situation is having on patients."
Mr Poots said the issues were complex and said there were no easy solutions.
The RQIA is also examining accident emergency provision across Belfast and Northern Ireland and will report back with those findings in the summer.
Mr Poots told the Assembly: "I have made it clear from my first day as Minister that the underlying objective for the entire health system is to protect and improve the quality of services that we deliver.
"The health service must be safe, effective and totally focused on the patient, as they are at the heart of everything that we do. Today, I assure the Assembly of my commitment to continue to work to improve the care provided for all patients, not least those who use our emergency departments."