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Nurses warn of A&E doctors on 'safari rounds' to find 'lost' patients

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Rising pressure in accident and emergency departments across the UK is leading to patients queuing on trolleys in corridors for hours and getting “lost” in hospitals due to repeated moves, senior nurses from the Royal College of Nursing have warned.

Chair of the Royal College of Nursing’s emergency care association Janet Youd told a press conference at the college’s annual congress many A&Es 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 A&E departments in England saw more than twice as many patients as the same week in 2012. Just 90% of these patients were admitted, treated or discharged within four hours compared to 95.3% in the same week last year. The national target is 95%.

RCN regional officer for the south east Patricia Marquis said the situation had got even worse in the past few weeks with more and more reports coming in from worried A&E nurses. She said at least one trust, Oxford Univeristy 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 the rise in demand.

 Regional officer for the East of England Karen Webb said hospital consultants in at least three counties in her region referred to doing “safari rounds” because their patients had been moved due to pressures on beds and become “lost”.

She said: “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.

Research by Nursing Times last year found the number of patients waiting more than four hours but less than 12 hours for admission from A&E in the first six months of 2012 had increased by 31% on the same period in the previous year.

Regional office for the south west Jeanett Martin told Nursing Times every trust in her region was experiencing extreme pressure.  She said Royal Cornwall Hospitals Trust had seen a 50% increase in attendances in the last weeks, 70% of whom required admission showing they were not inappropriate attendances.

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 Nursing Times there was a need to take a more patient centred approach to how services are designed.

A spokeswoman for the department of health 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.

  • 17 Comments

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Readers' comments (17)

  • DH Agent - as if ! | 25-Apr-2013 9:26 am

    Anonymous | 24-Apr-2013 7:14 pm

    I agree with you both but I think most of us think this way as we rather inconveniently tend to see the obvious which is what makes us such a nuisance and not to be listened to! maybe we just know too much like the three wise monkeys - multiplied by approximately 600,000 this could be highly problematic for the smooth running of the healthcare system! As the saying goes too much knowledge is dangerous, and in this case potentially fatal!

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  • hope they don't find any skeletons in the cupboards

    ;-o

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  • Fit a RFID to the ID band, these are the devices used in library books and security tags. Also use a bar code on the ID band, scan this in when a patient arrives on a ward and again when they leave. Suitable computer software, similar to that used for stock control in supermarkets,would then be able to track the patient from arrival to discharge. It's not rocket science and it would be relatively cheap as the hardware and software is already available, it just needs modifying to be fit for purpose.

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  • Anonymous | 26-Apr-2013 6:51 pm

    isn't human rights to freedom an issue there? it is turning the NHS into a prison.

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  • I thought it was only stressed out nurses that were found hiding in cupboards.

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  • I think the "cupboards" may be an issue reported in the press last year. My hospital uses treatment rooms as part of its escalation plan. Each ward has a treatment room which is used differently according to the ward's speciality. An ENT ward might use the treatment room for examining patients with nosebleeds, for example. Unfortunately, some of these rooms are used mainly for storage of equipment and patients felt that they were "put in a cupboard".

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  • Anonymous 26 April 7-14 pm, my suggestion does not entail tracking the patients every move just their general location. Every ward already does this by knowing when a patient is in radiology, physio or theatre for example. The hospital's patient database is manually updated when a patient is admitted, otherwise simple telephone requests from friends and family couldn't be answered. All I am proposing is automating this process. Why does it turn the NHS into a prison, and how is it a breach of the HRA? In fact it is essential that a hospital knows where each patient is at any particular time in case of fire or other emergency.

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