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Hospital chiefs urged to tackle A&E crowding

  • 4 Comments

Up to half a million patients could be put at risk every year as hospitals struggle to admit patients to hospital wards from bursting A&E departments, the College of Emergency Medicine has warned.

As many as 500,000 patients across the UK could see their situation deteriorate as a consequence of “exit blocking”, the college said. Exit blocking occurs when emergency doctors recommend that a patient should be allocated a hospital bed but they are unable to be admitted in a reasonable time frame.

The college, which speaks on behalf of doctors and consultants working in A&E departments in the UK, warned that patients can suffer as a result of crowded emergency departments.

“Crowding, where an emergency department becomes gridlocked, occurs in all emergency departments from time to time,” guidance issued by the college to hospitals states. “Crowding is associated with increased mortality.”

CEM president Dr Clifford Mann said: “This is such an important issue. It is about the flow of patients from ambulances, through A&Es and into hospital wards.

“The simple fact is that crowding kills. It is simply not acceptable to let this situation continue which is why we are speaking out to urge hospital chief executives and their boards to make sure they have plans to deal with this issue.”

 An NHS England spokesman said: “We are very aware of the pressures facing hospitals when patients need care but cannot access beds in a reasonable time frame.

“The extra £400m that we have released will help during this winter. In the longer term, our Urgent and Emergency Care Review is making recommendations to reduce crowding in the hospital system, improving the experience and outcome for patients.

“The specific problems raised by the College of Emergency Medicine are considered in our 2014-15 planning guidance.”

  • 4 Comments

Readers' comments (4)

  • Urgent care <24hr CDU beds are critical and v helpful to this end. However they rely on proper funding as everything else. My experience in a hospital which shall remain anonymous was appalling. Lack of appropriately qualified nurses, bed management and Dr's. Needless to say it was a commissioned service, bent on financial restriction and blatant dismissal of concerns. Cobbled services with little planning or risk assessment, commercially sensitive transparency and marketised operation. Thing is the patients were utterly unaware. They think its NHS of old. So wrong.

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  • In the light of all this, how can the closure of so many A&E departments (e.g. 4 out of 9 in NW London) really be justified especially when the numbers of in-patient beds are being cut? A&Es are being replaced by Urgent Care Centres (UCCs). UCCs may help take a bit of pressure off the Minors side of A&E but in NO WAY are they equipped to deal with other A&E patients. Patients are confused about where to go. They turn up at UCCs and end up delaying their own treatment, where I work we regularly have to call 999 to get patients to an A&E (let me not forget to add the Ambulance services are severely overstretched already). My experience of working in A&E is that there is almost always a lack of in-patient beds to promote flow of patients out & free up trolleys in the Majors/ Resus areas. I have also experienced frighteningly inadequate staffing levels in A&E. Not all admissions from A&E have to be in for a long period - the person may just need overnight observation/ IV antibiotics and then be able to go home, but also in my experience the number of sick elderly patients with severe underlying health problems is increasing, and many of them DO need admission for longer periods to stabilise. And anyone saying they should be managed in the community is right, but ONLY IF THE RESOURCES ARE THERE. And guess what, the A&Es being targeted for closure are in some of the most socially deprived areas of London. Sometimes I think the government is trying to reduce the population that it doesn't think is worth it .........

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  • Answer:- Fast track, cat 4/5 presentations
    Emergency medical unit 12-24hr
    Flex up/down beds and staff to accommodate the need.
    Charge for ambulance
    Make some provision for private ED
    Just a suggestion ....

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  • good suggestions except charging for ambulances.

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