On 24th June several media outlets reported on the long, indignifying and painful waits in A&E. The specific cases are merely examples of a systemic problem. We need to have assertive relatives who act as advocates when we are under the 4 UK health services. NHSreality has published advocacy advice and a personal history explaining how even a retired and informed GP cannot get proper care, and cannot get the service to learn and improve. NHSreality has explained how standards are falling and will continue to fall. NHSreality has asked that all Doctors should be required to do emergency medicine in some form or other for the next decade, and for no fault compensation to protect the doctors and their new staff (physician assistants – PAs) from the pressures of mistakes – which are inevitable. The BMA is so worried that it taking the GMC (General Medical Council) to court because of their complicity in reducing standards.. But are PAs the only solution, and are they better than recruiting from overseas?
BBC News – Long Shrewsbury A&E waits and hospital corridor care in TV doc – BBC News
Poppy Koronka in the Times: 30 hours waiting in agony. A&E patients seen screaming in agony and naked in corridors. Undercover Channel 4 documentary shows people waiting up to 30 hours for care at Royal Shrewsbury Hospital, with one forced to urinate in a bottle in a public corridor Patients are being forced to relieve themselves in hospital corridors and are waiting up to 30 hours for care, an undercover investigation at an NHS hospital has revealed.
The footage, which is being broadcast by Channel 4 Dispatches on Monday, exposes a “shocking lack of dignity” endured by patients at the A&E unit of Royal Shrewsbury Hospital.
In the footage, a patient who had suffered a suspected stroke spent 24 hours waiting to be seen in an area called “fit to sit”, where patients who can walk are placed to wait for care. Another had to undress and urinate into a bottle in full view of other patients in a public corridor while waiting to be treated. It comes as figures obtained under freedom of information laws found almost 400,000 patients were waiting in A&E for more than 24 hours between April 2023-March 2024. Channel 4 said that the numbers waiting for 24 hours in A&E were five per cent higher than the same period last year.
During 44 minutes of gruelling undercover footage from an NHS emergency department, an elderly man is forced to urinate in a trolley in a corridor in full view of staff and other patients. Another woman is seen crying and screaming in agony while waiting for pain relief, footage from the Channel 4 Dispatches investigation shows. Channel 4 has said the programme, in which a reporter went undercover at the Royal Shrewsbury Hospital emergency department, has exposed the “suffering and indignity faced by patients on a daily basis”.
The “truly harrowing” investigation, Undercover A&E: NHS in Crisis, sees an undercover reporter working as a trainee healthcare assistant (HCA) for two months. The reporter received ten days of training to become a trainee HCA and should not have been left unsupervised on the ward, Channel 4 said. Yet during the episode he was left unsupervised with four patients who were on beds in a corridor while a nurse went to get pain relief. One patient was left in “agony, screaming” during the 20 minutes the reporter was alone.
In the winter of 2022, deaths hit three times the national average at the Royal Shrewsbury Hospital emergency department. Just last week, the trust declared a critical incident as it was overwhelmed, the broadcaster has said.
At one point an elderly gentleman was forced to urinate into a bottle in a public corridor as he waited for care. Channel 4’s undercover reporter, Robbie Boyd, became visibly upset in the footage when recounting the incident. “I am so angry right now because if that … if that was my parent having to pee in a bottle, naked, in front of 30 people … it’s so undignified,” Boyd said in the episode.
• The A&E doctor will see you … in 50 hours
The Dispatches footage also shows a senior nurse reading a litany of serious complaints about the department during a morning handover meeting. “Basic nursing care standards have fallen significantly,” she told staff.
She listed recent incidents: “Patients on oxygen have not been monitored appropriately … patients being left in a state of partial undress and no urgency from staff to address the issue … patients being left on bedpans for too long … end of life patients not having appropriate observations.”“A patient was found deceased in a cubicle wearing an oxygen mask, and evidence of vomit around their mouth,” the nurse continued. One patient in the film — who was suspected of having a stroke — was left waiting for 24 hours for care. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, who was interviewed for the documentary, underlined how detrimental and distressing long waits in A&E can be: “You get people in the wrong place, receiving less good care, receiving undignified care. Spending two days in an emergency department […] it’s worse than spending two days in an airport lounge. There’s constant noise, there’s constant stress. There’s no end in sight.”
Siva Anandaciva, the chief analyst at The King’s Fund think tank, said: “Some of the scenes in tonight’s Dispatches are truly harrowing. NHS services are meant to be places of safety and it should be a wakeup call to senior leaders and politicians that this isn’t always the case.
“The most shocking thing may be just how widespread and deep these A&E performance pressures are. Not a single NHS hospital trust in England that operates a major A&E department is meeting the national standard for 95 per cent of people Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: “What has been observed in Shrewsbury and Telford Hospital NHS Trust in recent weeks is not commonplace in A&E’s across the country, and is not acceptable. The NHS will continue to work closely with the most challenged trusts.”
A spokesman for Shrewsbury and Telford Trust said: “As with other hospitals, our trust is facing significant challenges with urgent and emergency care. We are very sorry that our patients have experienced anything less than the quality care we strive for, and we are determined, working with partners, to improve the care and experience for everyone. “Whilst we dispute some of the claims made in the Dispatches programme, we will fully investigate[…] We remain committed to being open and transparent with our patients and staff and encourage anyone with concerns to contact our patients advice and liaison team.”
Undercover A&E: NHS in Crisis — Dispatches — will be shown on Channel 4 at 9pm on Monday
NHSreality on advocacy and no fault compensation
BMA takes legal action against GMC over ‘blurring lines’ between doctors and PAs | GPonline
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