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Showing results for tags 'Accident and Emergency'.
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News ArticleA patient in a West Midlands A&E was forced to urinate while lying in a corridor as another was left crying in agony for hours in an undercover report highlighting the NHS’ emergency care crisis. A Channel 4 Dispatches programme has exposed the “suffering and indignity faced by patients on a daily basis” after an undercover reporter secretly filmed himself working as a trainee healthcare assistant inside the emergency department of the Royal Shrewsbury Hospital for two months. The footage, which aired on Monday night, shows one patient waiting 30 hours in a “fit to sit” area while a suspected stroke sufferer was there for 24 hours, the broadcaster said. In one clip, an elderly man was forced to urinate in a trolley on the corridor in full view of staff and other patients, while in another a woman is left crying in agony for hours. Nurses are also seen discussing how one of their patients was forced to wait a staggering 46 hours for care and at one point the footage shows large pools of blood on the floor. Experts have said while the scenes were “shocking” and “harrowing” they were not unique to the Royal Shrewsbury Hospital and are occurring in hospitals across England. Read full story Source: The Independent, 25 June 2024
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Content ArticleIn this opinion piece for The Guardian, Adrian Chiles describes how his father was unnecessarily transferred from a community hospital to an A&E department by a locum GP. This caused his father—who was largely alone, confused and without his hearing aids—great distress, and should have been avoided, as healthcare professionals said the transfer had been unnecessary. Adrian describes his father's rapid deterioration following the incident and his regret that some of his father's last days were spent—avoidably—in distress. He says, "The process, the system, the protocols, the whatever, take hold and the wrong thing happens even though everyone can see it’s wrong but is powerless to put a stop to it."
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News Article
Ambulance response warning after woman's death
Patient Safety Learning posted a news article in News
Long waiting times at hospitals in the north-west of England are putting patient's lives at risk by holding up ambulance crews, a coroner has warned. It comes after the death of Bobilya Mulonge, who called 999 with breathing problems on 24 November 2022. She waited 72 minutes for an ambulance - four times longer than North West Ambulance Service's (NWAS) 18-minute target for her category of emergency call - which "probably contributed to her death", coroner Lauren Costello said. A NWAS spokesman said the service was "very sorry" an ambulance was unable to attend sooner and the service had made "significant" improvements since. A report by Ms Costello has been sent to the health secretary and NWAS and urges the region's health authorities to take action to prevent further deaths. She said evidence about ambulance delays revealed during the inquest had given rise to her concerns. "In my opinion there is a risk that future deaths could occur unless action is taken," she wrote. Dale Ollier, north-west regional organiser for Unison, which represents some ambulance staff, said backlogs in moving patients out of hospitals was having a "knock-on effect" at A&E, leading to a "bottleneck crisis". “We have patients that could be safely discharged but there isn’t anywhere to discharge them to because of the lack of capacity in social care." Ambulances were working "flat out", he added, but delays had lead to an "unbearable demand" on crews who were sometimes "tied up for several hours" waiting at hospitals. Read full story Source: BBC News, 20 June 2024 -
Content ArticleOn 24 May 2023 an investigation was commenced into the death of Bobilya Mulonge then aged 62 years. The investigation concluded at the end of the inquest on 19 April 2024. The conclusion of the inquest was a narrative conclusion that Mrs Mulonge died as a result of congestive cardiac failure against a background of hypertensive heart disease. Ambulance response times probably contributed to her death. The medical cause of death being: 1 (a) Congestive Cardiac Failure (b) Hypertensive Heart Disease II) Chronic Kidney disease and Type II diabetes mellitus.
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Content ArticleOver three months, a Dispatches reporter has filmed secretly while working in a major NHS A&E department. The undercover footage exposes the suffering and dangers patients face on a daily basis.
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News Article
Nearly 19,000 NHS patients left waiting for three days in A&E over 12 months
Patient Safety Learning posted a news article in News
Almost 19,000 NHS patients were left waiting in A&E for three days over a 12-month period, an investigation has revealed. Between April 2023 and March 2024, nearly 400,000 people were left waiting more than 24 hours across A&E departments, a 5% rise on the previous year. Channel 4’s Dispatches programme also found that 54,000 people had to wait more than two days, a freedom of information request to NHS England found. The investigation exposed “suffering and indignity faced by patients on a daily basis”, after an undercover reporter secretly filmed himself working as a trainee healthcare assistant inside the emergency department of the Royal Shrewsbury hospital for two months. The “harrowing” scenes from the hospital’s A&E department came as an analyst from a thinktank said people were dying in emergency care in England “who don’t need to be dying”. Footage shows one patient waiting for 30 hours in a “fit to sit” area while a suspected stroke sufferer was there for 24 hours, the broadcaster said. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: “I don’t think this is unique to this hospital by any stretch of the imagination. The things we’ve seen here today are clearly not just confined to winter. It was a year-round crisis in emergency care. “Spending two days in an emergency department is worse than spending two days in an airport lounge. These are people who are sitting in uncomfortable seats where the lights never go off. There’s constant noise, there’s constant stress. There’s no end in sight.” Read full story Source: The Guardian, 24 June 2024 -
News Article
NHS in summer crisis of emergency care waits, doctors say
Patient Safety Learning posted a news article in News
The NHS is engulfed in a summer crisis, senior doctors have said, amid severe ambulance delays, corridors crowded with trolleys and patients facing 25-hour waits in A&E units. The Royal College of Emergency Medicine (RCEM) sounded the alarm over the “national scandal” of long waits for emergency care that it said were leading to “entirely preventable” deaths at a time of the year when there should be some respite from the traditional pressure experienced over winter. Elderly people in particular were facing the brunt of the impact, with many forced to endure horrific long waits for a bed once a decision had been taken to admit them to hospital, the college said. A snapshot survey by the RCEM of emergency department chiefs from across the UK, conducted between Monday and Wednesday this week, exposed the extent of the summer crisis in hospitals. Nine in 10 (91%) of 63 A&E bosses admitted NHS patients were “coming into harm” on their wards due to the quality of care that could be delivered under current conditions. Eighty-seven per cent said they had patients being treated in corridors and 68% said they had patients waiting in ambulances outside their A&E. One emergency department leader revealed that one of their patients this week waited more than 19 hours for a hospital bed to become available once a decision was made to admit them after they had already waited six hours to be seen. Overall, the patient ended up waiting 25 hours in A&E. Read full story Source: The Guardian, 20 June 2024 Related reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift Reflections on a clinical shift: "After 20 years of nursing, this is one of the worst shifts I have ever completed" -
Content Article
Craig Russo is an Operational Manager at Leeds Community Healthcare NHS Trust. In this blog, he tells us about a recent project he delivered in partnership with Accident and Emergency (A&E) services, the police and custody healthcare. Craig talks about the safety concerns that led them to take action and the positive impact they have seen so far. -
Content ArticleSafety risks exist in all medical care settings, but emergency medicine professionals face particular challenges as they strive to deliver the safest, highest quality care to their patients. Massachusetts emergency departments rank high in a national review of ED quality and safety. Yet many frontline staff express concerns that the environment is not as safe as it needs to be for patients or staff. In response to these concerns from their members, leaders of the Massachusetts College of Emergency Physicians (MACEP) reached out to the Betsy Lehman Center to help facilitate work to improve safety in emergency departments across the state. The Massachusetts Emergency Nurses Association (MENA) and the Massachusetts Association of Physician Assistants (MAPA) joined as partners in the effort. Through this collaboration, the Betsy Lehman Center convened an expert panel to identify key risks to safety in emergency departments, recommend practical steps for mitigating these risks, and develop a toolkit to support implementation of the recommendations. Recognising the broad range of safety issues facing emergency medicine clinicians and staff, the expert panel focused on interventions that could be executed from “within the four walls” of the emergency department in three key areas: (1) crowding; (2) cognitive overload; and (3) care coordination.
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News Article
‘Health MOTs’ planned for people aged 65 and over arriving at A&E in England
Patient Safety Learning posted a news article in News
People aged 65 and over arriving at A&E in England who appear frail will soon receive a “health MOT at the front door”, the head of the NHS will pledge. A&E units must start giving everyone that age a battery of tests to see if they are frail or have any other underlying condition and then arrange whatever care they may need. NHS England hopes the initiative will reduce the number of older people being admitted to hospital, and cut overcrowding, “trolley waits” and “corridor care”. Amanda Pritchard, the organisation’s chief executive, will tell an audience of health service heads on Wednesday they must ensure by next April that all A&E units start offering detailed assessments of older people’s health. However, the service will only operate for 10 hours a day. “Health MOTs at the front door of A&Es for older people could be a lifeline for many. From blood pressure tests to a review of their falls history, these checks mean patients can be assessed quickly and directed to the right support for their needs,” Pritchard will say. “While some people do need to be admitted, it isn’t always the most suitable place for older patients’ needs, and they can also rapidly lose mobility while in hospital.” Read full story Source: The Guardian, 12 June 2024 -
News Article
New AI tool ‘can rapidly rule out heart attacks in people attending A&E’
Patient Safety Learning posted a news article in News
A new artificial intelligence tool (AI) developed in the UK can rapidly rule out heart attacks in people attending A&E and help tens of thousands avoid unnecessary hospital stays each year, according to its creators. Known as Rapid-RO, the AI tool has been found to successfully rule out heart attacks in over a third of patients across four UK hospitals during trials. Professor James Leiper, associate medical director at the British Heart Foundation (BHF), which funded the study, said: “This research demonstrates the important role AI could play in guiding treatment decision for heart patients. “By quickly identifying patients who are safe to be discharged, this technology could help people avoid unnecessary hospital stays, allowing valuable NHS time and resource to be redirected to where it could have the greatest benefit.” Read full story Source: The Independent, 3 June 2024 -
Content ArticleIn this article, published by Pragmatic Improvement, Pete Gordon discusses the 2023 NHS staff satisfaction survey and the link with emergency department performance.
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News ArticleInga Rublite died after being found unconscious under her coat in an A&E waiting room more than eight hours after arriving. Learning what happened to Rublite in the hours before her death has been gut-wrenching for her friends and family. She sat through the night at Queen’s Medical Centre (QMC) in Nottingham after arriving at 10.30pm on 19 January with severe headache, dizziness, high blood pressure and vomiting. When her name was called seven hours later, at about 5.30am, she did not respond and staff discharged her believing she had tired of waiting and gone home. But over an hour later she was discovered having a seizure after falling asleep, and then unconscious, under her coat. She was rushed to intensive care but had suffered a brain haemorrhage, and the bleeding was so severe it was inoperable. She was declared dead two days later on 22 January, when her life support was switched off. Inga's twin sister said, “In all those years, the one time she went to the hospital to ask for help, no one was looking at her. I can’t describe how that feels. That you can’t get help in the place where you’re supposed to go for help.” Read full story Source: Guardian, 26 April 2024
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News Article
Jammed 999 lines and not enough ambulances to go round
Patient Safety Learning posted a news article in News
This is a sick country, getting sicker. NHS waits will take years to clear, if at all. While people wait, they get sicker. When more and more people slip into absolute poverty – a fifth of people now – they get even sicker. More sicken as they age, and that peak has not yet been reached. Every part of the NHS feels at the sharp end, coping mostly because, amazingly, they just do, even with no end in sight to the stress. NHS data released last week on people waiting more than 18 weeks with serious heart problems suggests some will probably die before they get treatment. When waiting patients have heart attacks and strokes they call an ambulance – so there’s been an astonishing 7% rise in those category 1 calls. At an ambulance dispatch centre in Kent, Polly Toynbee listens in to calls like this at the South East Coast Ambulance Service dispatch centre in Gillingham, north Kent, covering Surrey, Sussex and Kent. She sat with D, a seasoned and sympathetic emergency medical adviser, call handler and life-and-death decider. Read full story Source: The Guardian, 17 April 2024 -
News Article
Why Mondays are the deadliest day to go to A&E
Patient Safety Learning posted a news article in News
The number of people dying needlessly in A&E soars on a Monday as hospitals are stretched to the limit and failing to discharge patients at the weekend, new data shows. Figures uncovered by The Independent show an average of 126 patients died every Monday between 2020-2023 – 25% higher than any other day. On a Saturday, the average number of deaths drops as low as 90. Waiting times are also shown to spike massively at the start of the week, with an average of 9,300 patients spending more than 12 hours waiting on a Monday – up to 2,000 more than any other day. Medical experts said the rise in A&E waits can be attributed to people staying away from hospitals during weekends and patients not being discharged from medical care, causing a bottleneck in an already buckling system. The stark statistics also directly contradict repeated government efforts to make the NHS a seven-day service. Multiple coroners have warned the government and health leaders about delays to patients’ treatment and diagnosis due to variations in staffing and access to specialists – particularly over the weekend. Adrian Boyle, president of the Royal College of Emergency Medicine, said the NHS England data clearly signposted an “increased risk” at the start of the week. Another expert said the sharp rise in deaths on Mondays showed an A&E “running constantly in the red zone”. Read full story Source: The Independent, 8 April 2024 -
News Article
A&E target missed despite tough line from NHSE
Patient-Safety-Learning posted a news article in News
The headline A&E target was missed in March despite NHS England’s controversial last-ditch attempts to deliver it. Four hours A&E performance was 74.2 per cent in March—1.8 percentage points lower than NHSE’s 76 per cent threshold—but up from 71.5 per cent in the same month last year. NHSE’s attempts to improve four hours performance ahead of a year-end deadline—which included new cash incentives, asking directors to sign personal commitments, and encouraging trusts to focus on less sick patients—saw March performance 3.3 percentage points higher than 70.9 per cent in February. Around a third of acute trusts (38 of 119) met the 76 per cent target in March–more than double the number of trusts above the threshold in February (15). An interim ambulance response time for category 2 incidents, set at 30 minutes, was also missed in 2023-14—despite some improvement, and despite the government providing significant extra funding. The average response time across the year was 36m 23s—better than 2022-23 when it was 50m—but much worse than the pre-covid average of 21m 47s in 2018-19 and 23m 50s in 2019-20. Many ambulance trusts have continued to struggle with delays in handovers to A&E departments and South Western Ambulance Service Foundation Trust – which has seen some of the worst delays over the winter—averaged 45m 54s for category 2 incidents in March. Read full story (paywalled) Source: HSJ, 11 April 2024 -
News Article
Hospital patient spent nine days in locker room
Patient-Safety-Learning posted a news article in News
A woman who feared she was having a heart attack said she spent nine days in a hospital staff room because of a shortage of beds. Zoe Carlin, 23, was admitted to Altnagelvin Hospital in Londonderry in March after experiencing severe chest pain. She said she spent more than a week in a “locker room” where she had to use a hand bell to call staff during what she described as a “dehumanising” ordeal. The Western Health and Social Care Trust (WHSCT) said it faced "extreme pressures" in its hospital emergency departments but could not comment on individual cases due to confidentiality. “For the full nine days I was in this alcove,” she told BBC Radio Foyle’s North West Today programme. “It’s basically the nurses' locker room. You can see the nurses’ lockers with their names on them. They [staff] just said there’s not enough beds,” she added. A privacy screen did not fully cover the room’s doorway and she had no access to a private bathroom. She said she was forgotten about at meal times on three occasions. A spokesperson for WHSCT said, "We are acutely aware of the continuing challenges and extreme pressures not just in our emergency departments but across both of our acute hospital sites with full escalation of beds on all wards and departments. In the Western Trust, when we learn of examples where care falls below the standard we expect, we review the circumstances and explore ways to improve care in the future." Read full story Source: BBC News, 11 April 2024 -
News ArticleIn the next few days, once the data has been collected, the Government will come out and say that, thanks to its policies, the situation in A&E is improving. Despite estimates released recently by the Royal College of Emergency Medicine that soaring waits for A&E beds led to more than 250 needless deaths a week in England alone last year, the Government will point to declining numbers of patients who breached the four-hour target this March. The four-hour target means we're meant to see and either discharge or admit patients within four hours of their arriving in A&E. But it's a sham, writes Professor Rob Galloway in the Daily Mail. Because, for the past month, the four-hour data has been manipulated, the result of two policies introduced earlier in the month by the Government. Read full story Source: Daily Mail, 3 April 2024
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Content ArticleNHS England’s response to claims of excess deaths due to long A&E waits leaves a lot to be desired, writes Steve Black for the HSJ. The Royal College of Emergency Medicine (RCEM) claim that more than 250 A&E patients are dying each week because they waited more than 12 hours to be admitted. If long waits in A&E are killing an extra 250-400 people every week, it is the biggest performance problem in the NHS. NHSE should urgently ask their analysts to rework this analysis with current data to test (or refute) the validity of the claim. The first step to solving a huge problem is admitting the scale of the problem, not denying it exists. This analysis features a refinement of the RCEM estimate that includes estimated mortality from waits between four and 12 hours. This increases the estimate to 400 extra deaths per week compared to the RCEM number of 250.
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News Article
Tenfold rise in A&E patients waiting more than 24 hours for a bed
Patient_Safety_Learning posted a news article in News
More than 150,000 patients had to wait a day in A&E before getting a hospital bed last year, according to new data. Freedom of information data compiled by the Liberal Democrats from 73 hospital trusts – about half the total – found that the number of patients forced to wait more than 24 hours in A&E before a bed could be found for them has increased by tenfold since 2019. The majority of those forced to wait were elderly or frail, with two-thirds of the patients over the age of 65. Read full story Source: Guardian 8 April 2024 -
News ArticleA gran was left lying outside in the cold facing a seven hour wait for an ambulance following a fall before finally being rescued — by firefighters. Betsy Hulme, 83, was left in agony with a broken hip when she tumbled in her back garden in Leek, Staffordshire. Son Steve, 60, a former ambulance technician, dialled 999 only to be told it would be several hours until paramedics could get to them due to long handover delays. After a further three hours of Betsy waiting on cold concrete slabs while soaked in rain water, desperate Steve decided to drive to a nearby fire station to ask for help. Fire crews then came to rescue to lift gran-of-four Betsy into her son's car who took her to hospital where she remains after undergoing a hip repair operation. Dad-of-two Steve, of Leek, has now branded emergency response times as “absolutely disgusting”. He said: "It’s opened my eyes if I’m honest. It’s absolutely disgusting. I’m so grateful and thankful to the fire service - but it really isn’t their job. I can't remember in my time working as an ambulance technician going to someone and saying, 'I’m sorry it’s taken us twelve hours to get here'." “It was never anywhere near those ridiculous times when I worked there until 2000 and something has gone drastically wrong since. I can't speak highly enough of the boys and girls who work in the NHS, it's the people above them. Its systemic change that's needed." Read full story Source: Wales Online, 4 April 2024
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Content ArticleRead the Royal College of Emergency Medicine's general election manifesto. A one page summary is below and the full manifesto can be found at the link at the bottom of the page.
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News Article
NHS watchdog to review patient safety at Glasgow A&E department
Patient Safety Learning posted a news article in News
Patient safety in the Accident & Emergency unit at the Queen Elizabeth University Hospital in Glasgow will be reviewed by an NHS watchdog. Healthcare Improvement Scotland (HIS) was first contacted by 29 A&E doctors in May 2023 warning that safety was being "seriously compromised". HIS last month apologised for not fully investigating their concerns. The review will consider leadership and operational issues and how they may have impacted on safety and care. In the letter to HIS, the 29 consultants highlighted treatment delays, "inadequate" staffing levels and patients being left unassessed in unsuitable waiting areas. They claimed this resulted in "preventable patient harm and sub-standard levels of basic patient care". The doctors also said critical events had occurred including potentially avoidable deaths. The consultants said repeated efforts to raise the issues with health board bosses "failed to elicit any significant response". Read full story Source: BBC News, 4 April 2024 -
Content ArticlePrime Minister Rishi Sunak promised speedier care, but specialists believe long waits for hospital beds are costing thousands of lives. The pledge he made in January last year, as one of five priorities on which he said voters should judge him, was that “NHS waiting lists will fall and people will get the care they need more quickly”. New calculations by the Royal College of Emergency Medicine (RCEM) show that, with regard to the broader aim of delivering speedier treatment, his government is falling shockingly short.
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News Article
Long A&E wait times lead to more than 250 needless deaths a week
Patient Safety Learning posted a news article in News
More than 250 patients a week could be dying unnecessarily, due to long waits in A&E in England, according to analysis of NHS data. The Royal College of Emergency Medicine analysed the 1.5 million who waited 12 hours or more to be admitted in 2023. A previous data study had calculated the level of risk of people dying after long waits to start treatment and found it got worse after five hours. The government says the number seen within a four-hour target is improving. This is despite February seeing the highest number of attendances to A&E on record, it adds. The Royal College of Emergency Medicine (RCEM) carried out a similar analysis in 2022, which at that time resulted in an estimate of 300-500 excess deaths - more deaths than would be expected - each week. The analysis uses a statistical model based on a large study of more than five million NHS patients that was published in 2021. RCEM president Dr Adrian Boyle said long waits were continuing to put patients at risk of serious harm. "In 2023, more than 1.5 million patients waited 12 hours or more in major emergency departments, with 65% of those awaiting admission," he said. "Lack of hospital capacity means that patients are staying in longer than necessary and continue to be cared for by emergency department staff, often in clinically inappropriate areas such as corridors or ambulances. "The direct correlation between delays and mortality rates is clear. Patients are being subjected to avoidable harm." Read full story Source: BBC News, 1 April 2024
