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Disaster doctor sent to help in A&E

Published 17/04/2015

The medical incident officer cared for patients at Worcestershire Royal Hospital on Friday
The medical incident officer cared for patients at Worcestershire Royal Hospital on Friday

A hospital's A&E department was under so much pressure that a senior doctor usually deployed only in cases of major disaster had to be sent in to help.

West Midlands Ambulance Service were forced to send their own medical incident officer (MIO) to help beleaguered staff at the Worcestershire Royal Hospital, as a shortage of beds resulted in some patients being treated in corridors.

It came as the weekly national figures from NHS England showed it has missed the four-hour waiting time target for the 28th consecutive week, despite a slight improvement.

The proportion of patients seen within the Government maximum of four hours at A&E departments in England is below the target of 95% again - they have not been met since September 28.

NHS England said 92.5% of patients spent four hours or less from arrival to admission, transfer or discharge in the week ending April 12. This was a slight improvement on the previous week, when it was 92.4%.

The figures include data from last Friday, April 10, where the MIO was sent in to help at Worcestershire Royal Hospital after months of problems .

The Worcestershire Acute Hospitals NHS Trust, which runs the hospital, said the circumstances were "less than ideal".

Unions said the fact the ambulance service had had to send in its own doctor to help was "totally unacceptable", adding its members were "furious".

However, the hospital trust said while pressure on beds had been "a constant issue" for over a year, the problem had been caused by pressures across the health system meaning it simply could not discharge patients quickly enough, resulting in a backlog.

The trust apologised and said a backlog of patients waiting to leave was having a knock-on effect in A&E.

On any given day the trust said about 70 patients are waiting to be discharged but only about 15 are going, because of delays getting home and nursing care packages in place for after they leave.

It said measures had been put in place, including daily meetings for the last eight months of the hospital and ambulance trusts, social services, and local clinical commissioners in a bid to speed up the flow of patients being discharged.

The trust said the problem had been building for more than a year, when back in December 2013, there was a 15% spike in ambulance arrivals which it has since struggled to clear.

"Different hospitals have different ways of dealing with the solution in A&E," said the trust spokesman.

"Other hospitals don't let patients out of the ambulances, and you have queues of ambulances building up outside. We don't do that - we took a decision to off-load patients into A&E."

The trust added the issues were "a national problem, not just a local one".

It confirmed the Care Quality Commission (CQC) had carried out an unannounced inspection at the hospital in March, but it had yet to see the report.

Ray Salmon, regional organiser for Unison, told BBC Radio 4's Today programme current problems had been "building up over a period of months".

He described the situation as "completely unprecedented", adding union members were "furious".

He said: "One of our reps went public just after Christmas and blew the whistle about the problems and the trust tried to exclude him from the premises, we had a massive argument about that and I reckon that since then the problem is getting even worse.

"Then last week when the ambulance service had to bring in their own doctor, well that was actually just completely unprecedented, it's really winding people up."

The trust said no patients came to any harm during last Friday's incident, but Mr Salmon said the situation was starting to affect patient care.

He said: "It's a combination of bad planning and it's also a combination of under-resourcing.

"We've been saying for years the Government hasn't put enough money in to the NHS.

"You listen to the politicians at the moment and the gloating about what a great job they've done over the last five years, and they're talking about what they're going to do over the next five years.

"But the situation is at the moment there's just not enough resources gone in, there's not enough staff, and that's affecting patients, it's totally unacceptable."

According to today's NHS waiting times figures, there were 443,274 attendances in A&E for the seven-day period, up slightly on the previous week when it was 441,099.

The number of people waiting for more than four hours was 7,434 - slightly lower than 7,459 a week earlier.

Similarly, the number of people waiting for more than 12 hours was 15 - down from 22 the previous week.

Emergency admissions were 102,163, compared with 106,160 the previous week.

Dr Barbara Hakin, national director of commissioning operations for NHS England, said: "The demands on the NHS remain high with an increase in the number of patients attending A&E this week.

"But in the face of this ongoing pressure we saw an improvement in performance and we continue to admit or treat and discharge more than nine out of ten patients within four hours."

Last month, the Department of Health confirmed the NHS in England has failed to meet its target every week of the winter, meaning the average for the whole year has not been met for the first time.

Shadow health secretary Andy Burnham said: "These figures reveal a worrying slump in A&E performance in the last 12 months. Under David Cameron, A&Es across England are operating at their very limits and at least one - in Worcester - has clearly gone beyond them.

"It is essential that the election debate now focuses on what the parties plan to do to stop this decline. The NHS needs more money this year and next, not a vague promise of an IOU in five years' time.

"David Cameron caused this A&E crisis by making it harder to get a GP appointment, cutting care budgets to the bone and wasting £3 billion on a damaging reorganisation. If he gets back in, extreme Tory spending cuts mean they can't protect the NHS and the crisis in A&E will get even worse.

"Labour has a better plan to turn around the NHS. We will ease pressure on overstretched A&Es by recruiting 20,000 more nurses and giving people a guarantee of GP appointments within 48 hours."

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