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ANALYSIS: NHS chiefs need to act on A&E warnings

Lengthy A&E delays escalated which subsequently impacted on planned major surgeries, with almost 700 operations cancelled in January alone including some urgent cancer surgeries. Picture by Peter Byrne, Press Association
 
Seanin Graham

WHEN an elderly pensioner died alone and unnoticed on a trolley in a Belfast A&E four years ago promises of change were made. A former health minister intervened and vowed to overhaul a crippled system.

Strict new targets were set and the first of a series of troubleshooting groups were set up to tackle spiralling 12-hour waiting time breaches, with pledges that heads would roll if improvements weren't made.

While there were some signs of relative progress - though the four-hour waiting time target has rarely been met since its introduction a decade ago - endemic pressures led to the system crashing once again last Christmas.

Lengthy A&E delays escalated which subsequently impacted on planned major surgeries, with almost 700 operations cancelled in January alone including some urgent cancer surgeries.

A major new report on A&E treatment examined in today's Irish News focuses for the first time on the most serious patients requiring life-saving care and exposes flaws in an already overstretched sector.

While the authors are at pains to point out the alarming 25 per cent death rate must be treated with caution due to the small number of sample patients involved, it is nonetheless a concern against a backdrop of other worrying failings they expose.

Average waiting times to 'definitively treat' patients with life-threatening injuries are at an average of four hours - on battlefields in Afghanistan and Iraq, this would be measured in minutes, according to the co-author and brains behind the report, Dr Russell McLaughlin.

Access to urgent x-ray scans are also highlighted, while the rate of transfer to the Royal Victoria hospital from the north's other eight A&E departments are at a staggering 40 per cent.

Written by doctors, a deep sense of frustration penetrates this carefully prepared report which no doubt would never have seen the light of day had the authors been more forceful in tone. It is worth noting that no press release accompanied its publication and the audit itself is buried in the bowels of a health watchdog website.

But although cautious, the authors do not hold back on exposing how far the north lags behind in assessing and acting on research into our sickest A&E patients.

It is troubling that we are the only region in the NHS that does not collect information on the care and outcomes of life-threatening patients - an exercise routine in large parts of Europe for 25 years - and does not have a dedicated trauma network.

In his interview with the Irish News, Dr McLaughlin goes further and refers to the reduced death rates in other regions when such networks are introduced. He urges the creation of a dedicated trauma unit at the Royal to tackle "wholly unacceptable" waiting lists.

Perhaps it is time that the health minister and his scores of officials, commissioners and various troubleshooters listened to the medics at the frontline - and acted on their advice.

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