A&E units have become like warzones, top doctor warns

NHS casualty units have become like “warzones,” with medics fighting a losing battle to cope with an increasing tide of patients, one of Britain’s most senior Accident & Emergency doctors has warned.

Since January 406,000 people have waited more than four hours to be treated in A&E or admitted to hospital Photo: Alamy

The comments came as new figures show the number of patients waiting more than four hours in casualty units has almost doubled in just two years.

Dr Cliff Mann, from the College of Emergency Medicine, said Britain’s emergency care system had now reached “a tipping point” – with many A&E units simply overwhelmed by the numbers of patients arriving at their doors .

He said the rising demand for services had combined with a recruitment crisis as medics abandoned careers in emergency care because the pressures were now so extreme.

The statistics show that since January, 406,000 people have waited more than four hours to be treated in A&E or admitted to hospital – a 90 per cent rise on the 215,000 who waited as long during the same period in 2011.

Dr Mann, registrar at the College of Emergency Medicine, which represents A&E doctors across the UK, said: “It seems that we have reached a tipping point. The pressures have kept rising over the years and until recently we have absorbed it – but in the last three or four months we have just become overloaded.”

He said doctors were now increasingly unable to cope with the pressures being placed on them.

“It is the nature of A&E that sometimes doctors can be overwhelmed with demand – and that is part of the rough and tumble – but we have reached a situation where in many units, it is now like that every day,” he said.

“I am careful about likening A&E units to war zones because this is not a term you can use lightly, with respect to the situations faced by the military – but increasingly doctors are saying to me that their unit feels like a war zone, and I think that is fair – because what they are saying is that they have no control over their environment,” he said.

“When that is the case every day, your heart sinks, because essentially you are fighting a losing battle.”

His comments came amid increasing alarm about the situation in A&E departments across Britain.

Yesterday NHS England, the central body responsible for quality of health services issued emergency plans instructing hospitals and GPs to take urgent action to tackle problems and bring down waiting times.

That follows warnings from David Prior, the new chairman of health and social care watchdog the Care Quality Commission that emergency care is now “out of control” across swathes of the country.

He said too many patients were arriving in hospital as emergency cases when they should have received help much earlier, because of a lack of community services, and the decision by the last Government to allow GPs to opt out of providing out-of-hours services.

Dr Mann, an emergency medicine consultant at Taunton and Somerset NHS Foundation trust, said emergency medicine was suffering a major recruitment and retention crisis, with more than 200 vacant posts for trainees because the demands had become too tough.

“I don’t think anyone disputes now that we have got a serious problem and that the current system is under threat.

“Doctors who were considering emergency medicine turn away because of what they see – queues of ambulances outside hospitals and queues of patients on trolleys inside,” he said.

Others who had already specialised were emigrating, or taking lucrative work as locums because the demand for A&E doctors has become so high, he said.

Investigations by The Sunday Telegraph have found NHS trusts spending £2,700 a day for temporary doctors to staff casualty departments.

Dr Mann said: “At the moment we have the absolutely ludicrous situation that there are A&E doctors out there working with locums earning three, four or even five times their money, often without the same level of skill.

“We are not going to solve this problem unless we increase the number of people we have who are available to see patients,” he said.

Analysis of hospital trust waiting times by Health Service Journal discloses that the number of patients waiting more than four hours in A&E has risen by 50 per cent in just one year, and by 90 per cent since 2011.

The figures also show that in the first three weeks of April, one in ten patients waited more than four hours before being were treated or admitted to a hospital ward.

Since 2004, the number of patients arriving at A&E has risen by four million, records show