'Urgent Action Needed' Over A&E

Urgent action is needed to ease the pressure on under-strain hospital emergency departments, according to the College of Emergency Medicine (CEM).

The body said A&E doctors are having to deal with a rising demand for services, made difficult by the "inadequate'' hiring and retention of skilled staff.

This is despite significant investment by the Scottish Government and NHS boards over the years, the CEM said.

CEM has published a list of 10 priorities to address the "sometimes overwhelming challenges'' facing emergency departments.

Current employment contracts should be revised to better recognise evening, night and weekend work as well as the intensity of emergency department work, it says.

Other agencies should share responsibility for the emergency workload and patients without acute illness or injury should be provided with an alternative to the emergency department.

Money must also be spent wisely and strategically, it said, and over-reliance on locums avoided.

The CEM has also identified steps it can take to boost employee numbers by promoting emergency medicine as a flexible and rewarding career.

President Dr Clifford Mann said: "The College has been warning for some time now about extreme pressure in the unscheduled healthcare system. These are most evident in the A&E departments and create sometimes overwhelming challenges for those working in these departments.

"Whilst this is a complex challenge and there a number of contributing factors the basic fact is that emergency physicians are working flat out to cope with the rising demand for services, in the context of inadequate recruitment and retention of skilled staff. Urgent action is required to protect patient outcomes and provide effective alternatives to emergency departments.

"The College, through its members and fellows, is playing its part. However, this crisis cannot be solved by us alone, we need urgent action by all stakeholders to work with us to provide a stable long-term future for A&E services whilst tackling the short-term immediate pressures.''

CEM represents more than 4,000 emergency department doctors and consultants in the UK. It sets and monitors standards of care and provides guidance and advice on matters relating to emergency medicine.

Scotland chairman Dr Jason Long said the college is in ongoing discussions with the Scottish Government on the issue of attracting and retaining a skilled workforce.

He said: "In the interests of a safe and quality service for emergency department patients, CEM Scotland will support the work of the Scottish Government and the wider NHS in Scotland in achieving the priorities of the CEM10 Scotland document.''

The Scottish Government has set up a working group to consider how best to tackle recruitment and retention in emergency medicine and said its £50 million "action plan'' has already seen 18 new consultants brought in.

Long waits in A&E have reduced by 65% and NHS Forth Valley and NHS Lanarkshire are piloting new methods to improve the flow of hospital patients and avoid blocking in emergency departments, the government said.

Health Secretary Alex Neil said: "I welcome this positive contribution from the College of Emergency Medicine Scotland to our ongoing joint efforts to improve A&E and unscheduled care treatment for patients across Scotland.

"The CEM Scotland are right to suggest there are ongoing challenges and we will continue to work in partnership to address them.

"Indeed, we are already making a difference. Across Scotland, local unscheduled care action plans are in place to deal with the issues raised and improve performance. This is part of our £50 million national plan which has closely involved the CEM and we believe will make long-term, sustainable improvements.''

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