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A&E doctors say pressure is threat to patient safety A&E doctors say pressure is threat to patient safety
(about 2 hours later)
Excessive pressure on A&E consultants has the potential to put patients at risk, doctors are warning.Excessive pressure on A&E consultants has the potential to put patients at risk, doctors are warning.
The College of Emergency Medicine said increased demand and the complexity of work was causing staff sickness and burnout.The College of Emergency Medicine said increased demand and the complexity of work was causing staff sickness and burnout.
Its survey of just over 1,000 UK consultants found six in 10 thought their jobs were unsustainable.Its survey of just over 1,000 UK consultants found six in 10 thought their jobs were unsustainable.
It comes amid mounting concern about the ability of A&E units to cope this winter.It comes amid mounting concern about the ability of A&E units to cope this winter.
At the start of this year, the NHS in England missed its target of fewer than 5% of patients waiting more than four hours, as waiting times hit their highest rates for nine years.At the start of this year, the NHS in England missed its target of fewer than 5% of patients waiting more than four hours, as waiting times hit their highest rates for nine years.
Ministers have since announced a £500m bailout fund for the next two winters to help those hospitals with the most acute problems.Ministers have since announced a £500m bailout fund for the next two winters to help those hospitals with the most acute problems.
The college has always maintained that a shortage of doctors is a contributory factor to the problems.The college has always maintained that a shortage of doctors is a contributory factor to the problems.
Previous reports have highlighted the fact that A&Es do not have enough consultants.Previous reports have highlighted the fact that A&Es do not have enough consultants.
The average is just over seven per unit when it should be 10 - and 16 for the largest hospitals - according to the college.The average is just over seven per unit when it should be 10 - and 16 for the largest hospitals - according to the college.
But now the college is warning that the shortages are beginning to affect the consultants who are in place.But now the college is warning that the shortages are beginning to affect the consultants who are in place.
BurnoutBurnout
In the survey, 94% complained they were working excessive hours - with more than half saying they were regularly doing more than a fifth extra on top of their contracted time.In the survey, 94% complained they were working excessive hours - with more than half saying they were regularly doing more than a fifth extra on top of their contracted time.
The report also uncovered a small, but growing problem with consultants emigrating.The report also uncovered a small, but growing problem with consultants emigrating.
Last year 21 left the UK compared with three in 2008.Last year 21 left the UK compared with three in 2008.
College vice president Dr Taj Hassan said: "Senior medical decision-makers in emergency medicine provide one of the most vital strands in maintaining safety.College vice president Dr Taj Hassan said: "Senior medical decision-makers in emergency medicine provide one of the most vital strands in maintaining safety.
"A failure to address these issues will compromise this ability and also further worsen the present workforce crisis.""A failure to address these issues will compromise this ability and also further worsen the present workforce crisis."
Katherine Murphy, of the Patients Association, said the situation was "unacceptable".Katherine Murphy, of the Patients Association, said the situation was "unacceptable".
"Patients have incredible respect for emergency medicine teams, but those teams need to be backed up with the funding they need to do their jobs without being stretched in this way.""Patients have incredible respect for emergency medicine teams, but those teams need to be backed up with the funding they need to do their jobs without being stretched in this way."
A Department of Health spokesman commented: "We know we need to do more to support emergency departments to do their important work through winter and beyond.A Department of Health spokesman commented: "We know we need to do more to support emergency departments to do their important work through winter and beyond.
"That is why we are investing £500m and we tasked Health Education England with developing plans to encourage more medical students to become A&E doctors in the future.""That is why we are investing £500m and we tasked Health Education England with developing plans to encourage more medical students to become A&E doctors in the future."
He also said a major review of the urgent and emergency care system - led by medical director Prof Sir Bruce Keogh - would be reporting shortly.He also said a major review of the urgent and emergency care system - led by medical director Prof Sir Bruce Keogh - would be reporting shortly.
Here is a selection of your views and experiences.
Helen Grimsmo, Devon
There needs to be recognition of the emotional stress, physical stress and demands of a career in Emergency Medicine when compared to all other careers. The pay structure in training should match that of Military medical trainees, that way recruitment and retention would be improved. A & E is a battle ground! The other issue is why would a graduate with an average of £50,000 debt choose to enter a career with reduced pay prospects (there is no chance of private income in EM), tougher hours, gruelling training, constant night and weekend work (family impact), loss of sleep, plus the pure, raw emotion of seeing/hearing trauma daily?
David Steward, Ipswich
Whilst there has been a lot of coverage on the shortage of consultants and nurses in A&E departments we have not seen the same call for the other supporting staff. For example, radiology departments are equally stretched at the moment and will also need expanding. Just employing more consultants will lead to more x-rays needed and therefore the hold-ups will simply move from A&E to other "supporting" departments, unless there is a plan to improve the whole service and not just the front end.
David Polkinghorn (FRCGP), Rotherham
Of course they need more - but not as much as GPs. Our workload has increased by a significantly greater amount without their massive investment over the last few years. My practice of 10,000 patients sees more daily than our local A&E. The media seems to think the NHS is hospital based. It is mostly in General Practice - 85%! with only 9% of the NHS money going into it. A proportion that is falling. If the public is serious about the future of a totally tax funded NHS it needs to wake up to the pressures GPs and community care is facing.
Sandip Patel, Uxbridge
I am a Emergency Medicine Consultant. I and many of my colleagues are working under tremendous pressure trying to provide a quality service to our patients. We are chronically understaffed despite significant attempts to recruit more doctors by my Trust. The situation is unsustainable and several of my colleagues are considering either leaving the country or early retirement. The antisocial hours and severe pressures deter junior doctors from choosing a career in my speciality.