A&E waiting times – are a dangerous disgrace. Casualty should be manned by more rather than less experienced doctors.

A recent admission to my local DGH A&E was an eye opener. It was as if nobody cared when a retired GP arrived at 00.30 to say he had a painful infected hand and needed an operation. The time taken to be seen was appalling, with 30 mins to see the triage nurse, 4 hours later to see the SHO and 1 hour later to see an F2 covering orthopaedics from another speciality. (Surgery). The result of a sleepless and painful night without adequate analgesia was my walking away at 06.00 (after being advised that there would be no way to see anyone before 10.00 am!) with a compartment syndrome not yet diagnosed or seen by somebody able to take action. This was a wait of 5 and a half hours, but then I got access to the specialist via my GP by barging in first thing. (GPs are not meant to be an emergency service!). She rang the consultant and arranged for me to be seen mid morning, and an operation ensued at 19.30 which was some 18 hours later than it might have been. The result, even for a doctor who presented himself, was delayed decompression of my dominant R hand, and a long recovery on antibiotics. I suspect that the pain could have been less, the operation sooner and the recovery quicker if the right person had been in A&E. 

This type of story is commonplace. Retired colleagues all tell me “dreadful” stories of their own experiences. It would have been better for me if I had travelled to a properly staffed tertiary centre than my local DGH, even though it is 90 mins away. We need honesty and transparency in all areas of health, and I suspect increased death and complication rates are already a fact if you happen to live in the wrong post-code.

Rosie Taylor in  the Times 13th September reports: Alarm grows over A&E waiting times

The number of patients kept waiting at A&E departments in England reached its highest level in a decade last year, prompting warnings that pressure on the NHS would rise this winter if it faced the “perfect storm” of high demand and a no-deal Brexit.

Patients kept waiting at least four hours more than trebled in the past five years. Last year only 88 per cent of patients were seen within four hours compared with 98.3 per cent ten years ago, according to the NHS’s Hospital Accident & Emergency Activity 2018-19 report.

Separate NHS figures show that last month was the busiest August ever.

Tim Gardner, senior policy fellow at the Health Foundation charity, said: “A no-deal Brexit would only exacerbate these pressures, intensifying staffing shortages, driving up demand for hard-pressed services, disrupting supplies of medicines and other necessities, and stretching the public finances which pay for healthcare.”

Helen Fidler, deputy chairwoman of the British Medical Association’s consultants’ committee, said: “This summer emergency departments had their busiest August on record. As we move into what will undoubtedly be a difficult winter the situation will get worse . . . A no-deal Brexit threatens to pile even more pressure on overworked staff.”

A&E attendances last month were up 6.4 per cent on the same month last year. Although doctors treated an extra 1,200 patients within four hours, the percentage of people seen within that time dropped from 89.8 per cent to 86.3 per cent.

About 24.8 million people attended emergency departments in 2018-19, a 21 per cent increase on the 20.5 million who visited in 2009-10. However, while attendances rose 2 per cent year-on-year, the population has grown by only 1 per cent a year over the same period.

Miriam Deakin, director of policy and strategy at NHS Providers, which represents hospitals, said the sheer dedication of staff was stabilising A&E performance despite a record number of patients. However, she added: “This winter will be a very testing time for trusts. We anticipate that performance will slip even further, with patients waiting longer for treatment across various services.”

Rising demand has also increased the time patients are left on trolleys. Last month 362 patients waited for more than 12 hours in A&E after it had been decided to admit them, more than double the figure for August last year.

An NHS spokesman said that in July a record number of patients were seen within two weeks of referral for urgent cancer checks, routine tests or treatment for serious mental health problems. He added: “Every part of the health service is playing its part in meeting the rising demand for care.”

This entry was posted in A Personal View, Post Code Lottery, Professionals, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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