AvMA Reaction to winter pressures in A&E

Published: 8 Jan 2015

This winter is seeing unprecedented pressure on accident and emergency departments right across the country. Much of the media attention has concentrated on hospitals not meeting the waiting time for admission target of 4 hours maximum. Whilst any decent service should aspire to assess, admit or treat and discharge patients within 4 hours, AvMA is more concerned about patient safety not being compromised and long term solutions being found to this problem. We will inevitably see more cases coming to us where there has been an unreasonable delay in assessing and treating patients, misdiagnosis and inappropriate discharge. Sometimes it will be in the patient’s interests to wait in A&E more than 4 hours. Clinicians need to be free to make decisions about priorities for admission on clinical grounds – not in a box ticking way to meet the target. Meanwhile, we agree with the College of Emergency Medicine that staffing levels in A&E departments need to be improved. Locums are used far too much at present to try to fill the gap. This is not ideal and is also very expensive – the money would be better spent employing permanent staff. Development of primary care centres attached to A&E have also been shown to relieve pressure on A&E.