Rising pressure in accident and emergency departments across the UK is leaving patients queuing on trolleys in corridors for hours or getting “lost” in hospitals due to repeated moves, senior nurses from the Royal College of Nursing have warned.
Janet Youd, chair of the RCN’s emergency care association, told journalists at the college’s annual congress that many emergency departments were seeing a return to practices of 15 years ago, when waits of 12 hours or more were common.
In the week ending 17 March 2013 emergency departments in England saw more than twice as many patients as the same week in 2012. Just 90 per cent of these patients were admitted, treated or discharged within four hours, compared with 95.3 per cent in the same week last year. The national target is 95 per cent.
RCN regional officer for the South East Patricia Marquis said the situation had deteriorated further in the past few weeks, with more and more reports coming in from worried accident and emergency nurses. She said at least one trust, Oxford University Hospitals, had started employing a “queue” nurse to look after patients waiting for space to become available for them to be triaged.
She said the introduction of the NHS 111 non-emergency phone number, which has been blamed for increased emergency demand in some areas, could have been the “final straw” but was not the main driver of rising demand.
Regional officer for the East of England Karen Webb said hospital consultants in at least three counties in her region talked of doing “safari rounds”, because their patients had been moved due to bed pressures and become “lost”.
She added: “Patients are woken up at three in the morning and moved around the hospital, cupboards and catheter laboratories are used to house patients. Across East of England these incidents are becoming increasingly commonplace.”
One nurse from Wales broke down in tears as he told of the “heart-breaking” situation in his hospital where patients had waited on trolleys for 24 hours and nurses struggled to find somewhere to take patients to wash.
RCN chief executive and general secretary Peter Carter said the system was not “coping”.
He added: “Rather than banter with the government about who is right and who is wrong, let’s come to terms with the fact the system is in crisis.”
Figures from the Department of Health show 17.3 million patients attended A&E in 2012, up by more than one million on 2011.
RCN nurse adviser on acute, emergency and critical care JP Nolan blamed the rise on the reduction in the number of NHS hospital beds without a corresponding rise in community services .
“For a long time there has been a perception the emergency department should solve the problems, but actually it’s beyond our control,” he said.
Mr Nolan is a member of the group set up by NHS England to review provision of urgent and emergency care. He told HSJ’s sister publication Nursing Times there was a need to take a more patient centred approach to how services are designed.
A DH spokesman, responding to the claims, said: “We know there are increasing pressures on A&E departments - they are seeing an extra one million more patients compared to two years ago but despite this are still trying to ensure patients don’t face excessive waits for treatment.
“At a local level, the NHS needs to ensure it has proper plans in place to deal with high demand on A&E. But it’s obvious that this isn’t just about A&E services in isolation it’s also about how the NHS works as a whole, and how it works with other areas such as social care.
“Local GPs are already leading great work in different parts of the country to prevent patients having to go to A&E in the first place, while Sir Bruce Keogh is already leading reviews of the way the NHS can work seven days a week, and of the structure of emergency care.”