Fix our ailing A&E units say West Midlands health chiefs

With unremitting pressures of exhausted staff reaching crisis point the heads of emergency departments across the West Midlands sent a letter to senior NHS bosses which calls on the Government to fix 'an emergency system failing to cope'.

The letter, signed by chiefs in Dudley, Walsall, Sandwell and Staffordshire as well as a host of others across the West Midlands, highlights the plight of the systemic problems within their emergency departments.

Today they outlined the growing pressures on their wards, revealing:

• Staff are exhausted and overwhelmed from their relentless workloads

• Patient safety is being put at risk from ‘toxic overcrowding’

• People need to stay away from A&E unless in a genuine emergency

The unprecedented A&E letter was signed by 18 heads from emergency departments and came about after bosses began liaising via email and held a summit meeting to discuss what could be done.

Chiefs at Wolverhampton refused to put their name to it as it is believed they felt the language to be too inflammatory and would upset patients.

Among those to sign it was Dr Bernadette Garrihy, who is the West Midlands representative for the College of Emergency Medicine. Ms Garrihy said that although the problem was by no means confined to the West Midlands, which has a population of 5.36m and sees 1.5m attendances every year, she and others wanted to speak up for the region.

Ms Garrihy called on commissioning groups to heavily involve A&E department heads in any restructuring, as they understood how emergency services needed to be configured. She added: "People don't always know what's available to them.

"What people do know is where their local hospital is and they know where the big red sign over the door is and they know that door never closes. This hasn't come around in the last six months, this has been building for years but I feel this year we reached the tipping point.

"If staff get burned out we're going to lose them and we're not attracting a great deal of people into this job now because it's seen as being so difficult and carries such pressure and risk."

The Express & Star saw first-hand the endless pressures staff are under when a team of reporters spent 24 hours in New Cross's A&E. Our report detailed patients being treated in corridors, people waiting hours in packed waiting rooms to be seen and alcohol-fuelled revellers being abusive and taking up staff's valuable time. Region-wide another issue to potentially add to the workload will be the decommissioning of services from Stafford Hospital, which could see A&E services transferred to other hospitals.

Stafford has reduced opening hours in its A&E department of 8am to 10pm, but bosses said they saw as many patients in those 14 hours as they used to in 24 hours.

Chris Holt, the chief operating officer at Mid Staffordshire NHS Foundation Trust, said: "Many of those people most definitely need to come to A&E but there is still a significant number who do not need emergency services.

"We continue to work with other health providers to make alternative services available."

Mr Holt said the trust, like many others in the region, found it challenging to meet a national target of seeing 95 per cent of all A&E patients within four hours of arrival.

The chief executive of Sandwell and West Birmingham Hospitals NHS Trust, Toby Lewis, said it was unacceptable to everyone in the organisation that they were not able to treat as many patients within four hours as they should do.

The trust invested £2m in emergency care last year, hiring physicians, doctors and nurses.

He added: "We believe that our vision of a single acute hospital in a new building in Sandwell and West Birmingham provides the best long-term solution for local people. We are all committed to improvements over coming months and are encouraged by the improvements seen recently."

Walsall continues to see high levels of activity in its A&E with traditional winter pressures continuing into spring.

Jane Tunstall, Walsall Healthcare NHS Trust chief operating officer, encouraged people to make use of the town centre's walk-in centre, which is open from 8am to 8pm, as well as their local pharmacies which could deal with minor ailments such as cold and flu-like symptoms.

She added: "We are keen to try and reduce the pressure on our services and minimise the impact that this can potentially have on our patients.

"We want the people of Walsall and the wider West Midlands to help support us during these times of high pressure and consider whether they need to come to A&E or whether they could be treated elsewhere."

The disturbing letter talks of hospitals delivering 'unsafe care' on a frequent basis and warns that a huge volume of patients has led to a 'state of crisis' and 'institutional exhaustion' in emergency departments. It states: "Following a winter and spring of sustained, extraordinary pressures throughout the EDs (Emergency Departments) in the region, we now believe we are in a state of crisis which needs to be more widely acknowledged and moreover urgently addressed.

"There is toxic ED overcrowding, the likes of which we have never seen before.

"Nurses and doctors are forced to deliver care in corridors and inappropriate areas within the ED, routinely sacrificing patient privacy and dignity and frequently operating at the absolute margins of clinical safety.

"What is entirely unacceptable is the delivery of unsafe care, but that is now the prospect we find ourselves facing on too frequent a basis."