A&E consultants: Hospitals in Wales at 'meltdown point'

 
Ambulances queue outside Wrexham Maelor hospital These ambulances were queuing outside Wrexham's Maelor Hospital

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Hospital consultants have spoken out to warn that A&E departments are at the point of meltdown and patients are dying as a result.

Almost half of the Wales' A&E consultants have signed a joint letter to new Health Minister Mark Drakeford.

It says pressure to meet financial targets has meant the loss of beds "at the expense of quality care".

Earlier this month A&E units were under intense pressure with record numbers of patients.

The Welsh government said one of Mr Drakeford's priorities was to look at ways of easing the pressures on unscheduled healthcare.

Start Quote

Each of us has seen standards of care slipping in our departments”

End Quote Consultants' letter to health minister

Meanwhile, the consultants warn that a lack of beds means serious overcrowding is almost a daily occurrence.

The letter, sent by the College of Emergency Medicine, reads: "Our emergency departments are at the point of meltdown. Most days, they are seriously overcrowded.

"This jeopardises safety and puts patients at risk: there is clear evidence that death rates go up if patients requiring admission remain in emergency departments for hours whilst they wait for ward beds to become available.

"Each of us has seen standards of care slipping in our departments, as we struggle to look after a dozen or more patients stuck in the emergency departments whilst waiting for ward beds, in addition to our normal workload."

They point to examples of patients coming to harm because of overcrowding:

  • A patient with chest pain having a cardiac arrest whilst being seen in the eye examination room (as there was no room in the resuscitation bay)
  • No space in the resuscitation bay to accommodate a baby having a severe seizure
  • These pressures, they say, have a knock-on effect on the Welsh Ambulance service which is unable to respond to emergencies "when scores of ambulances are queuing outside gridlocked emergency departments".
'Speak out'

Mark Poulden, chair of the Welsh National Board of the College of Emergency Medicine, and one of the signatories to the letter, said many factors played a role in their concerns.

He told BBC Radio Wales: "We have seen this deterioration. We're all working in a very complex system. We just see the system continuing to deteriorate. We felt that we had to speak out.

"There's obviously a lot of change in the NHS but that all takes time and what we see, because of the financial squeeze, is that beds have been closed but the system is not ready for that yet.

"Whatever we need to keep those beds open is what we need. It needs to change."

Wales' ambulances have missed a response time target for life-threatening calls for the ninth consecutive month.

Start Quote

This is a dire warning from Welsh NHS emergency consultants that patient safety is being dangerously compromised as a result of financial pressures”

End Quote Darren Millar AM Conservative health spokesperson

Statistics from February show 60.8% of emergency responses arrived within eight minutes, missing the Welsh Ambulance Service target of 65%.

A Welsh government spokesperson said: "The newly appointed minister for health and social services, Mark Drakeford, has stated that one of his priorities over the next 12 months is to look at ways of easing the pressures on unscheduled healthcare - this includes out of hours services, emergency departments and ambulance services."

The consultants warn that creating a culture whereby health boards are required to achieve financial balance could lead to the same result as the Mid Staffordshire scandal.

A public inquiry report found that neglect and abuse at Stafford Hospital between 2005 and 2008 had led to needless deaths.

Published at the start of February, the Francis report accused the NHS of putting corporate self-interest ahead of patients.

The consultants say: "The motive behind the financial squeeze affecting hospitals in Wales is different to that underpinning the Mid Staffordshire scandal, but from our perspective, the result is the same: the pursuit of targets and financial balance at the expense of quality of care."

Wales' seven health boards are currently in the process of trying to balance their books before the end of the financial year.

The largest, Betsi Cadwaladr, predicts it may be £3.9m in debt by the end of the financial year, despite £15m of extra funding from the Welsh government.

Analysis by BBC Wales indicates other health boards are also facing similar challenges, but some are predicting they will succeed to stay within budget.

Darren Millar AM, Conservative health spokesperson, said: "This is a dire warning from Welsh NHS emergency consultants that patient safety is being dangerously compromised as a result of financial pressures.

"Axing inpatient bed numbers to save money is leading to overcrowded A&E departments, which cause ambulance queues outside our hospitals and delay them from being able to get back on the road to emergencies."

Plaid Cymru's health spokeswoman Elin Jones said: "Labour health ministers have failed to take a strong hold of the NHS and ensure that it is delivering safe services for the people of Wales.

"Clinicians, health organisations and patients have been telling us for many months that there are serious failings in the current system, and it seems that key NHS targets are routinely missed."

 

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  • rate this
    +8

    Comment number 37.

    PFI is used by tory and labour alike as due to treasury rules,'PFI doesn't count as borrowing'. It costs us more, but Chancellors and PM's don't care. Osbourne said he would be honest about PFI and add it to government borrowing - but he didn't. Too much admin and paper pushers, no matrons

  • rate this
    +4

    Comment number 36.

    'The Welsh government said one of Mr Drakeford's priorities was to look at ways of easing the pressures on unscheduled healthcare'

    Don't close A&E's then!!! Prince Phiilip Hospital serves a big community (llanelli) and yet is planned to be shut in favour of WWG in Carmarthen....goes to show the NHS haven't got a clue what they are doing!!

  • rate this
    +2

    Comment number 35.

    Congratulation to Osborne & Co for the cut backs. Still at least the tax dodgers & bankers can sleep easy knowing they are safe.

  • rate this
    +37

    Comment number 34.

    Same old thing. . . .yet so easy to fix . . . . . . Get rid of unnecessary overpaid management and put the money on the front line . . . . . . I have no idea why they are all so blind to it

  • rate this
    -3

    Comment number 33.

    31.FishFingers
    The UK is overpopulated, particularly in the South East. No amount of spending OR cutting is going to solve this problem.
    We need a comprehensive policy to reduce the UK population and we need it 20 years ago.
    Until then, every public service will be overstretched and inefficient"

    While I agree with you, the NHS is only as stretched as the career Politicians want it to be.

  • rate this
    +6

    Comment number 32.

    How are NI contributions being spent? Surely the public should be informed about proposed changes and possible privatisation?

  • rate this
    0

    Comment number 31.

    The UK is overpopulated, particularly in the South East. No amount of spending OR cutting is going to solve this problem.

    We need a comprehensive policy to reduce the UK population and we need it 20 years ago.

    Until then, every public service will be overstretched and inefficient.

  • rate this
    +2

    Comment number 30.

    System is in meltdown, meanwhile on TV the public information films,paid for at public expense, urge us to recognise the signs of a stroke and rush the victim to hospital. For what? To lie in on a trolley in a corridor?

  • rate this
    +1

    Comment number 29.

    I'd quite like to pay more in tax so that we had an NHS that worked.but I can't trust politicians of any colour with my money.

  • rate this
    +1

    Comment number 28.

    Hi other countries! Are you in the EU and struggling with debt? Are you a country such as India where you are rich enough but your govt. is corrput and keep the poor, poor? If so, call the UK! We will give you our money even at the expense of our own people! Can't wait for us to send you the money? Then come here and we will give it to you in benefits! Call or enter the UK now.

  • rate this
    0

    Comment number 27.

    A&E should prioritise genuine cases and de-prioritise people who arrive drunk or drugged up. These problems are self-inflicted and are a drain on resources.

  • rate this
    +5

    Comment number 26.

    Why not let a private company run A&E? The private sector always is better - you only have to think of the many successes like the railways, gas, water electricity.....

  • rate this
    +2

    Comment number 25.

    Not exactly new news either.

    They've been closing down service in High Wycombe piece by piece for Years, even when the last government was throwing money about like confetti. Now if you need emergency care you have to travel 30 minutes to Stoke Mandeville which is overburdened.

    After a family friend was told to come back later when badly injured I'm making sure not to get sick any time soon.

  • rate this
    -1

    Comment number 24.

    the welsh assembly blaming Westminster and the other way round it is about time the Welsh assembly got their head out of the sand and take responsibility for wales as we all know Labour only works when the coffers are full and they throw money at the problem .some cant think on their feet

  • rate this
    +3

    Comment number 23.

    The people of GB have got to do something if they want to keep our NHS it is not free we pay for it the government under funds it every dept is short staffed They seem to get ideas put them into practice without thinking of the consequences

  • rate this
    0

    Comment number 22.

    The root cause is staring us in the face; an article littered with statistics, targets, budgets and service level agreements.
    Other than true accidents, admissions to A&E should be considered a failure of the rest of the NHS to address problems.
    Neither are ‘hospital beds’ the answer – prevention is far cheaper than cure.

  • rate this
    +5

    Comment number 21.

    The mistake the government has made is to drive through a massive reorganisation. I have handled a large organisational change. It takes everyone's eye off the ball. All the detailed processes get disrupted and have to be re-built. Learning curves get re-set. Whatever the gains they will not show for 3-5 years. It was a huge misjudgement by a headstrong inexperienced Mr Lansley.

  • rate this
    0

    Comment number 20.

    The rot started with the last government and is being taken forward by the current government. The NHS isn`t safe in any of the main political partys hands

  • rate this
    +1

    Comment number 19.

    I don't believe anything the politicians tell me about the NHS - particularly the tories. Like most GB citizens, I have witnessed the ward shortages, the penny-pinching and the top-heavy bungling spendthrift management. The NHS needs a culture change. The only funding cuts should come from genuine efficiencies, and not because some jobsworth wants to impress.

  • rate this
    +2

    Comment number 18.

    5.Blah
    Maybe if the likes of Amazon, Starbucks and the PM's chum Gary Barlow actually paid some taxes....."

    Big Corps, Politicians & celebrities are not the only ones avoiding tax. I worked for a privately-owned pharmaceutical that also had its own "tax efficiency" account located in Bermuda.

    NHS is under severe threat of privatisation from career Politicians of all colours....sadly.

 

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