A&E doctors say pressure is threat to patient safety


Dr Taj Hassan, College of Emergency Medicine, warns over "cutting corners"

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Excessive pressure on A&E consultants has the potential to put patients at risk, doctors are warning.

The College of Emergency Medicine said increased demand and the complexity of work was causing staff sickness and burnout.

Its survey of just over 1,000 UK consultants found six in 10 thought their jobs were unsustainable.

It comes amid mounting concern about the ability of A&E units to cope this winter.

At the start of this year, the NHS in England missed its target of fewer than 5% of patients waiting more than four hours, as waiting times hit their highest rates for nine years.

Ministers have since announced a £500m bailout fund for the next two winters to help those hospitals with the most acute problems.

The college has always maintained that a shortage of doctors is a contributory factor to the problems.

Previous reports have highlighted the fact that A&Es do not have enough consultants.

The average is just over seven per unit when it should be 10 - and 16 for the largest hospitals - according to the college.

But now the college is warning that the shortages are beginning to affect the consultants who are in place.


In the survey, 94% complained they were working excessive hours - with more than half saying they were regularly doing more than a fifth extra on top of their contracted time.

The report also uncovered a small, but growing problem with consultants emigrating.

Start Quote

Patients have incredible respect for emergency medicine teams, but those teams need to be backed up with the funding they need to do their jobs without being stretched in this way”

End Quote Katherine Murphy Patients Association

Last year 21 left the UK compared with three in 2008.

College vice president Dr Taj Hassan said: "Senior medical decision-makers in emergency medicine provide one of the most vital strands in maintaining safety.

"A failure to address these issues will compromise this ability and also further worsen the present workforce crisis."

Katherine Murphy, of the Patients Association, said the situation was "unacceptable".

"Patients have incredible respect for emergency medicine teams, but those teams need to be backed up with the funding they need to do their jobs without being stretched in this way."

A Department of Health spokesman commented: "We know we need to do more to support emergency departments to do their important work through winter and beyond.

"That is why we are investing £500m and we tasked Health Education England with developing plans to encourage more medical students to become A&E doctors in the future."

He also said a major review of the urgent and emergency care system - led by medical director Prof Sir Bruce Keogh - would be reporting shortly.


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  • rate this

    Comment number 22.

    Accident and Emergency?

    Surely even the name is a modern misnomer.

    Accident is when an accident happens.
    An Emergency is when some disaster strikes that could not have been avoided.

    Many elderly people end up in A&E because they have not got the proper care at home / in residential care. I know of one dementia person admitted three times within 4 days and even fell out of bed in the hospital.

  • rate this

    Comment number 21.

    what caused the pressure is the thousands of nurses being fired by the government and the pen pushers high up in the NHS directorship. typical corruption and all of it is in the namem of saving money. Tories dont like the idea of having to deal with the country themselves when they can sell portions of the countries needs to private firms, like the NHS will be soon. the NHS has been setup.

  • rate this

    Comment number 20.

    Firstly, add more GPs to surgeries who can work nights, Bank Holidays and weekends. - continuity of care guaranteed, doctors know who their patients are. Then you can do away with the likes of the 111 service and the out of hours, leaving the ambulance service to run the 999 service. Then advertise on radio and television the ambulance service' s criteria as to when it comes out to patients!

  • rate this

    Comment number 19.

    Get rid of two myths:
    1) It's not about money. In ED we have funding but just cannot recruit nurses and docs. Who would want to work In place where it is impossible to give good care, standards are compromised hourly, the work is at night and managers stand there with a clock?
    2) A&E is not full of young, well people - it is full of old, sick people. Population is ageing and needs hospital beds.

  • rate this

    Comment number 18.

    The NHS suffers the costs of inefficiency and waste, and too much high technology at the expense of basic health care.
    This morning I had a minor operation and was surprised to be told that surgical instruments now have to be thrown away instead of sterilised & re-used. Waste! I then found that, having been invited to have a shingles jab, I couldn't because vaccine isn't available. Inefficiency!

  • rate this

    Comment number 17.

    Money money money- AE should be financed as needed not work to a budget. If there is a major incident everyone needs treatment- even if the hospital has an empty purse. If there was staff on call on zero hours for overtime work there would be less pressure on staff on rota. Consultants should be on hand too.

  • rate this

    Comment number 16.

    We were in our local A&E on a Sunday afternoon two weeks ago. The nurse told us that lots of people attend A & E because the new so called Help Line advises everybody to go.

  • rate this

    Comment number 15.

    This is largely the result of the 2004 contract allowing GPs to dump all out-of-hours responsibilities on which for years they based inflated pay-claims because of their " anti-social" hours. Now that they work very short weekday hours only, people are forced to go to A&E as they have nowhere else to turn.

  • rate this

    Comment number 14.

    If people, specifically the under 30s didn't go to casualty at the drop of a hat rather than waiting to see their GP for a minor problem because they expect everything NOW, and immigrants did not use the service in lieu of a GP - specifically illegals, then things would be better managed. Not forgetting the other detritus of society, drunks and druggies who abuse the system often on a daily basis.

  • rate this

    Comment number 13.

    How long will it be before the Tories privatise the NHS using the excuse it's is not working. More money for their banker friends. But we must also do something to train our children not to get drunk every week-end.

  • rate this

    Comment number 12.

    On the Isle of Wight we have the Beacon Health Centre, next to the A & E Department at the hospital, which provides a 7 day a week GP Led Walk In service from 8am to 8pm daily. This means that between 8am and 8pm, 7 days per week, you can simply walk in and be able to see a GP. This takes the minor injuries etc away from the A & E and must surely be the way forward.

  • rate this

    Comment number 11.

    Perhaps those commenting on here should go along to see an A & E department on a Saturday night at, say, 1100 oclock.
    Ours is usually full of stroppy drunks with minor problems demanding their rights to be treated. Send for a policeman to control them? you must be joking, the police say they haven't sufficient officers.

  • rate this

    Comment number 10.

    It might seem sensible to make sure that the NHS is getting the best possible deal from it's suppliers, maintenance contracts and managers, before squeezing essential staff?

  • rate this

    Comment number 9.

    If a single patient dies because they cannot get treatment Jeremy Hunt should be charged with Unlawful Killing.

  • rate this

    Comment number 8.

    Do bears defecate in the woods?

    Thanks, PM.

  • rate this

    Comment number 7.

    We hear about a new A & E crisis every few weeks now.

    Have we really become so incompetent that we cant just have a place where sick people get treated and hopefully get a little better?

  • rate this

    Comment number 6.

    The planet is full, that's why .....

  • rate this

    Comment number 5.

    there is constant attitude of throw money at it to sort it out. How much has been wasted in 2 restructures of the NHS in the last 10 years, and all that's really happened is managers get a new job title & door plate.
    The fact that the NHS is fractured, means there are 1000's of people doing the same job for different CCGs/Trusts that could be done by a core of 30 people for the whole NHS. Stupid

  • rate this

    Comment number 4.

    "Excessive pressure on A&E consultants has the potential to put patients at risk, doctors are warning."

    Nice to know that med school education hasn't gone to waste.

    In other news, bears have been found defecating in woodland areas.

  • rate this

    Comment number 3.

    The biggest threat to the NHS is Jeremy Hunt.


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