Emergency Department staff speak out about appalling state of patient care in Northern Ireland

26 April 2018

In a survey published today entitled ‘What Emergency Department Consultants Really Think’, Emergency Department (ED) Consultants in Northern Ireland highlighted the difficulties facing emergency care within the context of insufficient resources. The questionnaire found that:    

98% of respondents think that Emergency Medicine in Northern Ireland is in a state of crisis.
89% agreed that the situation in their Emergency Department felt worse than previous years.
94% considered that patient dignity is compromised daily because of ED crowding. 
91% ‘strongly agreed’ that patients are at an increased risk of poorer outcomes due to crowding in their Emergency Departments.
98% of respondents agreed that there is an insufficient number of medical and nursing staff to cope with current demand in EDs.
97% said that they have at times felt stressed during their working day because of an inability to deliver high-quality care to patients. 
91% do not believe that it is sustainable working in emergency care in the current environment.

When asked to describe how it feels working day to day in an Emergency Department, contributors to the survey highlighted the challenges of being unable to deliver the high-quality of care to patients that they would like to with words such as: 

Ashamed, appalled, anxious, stressed, tired, fearful, helpless, impotent, guilty, let down, exasperated, angry, crushed, overwhelmed, worn-out, drowning, drained, deflated, demoralised, and disheartened.

Dr Ian Crawford, Vice President of RCEM Northern Ireland, said: “The combination of a growing and ageing population along with insufficient health and social care resources to match patients’ needs has resulted in ‘exit block’, crowding in Emergency Departments and declining four-hour performance.  

“We are not surprised by the findings of the survey. Northern Ireland’s emergency care workforce has been struggling to cope with the intense demands being placed upon them for a number of years. 

“The latest Emergency Care waiting time statistics released today show that in March 2018, only 59.3% of attendances at Type 1 Departments were treated and discharged, or admitted within four hours of their arrival. Furthermore, from January to March, the number of attendances waiting longer than 12 hours increased from 3,115 in 2017 to 9,567 in 2018 - a increase of 207%. These figures are a symptom of the extremely serious problems the NHS continues to face. 

“At the heart of this are patients. Patients whose welfare and dignity suffer whilst waiting in busy, crowded Emergency Departments for a vacant hospital bed, sometimes for 12 hours or even longer. Patients who may be harmed by a system that cannot cope. 

“As the survey demonstrates, these impossible conditions bring anxiety and frustration to the clinical staff trying to treat patients to the best of their abilities. 

“It is for the safety of our patients that we urge the Department of Health in Northern Ireland, NHS leaders and politicians to recognise the imminent need for sufficient capacity to meet demand. The implementation of the Bengoa Report alongside former Health Minister Michelle O'Neill’s 10-Year Vision has never been more crucial”.