20th Aug, 2019

Alex A&E consultants had predicted crisis at embattled health trust

Ross Crawford 30th Mar, 2018

NEARLY 700 patients a month are waiting longer than 12 hours in the Accident & Emergency Department at Worcestershire Royal.

In a crisis widely predicted by four Alex-based A&E consultants in their resignation letter three years ago, Worcestershire Acute Hospitals NHS Trust (WAHT) has been told it cannot enter another winter with its current level of capacity.

Of those patients waiting in A&E, more than 460 are over 65 and more than 100 over 85 – the Government’s target is that all patients should be seen and dealt with within four hours.

A damning report by independent firm Carnall Farrar into the Trust’s Urgent and Emergency Care, speaks of a ‘siege mentality’ among staff in the Royal’s A&E department where poor performance against breaches in targets, including the care of patients in corridors, had become ‘normalised’.

It identified the centralisation of services at Worcester without additional bed capacity as a key driver impacting on A&E and says a planned increase in capacity in 2020 is simply too far away.

It says: “The Trust has a long history of poorly planned bed reductions stretching back some 20 years, which has led to the current situation where

patients are routinely cared for in a corridor because of the lack of capacity to do otherwise.”

With more patients having to travel from Redditch to the Royal it identifies increased attendances by ambulances as one of the causes of overcrowding in A&E.

On one Friday evening in February paramedics had to look after 31 patients in corridors at Worcestershire Royal.

On average ambulances are waiting one hour and 28 minutes when they could have been on duty for an emergency elsewhere.

The situation is so bad, in a letter to Trust chief executive Michelle McKay, Mark Docherty, director of clinical commissioning and service development at West Midlands Ambulance Service called for ‘immediate and radical action if we are to avoid a catastrophic situation’.

In their resignation letter back in March 2015, the Alex consultants, Richard Morrell, Sarah Crawford, Chris Hetherington and David Gemmell, said WAHT appeared to accept the massive overcrowding of A&E departments which was “a disgrace and a patient safety issue which causes serious harm to many patients and intolerable stress on all A&E staff”.

“This in our opinion is neither an A&E service nor a safe service,” their letter said.

A spokesperson for Worcestershire Acute Hospitals NHS Trust said: “The issues identified in the report are not new. We have a major programme of work relating to flow across the Trust and Carnall Farrar are providing valuable additional resource and expertise as part of a national arrangement put in place for Trusts facing the greatest challenges on Emergency Access standards. The Trust’s outline business case for additional capacity on the Worcester site was approved by the Department of Health in December, and the Trust is working with NHSi to progress the creation of additional capacity by next winter.”

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