Are A&E Departments in Intensive Care?

16th December 2013

Perhaps tellingly, treatment in A&E ranks highly in the list of the most common areas of medical negligence, with claims centred on misdiagnoses or failures to refer to a specialist department. At Fletcher’s we deal with such claims on a regular basis.

The causes and effects of spiralling numbers of A&E visitors are themselves plentiful but one outcome is undeniable – pressure.

One of the biggest factors in creating this pressure is a lack of staff, with simply not enough of them to deal with everyone who believes they need treating and those who are dealing with them working long hours with very little rest.

The sheer amount of people seeking treatment is, in some cases, almost overwhelming. On a basic level, the UK population is growing and therefore there are more of us making visits to hospitals. Another factor playing a part is unnecessary referrals, with a recent study by the Nuffield Trust indicating that one in five emergency admissions in England between 2001 and 2013 was avoidable and treatment could have taken place elsewhere, such as via a GP.

The issue of bed-blocking is also causing problems. This relates to people who can’t be discharged because of a lack of available social care, for example elderly patients waiting for a place to become available in a nursing home. The knock-on effect in A&E is that those who need to be admitted have to wait longer due to a simple lack of space.

We’ve already seen one of the most significant effects of A&E being ‘full up’, with some patients having to wait hours in ambulances outside hospitals because it’s too busy inside. In one case, a woman from Wales was left for nearly six and a half hours in an ambulance.

Alternative sources of advice, care and treatment are also under pressure – in some cases financially. More than 50 out of 238 NHS walk-in centres have closed since 2010, many because they actually became too popular and were costing too much. People who would have used these facilities will no doubt have faced having to wait at their nearest A&E instead.

Hospitals have targets when it comes to waiting times and 95 per cent of patients are supposed to be seen within four hours. In truth, some hospitals – particularly major ones – are falling below that mark and the onset of winter will surely only lead to more pressure.

Attempts are being made to deliver improvements, with one such example being a two-tier A&E system which could see A&E units being split into major emergency centres to treat seriously ill patients and the rest for those requiring less specialist care. Whether this will succeed is another matter.

For now, A&E departments are under scrutiny and subject to the pressures outlined above. And while the vast majority of patients will receive a good standard of care despite those pressures, the fraught atmosphere in many A&Es has the potential to lead to errors. At Fletchers, we can assist if you are unfortunate enough to suffer negligence as a result of mistakes made in A&E. And no matter what your circumstances, our team will be there to help from beginning to end.

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