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Crowding and exit block cause rise in mortality rate

emergency department patients and staff bear the brunt of failings in other parts of the health system. If we are to make any improvements to emergency care, we must address the acute and ongoing health care and social needs of our ageing population, and provide adequate inpatient and community capacity for them. ‘The report also refers to the wellbeing of staff working in crowded departments. The daily pressure from managers to prevent breaches is driving many to seek work in other areas of health care. The result will be a workforce without the expertise necessary for safe care.’ British Medical Association council chair Mark Porter said: ‘As this report highlights, exit block is letting down patients who depend on emergency departments. ‘This is because exit block, coupled with a shortage of hospitals beds, can leave patients waiting for hours on trolleys. Or they may be admitted to wards that are inappropriate to their needs, which affects the quality of care they receive.’ See analysis, page 11

Royal College of Emergency Medicine report claims that delays account for hundreds of deaths a year

Increase in 12-hour waiting-time breaches in Northern Ireland

The launch of its review comes after the health secretary Jeremy Hunt announced a plan to reduce the number of avoidable deaths in the NHS. According to RCEM, exit block ‘accounts for hundreds of deaths per year’ so tackling it must be part of Mr Hunt’s initiative. Burnout College president Cliff Mann said: ‘Exit block remains a serious problem. Where it occurs, mortality rates increase, operations are delayed, and overworked staff in emergency departments experience stress and burnout. We are calling on hospital chiefs across the country to implement our recommendations for tackling this pernicious problem.’ RCN Emergency Care Association chair Janet Youd said: ‘This report highlights that

Find out more For details of the Exit Block campaign, go to tinyurl.com/nhe2tcl

Media Wales

By Nick Lipley THE LATEST report by the Royal College of Emergency Medicine (RCEM) highlights how performance against the four-hour standard has deteriorated across all four UK nations. The report, Exit Block in Emergency Departments: 6 Month Review, gathers together research on crowding and ‘exit block’ in urgent care services, along with emergency care consultants’ personal accounts of the effects of these on their emergency departments (EDs). The college launched its Exit Block campaign in September, and wrote to healthcare-provider chief executives asking them make tackling exit block a priority. Six months on, and following increases in winter pressures and ED attendances, the college wants to reaffirm its commitment to the issue.

LATEST GOVERNMENT figures show there has been a 59% increase in 12-hour emergency waiting-time breaches over the past year in Northern Ireland. Provisional statistics for January show that the percentage of patients treated within the four-hour target at major acute hospital emergency departments fell from 71.8% in January 2014 to 71.4% a year later. The number of patients waiting more than 12 hours increased over the same period by 224, from 156 to 380. Ulster Hospital reported the largest increase, from 19 to 237. At Antrim Area Hospital, the number of twelve-hour breaches fell from 94 to 42. Find out more For details, go to tinyurl.com/om2uf5k EMERGENCY NURSE

University of Wales Hospital, Cardiff, security officer Heather Johnston with one of the cameras issued to staff

Keeping an eye on crime Cardiff and Vale University Health Board (UHB) is the first health board in Wales to provide staff with body-worn security cameras to help protect them from abuse and violence. The cameras have been commissioned to reduce the likelihood of violent assaults against staff at the health board, where one quarter of incidents against NHS staff in Wales occur. Junior sister in the emergency unit Jacqui Westermoreland said: ‘As a nursing sister, I look after the staff and patients, but I am often asked to deal with incidents. I have been verbally abused, physically abused with kicks and punches, and have been spat at. The cameras will help me feel at ease. ‘All the staff welcome the cameras. They will offer us opportunities to prosecute.’

March 2015 | Volume 22 | Number 10

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