A snapshot survey of hospital casualty departments has uncovered fresh evidence that patients still have to endure long waits for appropriate care.

The Association of Community Health Councils for England and Wales (Achcew) carried out checks at hospitals in London and the South East, Birmingham and Worcester on 30 September.

In the NHS Plan published in 2000, ministers pledged that no patient should have to wait more than four hours from arrival to admission, transfer or discharge in A&E by 2004.

But the survey found 100 patients who waited over five hours for treatment - and 22 patients who waited over 10 hours for a bed.

Among the worst cases were:

• A 77-year-old woman with heart problems waited 43 hours on a trolley at Bromley Hospital, Kent
• An 89-year-old man who had suffered a stroke waited 28 hours on a trolley at the Royal Surrey Hospital
• A 73-year-old women with unstable angina waited 21 hours at Bromley Hospital
• An 82-year-old women with diarrhoea waited 19 hours at Maidstone Hospital

Malcolm Alexander, Chief Officer of Southwark CHC, the data showed that many hospitals were failing to meet government targets.

He said; "A&E waits are the Government's top priority in the NHS but ministers have failed to solve the problem.

"The elderly are still in the front line when it comes to casualty care, despite Health Minister's promise to end ageism and long trolley waits in the NHS."

Mr Alexander called on ministers to provide more beds and more staff for hospitals, which are failing to treat seriously ill patients within four hours.

"Patients need beds in wards, not unbearable waits on trolleys. Waiting on a trolley can be terrifying and lonely because you don't know what is going to happen to you."

Lack of beds

Peter Walsh, Aschew director, said: "There are far too many people waiting for far too long for a bed or simply to be discharged.

"One of the key problems seems to be the lack of beds elsewhere in the hospital - particularly beds for older people.

"A&E staff simply can't move patients to the appropriate ward."

Mr Walsh said he had particular concerns about the use of Observation and Assessment units.

"While it is appropriate for some patients to be in these units for medical assessment, in other instances the units are simply used to 'warehouse' patients until a bed becomes available.

"Not only is this medically inappropriate, but it also obscures the genuine length of time that patients are waiting for."