CONCERNS about bullying, staff shortages, and medics under intolerable pressure have been highlighted in an inspection report into emergency care at Belfast's Royal Victoria Hospital.
Initial findings of the Regulation and Quality Improvement Authority (RQIA) were revealed by health minister Edwin Poots yesterday.
The DUP minister commissioned the inspection after a 'major incident' was declared at the hospital last month due to a backlog of patients at the A&E unit.
At one stage on the evening of January 8, 42 people were waiting on trolleys.
Inspectors spoke to 100 staff at the hospital, and Mr Poots said some of the feedback was "cause for concern".
"The inspection has confirmed concerns about staffing levels in key areas, allegations of bullying, staff under intolerable pressure and a system of care that does not function fully as it was set up to do," he said.
"The concerns relate to the emergency department (ED) itself, to the acute medical unit, which is a 60-bed unit for the assessment and treatment of admitted patients, including many admitted through the ED, and to some aspects of the wider hospital and trust functions.
"There are genuine and heartfelt concerns from clinicians about the impact that this difficult situation is having on patients."
He said it appeared that concern about A&E targets "may have led to some unacceptable behaviour by some staff on some occasions".
But he warned there was no straightforward answer to the problems.
"If easy solutions were available they would have been adopted," he said.
The RQIA is examining accident emergency provision across Belfast and Northern Ireland and will report back to Mr Poots in June.
The chair of the assembly's health committee, Maeve McLaughlin of Sinn Féin, said the report's initial findings were "quite damning".
The SDLP's Fearghal McKinney accused the minister of failing to acknowledge there was a problem last month, calling the major incident a one-off.