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 77.

    This is pleb cull! The politicians want to reduce pleb population; This will lead to a reduction in deficit. If you are a politician you will always have access to A & E after all "do you know who I am ...

    The political classes simply do not care! lets get rid of career politicians and vote in some "normal" people.

    Why not put NHS in the hands of the bankers they are sound. Only joking.

  • rate this

    Comment number 76.

    @75 J Public

    When are you standing?, , , , , ,You get my vote

  • rate this

    Comment number 75.

    This situation has rapidy become State-sanctioned death to innocent people by the greedy, tax-avoiding, multi-millionaire career Politician.

    We public cannot stand back and let untold thousands needlessly die this way while the very people that are controlling/instigating this situation live in growing wealth, security, luxury & priviledge AND private healthcare at OUR cost.

  • rate this

    Comment number 74.

    When will people contributing here realise it is a piece about the Welsh NHS not England, in Wales, Labour are in charge they are the ones perpetrating this action on the Welsh NHS.

  • rate this

    Comment number 73.

    Usual nonsense about Tories hating NHS, NHS starved of cash, Blah Blah. This style of management is typical of DOH regardless of party in power. Projects are driven in Hard and fast by ex DOH execs earning huge consultancy fees, freququntly for big accountancy firms. A deadline is a a deadline, conformance is not negotiable, failure is an opportunityto blame somebody else.This is not the right way

  • rate this

    Comment number 72.

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


  • Comment number 71.

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

  • Comment number 70.

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

  • rate this

    Comment number 69.

    NHS is a bloated public organisation with a manager for every pencil it owns, and not enough front line staff to actually operate effectively.

    It's a bottomless money pit, and is not sacred.

    Sell it off, give me back my tax that funds it. I'll use that to go private, get good service, and know I'm only paying for family and me, not everyone who gets wellied and falls over on Saturday night.

  • rate this

    Comment number 68.

    Is there ANY good news in Coalition Britain's NHS..........??????????

  • rate this

    Comment number 67.

    Well, we've found £52 million from somewhere - let's buy Cardiff Airport ...

  • rate this

    Comment number 66.

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

    So. An obsession with targets causing problems again. Remind anyone of another hospital, in Stafford ?

    Question : What has an obsession with targets in Wales & England got in common.

    Answer : Politicians.

    Staff are not to blame for this mess. The meddling politicians are ! Get rid of them!

  • rate this

    Comment number 65.

    "I'll cut the deficit, not the NHS" - Now, who was it that said that, in 2010 ?

    Clue : the same shyster that said "I'm going to mend broken Britain".

    Answers on a postcard please.

  • rate this

    Comment number 64.

    A&E is a much better use of NHS resources than many expensive, headline grabbing treatments (like cancer surgery/drugs) where all that is achieved is extending life for a few more agonising months. I would prefer that funds are diverted from cancer treatment, obesity/cosmetic surgery and fertility treatment to A&E.

  • rate this

    Comment number 63.

    What's happening in Wales is happening in England too.
    Not only are there far fewer A&E departments than twenty years ago, causing more deaths and worse outcomes due to the longer times taken to reach them, but those remaining aren't equipped to cope with the rise in demand that is a direct result of closing so many others.

    It's a question of government money or your life; life seems cheaper...

  • rate this

    Comment number 62.

    How dare people criticise the NHS! Remember the eleventh commandment anybody? "Thou shalt not speaketh evil of the NHS; those that do fear'eth the wrath of the one-eyed"

  • rate this

    Comment number 61.

    39. iplaybass

    Spot on.

    To SERVE your country, not RULE it. Politics should be a service and a duty, and not a privileged easy ride. No expenses, and an average £25k salary, like the rest of us. That'd quickly sort those who genuinely wanted to serve, from those who simply wanted to exploit.

  • rate this

    Comment number 60.

    "I'd like to pay less tax and use the saving to go private; at least I pay for myself and my family only"

    You pay for everybody in the same scheme who makes a claim, especially those whose claim is a high proportion of a lifetime's premiums. You may never make a claim, or only claim for relatively minor things. Insurance is like that. And A&E is unlikely to be funded privately.

  • rate this

    Comment number 59.

    You pay your road tax to make sure the roads are nice to drive on with no pot holes etc. Except that that doesn't seem to be the case.

    If this government had it's way, we will all be paying insurance ie health tax. Where do you think that money will go?

  • rate this

    Comment number 58.

    How is it that endless £billions can be found to bail out banks but nothing can be found to 'bail out' health, education and the Police?


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