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Thursday, 24 February, 2000, 15:20 GMT
Patients 'at risk' in casualty
casualty
Casualty units under-staffed
Patients are put at risk in nine out of ten A&E units, nurses claim.

Staff shortages are to blame for the danger to patients, says the report form the Royal College of Nursing (RCN) and the Association of Community Health Councils for England and Wales (ACHCEW).


The picture is of A&E units full to overflowing, with nurses and other staff often unable to provide even the essentials of care

Christine Hancock, Royal College of Nursing
Casualty departments are under immense pressure, with one fifth of patients waiting for four hours or more for treatment, according to the report, which follows visits to 170 A&E departments on January 31 this year.

The report reveals that 88% of nurse managers believed patients were put at risk due to short staffing at least occasionally. A third said it happened regularly or often.

The two organisations made a series of recommendations to solve the problem of long waits in casualty departments, many of them relating to organisational changes.

Some extra funding was also required.

RCN general secretary Christine Hancock said: "The picture is of A&E units full to overflowing, with nurses and other staff often unable to provide even the essentials of care."

'Die in corridors'

One nurse quoted anonymously in the report said: "Patients are resuscitated in corridors, die in corridors - unnoticed on one occasion - and many never get into a cubicle during their entire A&E experience."

More than 75% of A&E departments reported vacancies for nursing jobs - some had as many as 16 unfilled posts.


We recognise that some patients have to wait longer than we would like in A&E departments and we are looking at better ways of working that will aim to improve services for those patients

Mike Lambert, A&E Modernisation Programme
The report included details, released earlier this month, of extremely long waits suffered by some patients, including a 71-year-old woman at Northwick Park and St Mark's Hospital, in Harrow, who waited more than 40 hours for treatment after fracturing her pubic bone.

One of the report's authors Brian Dolan claimed some hospitals were "fiddling" the findings of the annual survey by the ACHCEW by making more beds available on the day of the visits, which are arranged in advance.

Mike Lambert, who is leading the Accident and Emergency modernisation programme for the Department of Health, told BBC News Online: "We recognise that some patients have to wait longer than we would like in A&E departments and we are looking at better ways of working that will aim to improve services for those patients."

He accepted that there were shortages of nurses in some areas of the NHS but said efforts were being made to improve the situation, though this would take time.

And he questioned the report's claim that a fifth of patients are waiting four hours or more for treatment, saying the definition of "waiting" was not clear.

Mr Lambert added: "It is a function of A&E to prioritise care, to put available resources towards the care of the more seriously injured patients."

See also:

04 Oct 99 | Health
Links to more Health stories are at the foot of the page.


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