Doctors in acute medicine paint “worrying” picture of NHS

Doctors working in acute medicine have painted a “worrying” picture of the NHS in a survey reported today (Friday) by the Society for Acute Medicine.

The body, which represents more than 1,000 clinicians who deal with patients who present to hospital with medical emergencies, surveyed its membership ahead of its spring meeting in Cardiff.

Nearly 94% said their units faced regular problems providing a full quota of medical staff for their units and 85% reported permanent medical staff work extra shifts to maintain staffing levels, while 91% said their units employed locum trainees and 60% locum consultants.

More than two-thirds (70%) said their acute medical units do not have a full quota of permanent nursing staff, 67% had experience of patients being moved from their units without being seen by a consultant and 64% recorded consultants being asked to work overnight because of staff shortages.

“During the past winter acute medicine was again at the forefront of supporting the increasingly-pressured NHS to deliver the very best care for patients,” said Dr Mark Holland, president of SAM.

“However, having sought the views of our members, we have identified many barriers impeding them from delivering the care they aspire to give their patients. Clearly we find this very worrying.”

In relation to full medical staffing on acute medical units, which saw almost all respondents report regular problems, 86% said the problems occurred mainly during weekdays out of hours and 84% on weekends.

In addition, more than 57% of units have also faced the situation where they have more patients than beds and 92% of consultants said they regularly started their working day with patients in the emergency department waiting for a bed.

“The range and significance of the problems we have seen suggests that we have a system-wide problem as opposed to isolated pockets of difficulty,” explained Dr Holland.

“The increasing volume of work coupled to a perceived inadequate hospital bed-base were high on the list of concerns of acute clinicians, as was the inability to recruit and retain both medical and nursing staff.

“Most importantly, our members expressed concerns about delivering high quality care when they are seeing and caring for people in inappropriate environments, such as corridors.”

Dr Holland added: “We report these figures and the views of members today simply because they reflect the working conditions in acute medical units up and down the country.

“There is an NHS-wide workforce crisis and everyone acknowledges the desperate need for change.

“An immediate objective must be to improve the working environment for our staff to enhance recruitment and maintain retention.

“We need to make substantive posts as attractive as locum positions, a move which would enhance our service and save money.”

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