‘Worsening crisis’ in emergency departments
The Government must prioritise the worsening crisis in emergency departments across the country – with understaffing, underfunding, and ‘unprecedented crowding’ causing harm to patients and staff.
Doctors and medical students at the BMA’s annual representative meeting in Liverpool said it was ‘imperative’ that the association work with the royal colleges to lobby ministers about health and social care underfunding and demand that hospital trusts begin to record and report the numbers of patients being cared for in corridors.
The motion, overwhelmingly passed at the ARM, also called for doctors to record in their notes the location they are reviewing a patient, if not in a proper cubicle or trolley space.
Demanding the Government take action, Merseyside emergency medicine consultant Den Langhor proposed the motion and told the conference about the horrendous state of a ‘typical day’ in her hospital emergency department.
She said: ‘We have around 80 cubicles but there are 80 patients waiting for beds and 160 patients in total. Every cubicle in resus is full and there are severely ill patients in the middle of the room away from essential equipment/. There are 30 patients in the corridor - most of them have been there all night. One has a broken hip, one is on chemo, one has C-diff and one has the flu.
‘There are elderly patients in the waiting room awaiting beds who have been sitting on a plastic chair for 24 hours. There are patients waiting to see a doctor including those with sepsis, chest pain and traumatic injuries. The wait to see a doctor is 10 hours. There are four doctor rota gaps, and three nurse gaps not covered due to a spending freeze prohibiting the use of locums and bank staff.
‘The priority is assessing the sickest patients, trying to get them safely into a cubicle for life saving treatment and minimising harm for those with time critical conditions. Only there is nowhere to put them. Every patient awaiting care is in a non-clinical area. Everyone is assessed in the corridor. No-one gets to talk to their doctor in private. Examinations are limited to preserve dignity, risking missed diagnosis. Procedures such as the fascia iliaca block needed for the patient with the broken hip cannot happen at all.
‘Patients deteriorate awaiting treatment. RCEM (The Royal College of Emergency Medicine) has reported an excess death for every 72 patients in the ED for longer than eight to 12 hours. This is the reality in EDs nationally and it is getting worse.
‘In my own hospital we have reached a staggering 43 patients in the corridor at any one time and over a 100 hour wait for a medical bed. None of us want our family members or anybody to be in that position.’
Dr Langhor added: ‘The effects are being felt not just by patients but also by staff facing moral injury and burnout. We can’t carry on like this. Patients deserve better. It’s imperative that action is taken now. Funding needs to be increased to ensure EDs are staffed and resourced appropriately.
‘Staffing gaps are unsafe at the best of times and these are not the best of times. Social care provision must be tackled to enable discharges, corridor care must be abolished but first we need to understand the scale of the problem. We need to act now.
Emergency medicine consultant Simon Walsh spoke in favour of the motion and said the crisis was worsening year on year. Dr Walsh said it impacted everyone working in the health system. He added: ‘The government must prioritise this crisis.’
