Desperate health managers are set to move GP surgeries into overwhelmed A&E departments in Birmingham.
The move comes as it was revealed that West Midlands hospitals are in “a state of crisis”, with senior staff admitting the safety of patients could not be guaranteed.
Soaring demand for accident and emergency services have led Birmingham’s Clinical Commissioning Group, the new body responsible for overseeing healthcare, to review urgent care arrangements across the city.
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And the huge numbers of people visiting A&E with only minor ailments is leading to the decision to bring GPs into the departments.
There are also widespread problems with the new 111 phone service, replacing NHS Direct, meaning patients are instead chosing to go direct to A&E.
A joint letter signed by 18 A&E managers, including those from Solihull, Mid-Staffordshire, Sandwell and West Birmingham, Solihull and Birmingham Children’s Hospitals and the Heart of England Trust and sent to hospital chief executives warned that a massive increases in demand for services had placed hospitals under so much pressure that there was an “increase in serious clinical incidents and complaints”.
The letter said: “Following a winter and spring of sustained, extraordinary pressures throughout the emergency departments in the region, we now believe we are in a state of crisis which needs to be more widely acknowledged and moreover urgently addressed.” It continued: “There is toxic emergency departments overcrowding, the likes of which we have never seen before. Nurses and doctors are forced to deliver care in corridors and inappropriate areas within the ED, routinely sacrificing patient privacy and dignity and frequently operating at the absolute margins of clinical safety.
“We regularly see our EDs overwhelmed with patients, with all cubicles occupied, and no egress into the hospital forthcoming, while patients continue to pour through the doors. Our departments are simply not equipped to safely care for such numbers of patients, an increasing proportion of whom are elderly and frail with complex medical, nursing and social needs.
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“All of the available evidence demonstrates that in-hospital mortality is increased when the emergency departments is overcrowded and patients have to wait excessively for beds. Such overcrowding is now the norm in our emergency departments.
“In addition, we are seeing an inevitable and unsurprising increase in serious clinical incidents and complaints, as well as delays and deficiencies in care. And for every incident reported, we know there are multiple examples of substandard care that go under the radar. We and our staff are carrying a huge burden of clinical risk which no other agency seems willing or able to share.”
And they warned: “The position is such that we can no longer guarantee the provision of safe and high quality medical and nursing care in our emergency departments. It is not a case of standards slipping, but the inevitable consequence of being forced to work in sub-standard conditions.”
In April, the Birmingham Post revealed that the number of patients forced to wait hours for treatment has shot up at many West Midlands hospitals.
At least 98 per cent of patients attending A&E should be seen, treated, admitted or discharged in under four hours under government targets, but the latest NHS data shows the target was missed across the region.
Gavin Ralston, chair of Birmingham CrossCity CCG, said: “We do... recognise that large numbers of patients are going to A&E and that an increasing proportion of those attending are unwell and very complex to treat. This is why we are reviewing urgent care arrangements across the city.
“In the Birmingham CrossCity CCG area we continue to work with member practices, our patients, the local hospitals, community services, the local council and all other interested groups and we are currently exploring a number of ideas for improvements.
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“These include piloting co-location of a GP-led service within an A&E department. The evidence nationally is that this is both a safe and effective arrangement. Any changes will initially be made at a local level as a pilot to make sure they work well.”
It was revealed last month that the NHS was also considering moving one walk-in centre into a hospital in the city.