Hospital management have warned the situation is “increasingly precarious”
&E patients at the Royal Preston Hospital are regularly waiting more than two days to be admitted to wards, doctors have warned.
Some of the most senior members of hospital staff shared their concerns in a letter to bosses at Lancashire Teaching Hospitals Foundation Trust as they warned that staff are reduced to tears by frustration and anger. The managers have raised concern over a lack of support from the rest of the trust and say that ambulances are regularly facing waits of more than four hours to handover patients.
Meanwhile, they also say it has become commonplace for more than 50 patients to be waiting for beds at the same time and that they wait for more than 60 hours to make it to a ward. The letter – dated March 30 – is signed by clinical director Graham Ellis, two unit managers, the specialty business manager, and the matron.
Details of the letter were first published by the Health Service Journal, which pointed out that clinicians have been raising safety concerns about the ED for several years behind closed doors but have not before gone public. In response, the Trust’s CEO Kevin McGee said patient safety and staff welfare were top priorities and noted that all NHS hospitals were facing similar pressures.
In the letter, the managers say the emergency department’s situation is “increasingly precarious”. The wrote: “For the past few months we have on a regular basis had more than 50 patients waiting for a bed and that wait being in excess of 60 hours.
“This means that at most times there is limited or no space to accommodate newly acutely ill patients causing ambulance handover delays of over four hours and delay in treatment.”
The letter continues: “This has a huge impact on members of staff who are working extremely hard but complete their shifts knowing they haven’t provided the care they would want to, are physically and mentally drained and despite their best efforts have seen patients suffer and have received negative comments from distraught relatives and carers. We have witnessed senior experienced staff crying with frustration and anger…”
It is also argued that there is a culture of using the ED as “the fall back for everyone”, where “each ward and assessment area claim to be full or have criteria preventing admission.”
The letter continues: “ED apparently has never-ending elasticity in the eyes of others…. ED should not be the solution to the problems of every other specialty. Why are we never considered full?”
According to the HSJ, the trust acknowledges there is an “urgent need” to improve the ED infrastructure, as it is too cramped for the volumes of patients it receives. In a statement to the journal, Mr McGee said: “The safety of patients and the welfare of staff remain the trust’s top priorities and we would like to express our ongoing thanks to our emergency department colleagues who continue to demonstrate commendable resilience and compassion to each other and our patients in very challenging circumstances.
“Like NHS providers across the country, our hospitals have continued to sustain unprecedented pressure which has been exacerbated by the covid-19 pandemic. Lancashire Teaching Hospitals has established and robust processes in place to ensure patient safety and discussions have taken place between emergency department clinicians and trust leadership to help collectively agree approaches to reduce the impact of concerns raised.”