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One in five accident and emergency units relies entirely on junior doctors at evenings and weekends, according to a report by the College of Emergency Medicine. The study of more than 130 casualty units said that NHS departments were struggling to provide safe care, with doctors working in "intolerable" environments that place patients at risk. In some cases, gaps at evenings and weekends were filled by "middle-grade" doctors, those who have finished basic training but are still learning specialist skills and have yet to qualify as a consultant. However, at one in five A&E units, junior doctors fresh from medical school were the most senior staff working at evenings and weekends. The Foundation Trust Network also warned that casualty units are close to collapse within a year. The Foundation Trust Network (FTN) criticised the funding system in England which penalises A&E units that oversee a rise in patients.
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The Daily Mail reports that Robert Francis told the Nursing Times and Health Service Journal in an interview that he was concerned the nursing profession was failing to make urgent improvements following the Mid Staffordshire scandal. Mr Francis led the inquiry into the Mid Staffordshire care failings and made 290 recommendations for the health service on how to improve care.
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Hospital staffing levels ‘unsafe’ Senior nurses have issued an "unprecedented warning" about hospital ward staffing levels in England. The Safe Staffing Alliance, which includes the Royal College of Nursing and Unison, says wards regularly have one registered nurse caring for eight patients - which they say is unsafe. The warning comes in the wake of a study by Southampton University that found hospitals with more than eight patients per registered nurse would see about 20 more deaths a year than better staffed hospitals. The story was reported in BBC News Online, The Independent, The Daily Mail, The Sun, The Guardian, The Daily Telegraph and The Daily Mirror. Howard Catton, Head of Policy was interviewed by BBC News Channel.
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Levels of demand on NHS accident and emergency departments in England have been described as unsustainable by the head of the health service regulator. Care Quality Commission Chairman David Prior said there was no guarantee that another disaster like that at Stafford Hospital could not happen in future. Mr Prior's comments came at a conference hosted by health think tank the King's Fund. Dr Peter Carter was interviewed this morning by BBC News agreeing with Mr Prior’s comments that the system is under huge strain.
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The BBC reports more than £12.5m was spent on agency doctors and nurses in Hereford and Worcester in 2012, according to figures obtained through a Freedom of Information request to both trusts. Figures show the bill for agency staff increased by £4m from 2011 to 2012 and included one example of nearly £1,000 being spent on a single shift. The Worcestershire Acute Hospitals NHS Trust spent £7.7m on agency doctors and £1.9m on agency nurses in 2012. Wye Valley NHS Trust spent £1.3m on agency doctors in the same period and £1.5m on agency nurses. Paul Vaughan, Director of the Royal College of Nursing in the West Midlands said the use of agency staff was necessary to manage peaks in demand, and there had been some "huge and unprecedented" pressures on A&E departments and acute hospital beds over the last winter. He added: "At the end of the day, wards do need to be staffed adequately so patients are safe and well cared-for. But an over-reliance on agency staff is not only expensive to the NHS and the taxpayer - because what the agency nurse is paid is usually far less than the agency receives - it also means it's more difficult to provide continuity of care for patients as the nursing staff are continually changing."
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