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

    Comment number 57.

    How lovely that this debate hasn't descended into entrenched stereotypical slogan chanting. Here's the news: the Welsh NHS is run by people who arent upto the job.

  • rate this

    Comment number 56.

    You cut back on care for the elderly, they end up blocking hospital bed. You let doctors not do out of hours care, and don't change things back, and people go to A&E instead. You employ lots of people to check targets (even if you say they don't really exist) and you have lots of people not working in A&E.

  • rate this

    Comment number 55.

    Suck it up people

    They are doing the same to the NHS what they are doing to the police.

    They'll lobby the EU to make sure 'our'? bankers keep their untold millions but want public services that actually protect the public run down until they can 'underpin' it with their sponsors services.

    Criminal...truly criminal... really looks like we're all in this together.

  • rate this

    Comment number 54.


    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.


    I'd like to pay less tax and use the saving to go private; at least I pay for myself and my family only, instead of half the population of the EU.

    If they privatised, we'd not see a tax cut, mind.

  • rate this

    Comment number 53.

    28. Howesyourview

    Here's a tip for you, don't buy The Sun.

  • rate this

    Comment number 52.

    The NHS has always been a thorn to the side of the Tory faithful.
    It is a socialist remnant that they would dearly love to get rid of.
    In the meantime anything to stealthily or openly destabilise it and thus accelerate its collapse.

  • rate this

    Comment number 51.

    Sadly my husband was a victim of this meltdown. He died in extreme distress last week because the ambulance took far too long to arrive.

  • Comment number 50.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 49.

    It's a shame that people can't see the bigger picture here.

    There is a concerted and growing effort by people with vested interests in privatisation to discredit and run down the NHS.

    All this media coverage is designed to destabilise the NHS and demoralise the staff so they start leaving what becomes a sinking ship.

    The BBC particularly should be ashamed of their assistance in this practice.

  • rate this

    Comment number 48.

    People are ending up in A&E needlessly, because they cannot get to see a GP. 'Out of hours Care' is a joke.

  • rate this

    Comment number 47.

    They want us to be insured for everything, a bit like another tax really. . . . . .and when the need to claim arises, they will use every trick in the book to get out of paying up. . . . . .Then what?

  • rate this

    Comment number 46.

    If privatisation of health care is the answer I can only assume the question is "has anyone got a really stupid idea?".

  • rate this

    Comment number 45.


    So true. It is very difficult for working people to get a GP appointment. It would make sense to have an out of hours service for which a small fee could be charged. Working people would be happy to pay to have the convenience of seeing a doctor without having to take time off work. A&E is too often used by people who know they aren't emergencies but have nowhere else to go.

  • rate this

    Comment number 44.

    The UK is overpopulated, particularly in the South East. No amount of spending OR cutting is going to solve this problem...Until then, every public service will be overstretched and inefficient

    This report is specifically about Wales, most of which, is not overcrowded as, due to lack of jobs, a large chunk of the population has historically moved to SE England

  • rate this

    Comment number 43.

    Privatisation don't work just look at the breast implant scandal which has been forgotton about, the biggest private provider has gone bust giving the NHS the bill. Individuals hide behing company limited liability. If they were personally LIABLE how many would be investing then. !!!

  • rate this

    Comment number 42.

    I can visualise a group of hideous creatures squatting on a million corpses
    setting their plans out on how to create misery and pain, they exist for it.
    My God how the masses have been duped by the so called elite of this country.

  • rate this

    Comment number 41.

    if the nhs didn't get a lot worse now then how could they claim it was getting better after privatisation

  • rate this

    Comment number 40.

    As usual the BBC is being economical with the truth e.g.
    "It says pressure to meet financial targets has meant the loss of beds "at the expense of quality care".
    should really be It says pressure to meet financial targets imposed by PFI has meant the loss of beds "at the expense of quality care".

  • rate this

    Comment number 39.

    If politicians and their families HAD to use the NHS, instead of being gifted private healthcare, things would get better overnight!

  • rate this

    Comment number 38.

    Although it was Labour's inept bungling of PFI contracts that caused many NHS financial woes, the Tories want it to fail so that they have an excuse to switch to a system more like the US, where the first thing they ask for in A&E is your credit card.

    I would much rather my taxes were spent on the NHS rather than 'Trident Nuclear Weapons', but the Tories seem to care more about bombs than people!


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