Saturday, 19 March 2016

A&E now 'overwhelmed' says top doc as he calls for army of medics to be sent in

Exclusive: Britain's most senior A&E doctor says a crisis in casualty departments is escalating rapidly, with risks to safety amid desperate shortages of medics.

Dr Cliff Mann, President of the College of Emergency Medicine, which represents A&E doctors
Dr Cliff Mann, President of the College of Emergency Medicine, which represents A&E doctors Photo: Rex

Casualty departments are on the brink of collapse and hundreds of doctors should be drafted from other duties to avert an immediate crisis, Britain’s most senior Accident & Emergency doctor has said.
Dr Cliff Mann said hospitals across the country were being overwhelmed by "unprecedented" levels of pressure and overcrowding amid desperate shortages of medics.
At several NHS trusts, more than half of A&E shifts for doctors have gone unfilled since a cap on spending on locum medics was introduced, the President of the College of Emergency Medicine said.
In an extraordinary intervention, he urged health officials to now divert hundreds of doctors from other hospital duties to get “all hands on deck” and ensure casualty departments could operate safely.
In a letter to The Telegraph, Dr Mann said overcrowding in A&Es had reached “unacceptable” levels as he called for urgent “exceptional measures” in order to protect the public.
Dr Mann said hospitals been under extreme strain despite a mild winter, but that the situation was rapidly escalating.
He told this newspaper: “The pressures have become unrelenting. In recent days I’ve been contacted by a number of senior doctors, medical directors, high-level people, who are saying the situation now is like nothing they’ve seen before.
A&Es have come under growing pressure in recent years
“One medical director was describing scenes at 4am, endlessly firefighting, trying to keep people alive in corridors.”
“My own hospital had the busiest day I had ever experienced two weeks ago – these are situations where every time you turn round, there are another four ambulances queueing.”
He said A&E doctors were doing their best, but could not guarantee safety in such circumstances.
“We are not delivering best care and on some occasions we are not delivering safe care,” he warned.
The senior doctor, who works as a consultant in Taunton, said medics should now be drafted from every department which could spare them, to prop up A&Es.
“At the moment we just have to deal with this sheer volume of patients, the pressures are overwhelming,” he said. “We just need more hands on deck to cope.”
Rising demand from a growing and ageing population amid shortages of A&E doctors meant hospitals had been under severe pressure for some time.
But new rules limiting pay for agency workers meant many hospitals were now unable to find locums, pushing units closer to the edge, he said.
Limits were first set in November, dropping again in February.
Dr Mann said the latest restrictions have left NHS trusts struggling to find temporary doctors who will accept the rates, leaving vacancies or forcing trusts to breach the rules.
They will drop again in a fortnight.
Dr Mann said: “Since locum caps came in we are seeing data from a number of trusts – in Barnsley, Leeds, Bolton, Plymouth and London which shows 50 and 60 per cent of shifts going unfilled.”
Just one quarter of new A&E consultants posts were filled this year, he said, and there is a shortage of 450 trainee doctors.
“People aren’t choosing it and those who did are increasingly walking away,” he said. “They can’t sustain 30 year careers with this level of intensity.”
NHS England has refused to publish weekly data on casualty waiting times this winter – in a move which was heavily criticised.
However, the College’s own audit of 40 casualty departments suggests performance against an NHS target to treat 95 per cent of patients in four hours has reached a record low.
Just 82 per cent of A&E patients were treated in four hours in the first week of March, the new figures show, a fall from 89 per cent in December.
“We have been stretching an elastic band – it has now snapped,” the college warned in a briefing paper today.
A Department of Health spokesman said: "The NHS is coping well in the face of exceptional demand and compared to January last year saw 111,000 more people in A&E within four hours. We are committed to delivering a safer seven day NHS which is why we have invested £10bn to fund the NHS's own plan to transform services in the future.”
A spokesperson for NHS England said: “A&E visits are up sharply since Christmas but fortunately the number of A&E trolley waits is down compared with last winter.
"In fact fewer hospitals have reported serious operational issues, but winter has bitten later this year and following renewed pressures in January and February, detailed plans are being put in place for Easter to ensure good service availability over the four day bank holiday. In the face of these challenges it is a credit to all those working in emergency care that we are still admitting, treating and discharging almost nine out of ten patients within four hours”.
10:00PM GMT 18 Mar 2016

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