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‘Fragile’ A&E departments hit by spate of nurse resignations


Seven nurses have resigned in just two months from a trust’s under-pressure accident and emergency departments in the Midlands, with at least one flagging patient safety concerns.

Shrewsbury and Telford Hospital NHS Trust confirmed the resignations and that one of the nurses had expressed concerns about safety within the department during an exit interview.

“One nurse who recently left her position in A&E did raise concerns about safety”

Simon Wright

Trust board papers published this week stated that throughout June and July there had been five resignations at the Royal Shrewsbury Hospital and two at the Princess Royal Hospital.

These comprised one band 6 and four band 5s at the Royal Shrewsbury and one band 6 and one band 5 at the Princess Royal.

The papers noted that eight new starters were expected to be commencing in post in September, though it did not describe their banding level.

“Whilst this is positive, there will be an impact upon the skill mix of the departments through losing experienced staff,” warned the board documents.

The report highlighted that nurse staffing levels were a “concern” because it meant the trust had to use meant high levels of temporary agency staff.

“Over the last four-week period an average of 44% agency usage has been required. On some shifts recently there has been 75% agency versus 25% substantive,” said the Services under the Spotlight report.

“The fragility of our A&E departments is well known”

Nigel Lee

It added: “Both ED’s now have permanent practice development nurses to support the development of the nursing teams and co-ordination of the department however they are regularly pulled into clinical roles due to current staffing gaps.”

The two departments are among a “number of services currently provided by the trust that are considered fragile due to workforce constraints which impact on service delivery”, noted the report.

The trust is currently going through a consultation on the reconfiguration of its A&E, which will see the majority of emergency services move to the Royal Shrewsbury Hospital.

Last month, regional directors at NHS Improvement called on neighbouring trusts to provide Shrewsbury and Telford with clinical support for its emergency department.

However, none of them could help due to their own work pressures, according to papers published by Shropshire Clinical Commissioning Group.

“We have raised concerns jointly with the trust with NHS Improvement and NHS England”

Julian Povey

Trust chief executive Simon Wright said: “A risk review was recently carried out at the request of both CCGs and the trust. The review looked at a number of issues including workforce capacity.

“There have been long-term issues around the shortage of A&E staff, including consultants, middle grade doctors and nurses, which haven’t been resolved despite recruitment efforts,” he said.

“One nurse who recently left her position in A&E did raise concerns about safety,” he said. “A&E has managed to keep open thanks to the dedication of the staff trying to cover shifts, but this is just not sustainable.

Mr Wright added that the trust was “working hard to recruit additional nurses and in September the Trust will see 63 new nurses and nurse associates join”.

Nigel Lee, the trust’s chief operating officer, said: “The trust is continuing talks on the best way of keeping patients safe in the event of fragile services becoming unsustainable.

Shrewsbury and Telford Hospital NHS Trust

Trust told to improve staffing and safety in maternity units

Source: Row17

Princess Royal Hospital in Telford

“The fragility of our A&E departments at the Princess Royal Hospital in Telford and the Royal Shrewsbury Hospital is well known, having been discussed by our own board and in meetings with our partners, as well as being the subject of a great deal of coverage in the media,” he said.

Dr Julian Povey, GP clinical chair at Shropshire CCG, said: “We take these concerns very seriously and are working closely with Shrewsbury and Telford Hospital NHS Trust to monitor the safety of the A&E department.

“We have raised concerns jointly with the trust with NHS Improvement and NHS England as to the sustainability of staffing across the two A&E Departments,” he noted.

“Among the actions are daily assessments of staffing, a process which the CCG’s nursing director is involved,” he said.

He added: “We are currently going through a public consultation on the reconfiguration of the Royal Shrewsbury Hospital and the Princess Royal Hospital A&E’s, which aims to improve the way our hospital services are delivered by providing a long term, sustainable solution.”


Readers' comments (5)

  • I think it’s time to change the way we run our A &E Department’s and the answer is bring in paramedics and they will allow nurses to get back to real nursing

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  • Tis is awful but its nothing new and can be seen across the NHS ! Our ward has lost 11 staff in the last six months, 2 left for career progression, the rest were simply tired of the unreasonable pressure and demands . Our team is constantly working harder than is humanly possible and it is not sustainable.
    Sickness levels have increased, we have many shifts without a nurse in charge in order to save the budget, but no one is saving the nurses, its impossible to provide even some of the basic care and the nurses fear that something will go horribly wrong and it will be us and not management that are called to account.
    The NHS needs to recognise that frontline staff are their most valuable asset and that this is not where money should be saved. This is why I will soon be one of the 11.

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  • Anon 7:18 such a great idea! As you would know there is already an abundance of paramedics who are laying about doing nothing so we might as well bring them in to cover nursing shortfalls

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  • Don t think any ward or hospital is safe

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  • It's down to money. If the public want low taxation, then the NHS (and other public services) will continue to be starved of resources, and in the face of relentlessly increasing demand will collapse. The Govt need to admit that we get what we pay for. I would also say that the front line staff are grossly underpaid, unlike the high echelon management who receive very good pay with bonuses for service delivered by said front line staff!

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