Bed cuts threatening A&E targets

18 Jan 07
Hospitals' attempts to recover financial balance are leading to longer waits at accident and emergency departments, the British Medical Association said this week.

19 January 2007

Hospitals' attempts to recover financial balance are leading to longer waits at accident and emergency departments, the British Medical Association said this week.

A&E departments were struggling to hit the government's access target – that 98% of patients wait no longer than four hours from arrival to admission, transfer or discharge, the BMA said. The main reason for this, according to a survey of emergency doctors, was lack of beds due to cost-cutting measures.

Don MacKechnie, chair of the BMA's emergency medicine committee, said: 'Many hospitals have cut bed numbers as part of their financial recovery plans and attempts to balance their books. This means that there are fewer available beds for patients coming through A&E.

'Working towards the four-hour target on A&E waiting times has been a fantastic achievement. However, respondents tell us that despite this success, the level of performance in many departments is proving unsustainable and these departments are finding it difficult to cope on a daily basis.'

Almost nine out of ten (87%) said bed shortages were the main reason for not meeting the target. A third claimed their trust had manipulated data to hit the target, while 53% said additional agency or locum staff were brought in to achieve it.

However, 65% of respondents in England reported that the figures submitted by their department showed the target had been met. The latest Department of Health figures show that 98.2% of A&E patients were seen, diagnosed and treated within four hours of their arrival in 2005/06.

Two-thirds of respondents said that some patients might be moved to inappropriate areas or wards and 58% said that patients might be discharged before they had been adequately assessed or stabilised.

Emergency doctors told the BMA that 19 A&E departments in England were at risk of closure, while 42 doctors reported that their department could be downgraded.

Martin Shalley, president of the British Association for Emergency Medicine, said: 'Attendances at urban A&E departments continue to rise and pressure on beds remains a significant factor for achieving the four-hour target. It is vitally important to separate acute and elective facilities so that each can perform efficiently.'

PFjan2007

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