Report on A&E raises staffing concern

Published Monday, 10 February 2014
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Health Minister Edwin Poots has described the findings of a report into the emergency department at the Royal Victoria Hospital as worrying.

The DUP minister commissioned the Regulation Quality and Improvement Authority investigation after a major incident took place at Belfast's main A&E ward in January.

On what should have been a routine evening, a backlog of patients caused 12-hour trolley waits and "scenes like Beirut" with dozens of extra staff having to be called in.

Mr Poots revealed last week that an inquiry was underway and on Monday the Assembly was briefed on the initial findings.

"I have been advised that the inspection identified a range of issues which cause me and my department to have serious concern about whether the Belfast Trust is consistently performing to the high standards that I require in executing its responsibilities," he told MLAs.

"I do recognise however that some of these are wider issues that cannot necessarily be addressed by the Trust on its own. The emerging findings help to put all the concerns that had been circulating into a clearer context.

I am glad to say that the Inspection confirmed that there is an overwhelming desire from the staff to be part of the solution and I want to assure members that this will happen.

Edwin Poots

"Nevertheless, this is a disappointing outcome and reflects the unacceptable experiences that many of us have had related to us by some patients and staff. I am resolved that this will be fully and comprehensively addressed as a matter of priority."

Health bosses were forced to declare a major incident at the Royal Victoria on 8 January with more than 100 patients left waiting for treatment.

The next day, hospital workers were so angry that they staged a protest and booed the Health Minister as he was driven away from the facility.

Mr Poots said RQIA inspectors have spoken to over 100 staff from a variety of roles and concerns were raised about staffing levels in key areas, allegations of bullying, staff under intolerable pressure, and a system of care that does not function fully as it was set up to do.

However he praised the efforts of front line staff for their "blitz-like spirit" and gave assurances of his commitment to improving emergency care in Northern Ireland.

"The concerns relate to the Emergency Department itself, to the Acute Medical Unit (AMU) and to some aspects of the wider hospital and Trust functions," the Health Minister explained.

"There are genuine and heartfelt concerns from clinicians about the impact this difficult situation is having on patients."

Politicians at Stormont were scathing in their reaction to Monday's findings.

Fearghal McKinney, SDLP, said: "Three weeks ago he refused to acknowledge there was even a problem, calling the Royal A&E incident a one off.

"Today he makes a statement to the Assembly on a review which he announced last week and doesn't even bring to the House the terms of reference of that review."

Health committee chair Maeve McLaughlin, of Sinn Féin, called the intial findings "quite damning".

She went on: "Is the minister now saying there is a crisis in emergency care and that this reaches beyond the Belfast Trust? It is welcome that the minister has now placed a focus on emergency departments, he should have done this a lot earlier.

"The inspection found that there are not enough doctors and nurses to provide the appropriate levels of care. Recruitment and retention of staff is an issue but how then can the minister say in his statement that he expects to appoint additional medical and nursing staff quickly - why can this happen now and didn't happen before?

"The minister has jumped from one problem to the next and really should be taking a pro-active grip of his department and ensure that when problems are identified they are dealt with and not left to fester and get worse."

© UTV News
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21 Comments
anonymous in Omagh wrote (64 days ago):
The Health Minister has closed 2 A/E departments One at Belfast city hospital and one in Lisburn at the Lagan Valley Hospital. Where area all the doctors, nurses etc. who had staffed these departments, can they not be called upon to staff the A/E dept. at the Royal Victoria Hospital in Belfast?? Clearly this is a paper exercise to cut costs and not about Developing better services as we were all hood winked into believing. 'Transforming your care' sold to the public in that they can and will be cared for in their own homes, nurse specialist's to monitor and look after them at home with a good Package of Care to meet their assessed need. Great idea, but not a penny to back it up. In reality the patients are needlessly suffering as the latest scandal from the R.V.H. hi-lights. We are getting to a stage where third world services are being implemented here. Trust's in Northern Ireland are too top heavy with many bands of managers. How many managers have we all seen step across to another newly created post, rather than being made face redundancy. The front line workers who face the public day and daily are left to pick up the pieces and face the wrath of the public. Directors and these decision makers are far removed from reality. This should be looked into through Freedom of Information, how much money are they costing an already crippled service, nowhere else in the world would this be allowed to happen, there should be more transparency, too many chiefs and not enough Indians has been the story for far too long.
ros mccartan in belfast wrote (64 days ago):
The problems do not end at AandE,people are discharged from hospital without the appropriate support to ensure their safety and comfort, because of the pressure to freeup beds to facilitate admissions.Staff employed to help set up safe discharge are constantly put under pressure to get patients out and are seen as obstructive if they raise concerns
Worked to the bone in Belfast wrote (64 days ago):
U should try 3 nurses for 25 in the wards at the royal!
No Name in Nowhere wrote (64 days ago):
There will be more pressure on the RVH & Ulster this is due to the centralisation of services to Belfast. Rural communities i.e. Down and South Down are being neglected. People are being forgotten about and a top heavy service looking after their own interests and not the public's seems to be the only HEALTH CARE MODEL in play.
pat in Belfast wrote (64 days ago):
I work in the belfast trust mr poots says its a one off! No it isnt, we canall see the cracks and youre trying to pretend all is well mr poots, its not only A and E mr poots, its all departments getting a knock on effect! Theres not enough staff to cope, so instead of employing more staff you close beds...this doesnt solve the pro lem, staff are frustrated and taking it out on eachother there is low morale, so many wanting to leave healthcare altogether, patients are not getting the care they deserve due to staff shortages, lack of supplies, we have amazing staff but are so overstretched theyre being made to look incompetent as they quite simply cant do it all and mistakes will happen
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