NURSES have worked 90-hour weeks at Poole Hospital to cope with demand for its emergency department – but one patient was still left waiting 14 hours on a trolley before being treated.

Dr Gary Cumberbatch, clinical director for emergency care at the trust, revealed the shocking workload of staff and the impact it had on patients after a period in December he described as “the worst the department has ever had”.

The hospital missed government targets requiring 95 per cent of patients to be dealt with within four hours and declared an “internal incident” in December due to “unprecedented pressure”.

Dr Cumberbatch said there was a 16 per cent year-on-year increase in emergency admissions between December 24 and 28 – 40 per cent of which was among people older than 70 – prompting doctors and nurses being called back into work from leave.

“We have had nurses working as many as 90 hours a week,” he added.

“Previously we always worked those sorts of hours. Doctors used to do 108 hours a week when I was training and that was acceptable.

“Now those hours are not acceptable.

“As long as they have had decent breaks they are safe. They are not allowed to nurse and do those hours unless they are still within the rules.

“For example, they have to have 11-hour breaks between shifts.”

At one point the hospital required 75 extra beds and patients were left on trolleys in corridors and parts of the hospital never used before for emergency admission were utilised, said Dr Cumberbatch.

“We had one patient approaching 14 hours waiting on a trolley and others coming up to 12 hours,” he added.

“The ambulances were coming in and we had nowhere to take them. We had patients in the corridors.

“The waiting room capacity is for 40 and there were around 60 – so there wasn’t even the seating capacity to seat everybody.”

Asked by the Daily Echo whether there was anything more the hospital could have done to prepare, Dr Cumberbatch said: “Categorically no. This was a four-day bank holiday – we knew what was coming.

“We know social services are not going to have their social care packages ready and they will only open on Monday, if we are lucky.

“Everything was done before to try and empty the hospital in the knowledge we had a four-day bank holiday. Despite all those measures, this still happened.”

Not enough GPs to ease burden

A LACK of GP availability and a culture of impatience added to Poole Hospital’s bed crisis over Christmas, its emergency care chief has claimed.

Dr Gary Cumberbatch said an exceptionally-high volume of acutely-ill patients caused the problems, but that the burden could have been reduced with greater access to GPs.

He cited the 2004 General Medical Services contract, introduced by the last Labour government, which effectively ended regular weekend and evening working for GPs.

“Without a shadow of a doubt if primary care was open seven days a week uniformly then that would certainly reduce the burden,” he added.

“It doesn’t help that the GPs contract stopped seven-day working – some of them were not comfortable with that.

“A lot of patients we have come from nursing homes – they have suddenly become unwell, they are a complex patient with complex needs. They are in this hospital and here for some time.

“Any attempt to keep them in the nursing home by the supporting GP goes a long way and is nicer for patients where they are in an environment and staff know their needs.

“Some of them can’t communicate very easily, but if they have been there [the care home] for a year then staff know exactly how to look after them. Actually bringing them in here [to the emergency department] is unfair, but often they have no choice because they can’t get the GP access.”

Dr Cumberbatch said tourists visiting the area and not temporarily registering with their GPs had added to the problem.

However, he also laid blame on patient behaviour and that many do not call their GP in the first place.

He added: “I think there is a change in culture where the young want everything now. We will get an elderly lady with a busted wrist, who has had it for two days, who will apologise for using the service.

“Equally, I will have a patient saying ‘I am paying taxes – why aren’t I being seen in 20 minutes?’

“It is a generalisation only, but there is something in the generation clash where there is an expectation [from the younger generation] and they are not going to wait two days for a GP appointment – because they want it now.”

‘We have now reached a crisis point’

A UNION boss has claimed the NHS has reached “crisis point” and demanded nurses working long hours be paid more.

Mike Cracknell, Unison’s regional organiser for the South West, described the nurses at Poole Hospital as “incredible” for working 90-hour weeks and said they deserve the one per cent pay rise recommended last year by the NHS pay review body.

“Because of their commitment and dedication, nurses often put the needs of the patients above their own,” he said.

“The cuts across the services mean we have now reached a crisis point.

“It has been that political dogma of running down the resources of the NHS and the government seeing how far it can push it.”