EMERGENCY departments are not like a 24-hour Tesco service and using them inappropriately risks lives.

This is the stark message from Royal Bournemouth Hospital’s emergency chief Dr Karim Hassan, who told the Daily Echo a lack of GP access and a culture of impatience produces a needless bottleneck in his unit which in turn creates a "brilliant environment for mistakes".

Dr Hassan has worked at the department for almost two decades and said he has seen annual admissions rocket from 40,000 in 1999 to around 79,000 last year – a rise that cannot be accounted for solely by population increase.

“The actual real emergencies, the lifesaving work has not gone up that much,” he said. “The way of life has changed – people do not want to wait for anything anymore. Gone are the days when you have a problem and wait a week or 10 days to see your GP.

“We have this culture where if you want something to eat at whatever time you go to Tesco and get it. Likewise you will have someone who, for example, has a problem with their arm and wants to have it sorted straight away because their life is busy and they want it fixed.

“The service itself has not matured to meet those expectations. It is a 24-hour service, but it is not a Tesco service, because actually the resources are small and the staff numbers are scarce.”

Dr Hassan said the high volumes of people using the service ‘inappropriately’ for non-emergency problems take resources away from those who really need it and they end up relying on costly locums of varying quality.

“A congested environment is an unsafe environment – there is no doubt about it,” he added. “It is a brilliant environment for mistakes.

“On Boxing Day I arrived at the department to do a late shift – it was a siege of ambulances – it was like the hospital had been taken over. Ambulances were surrounding the hospital and there were patients everywhere in the corridors.

“It becomes a crisis. No matter what is done the congestion will always lead to risk.

“And it is stressful for the staff and reduces their power. If I work an 11-hour shift in a department that looks like this I am stressed out. The quality of care will be compromised. You cannot deliver that quality of care when you have such over capacity.

“Let’s define the emergency department – it is for people who are really ill, sick or need immediate treatment. It is not an alternative to accessing your GP.”

'Dependence culture' lambasted

Dr Hassan slammed the 'dependence culture' which sees the emergency department's time wasted. 

He said: "People no longer use their initiative. Schools now - a child falls in the playground and they send them to hospital. I mean, please, exercise some degree of initiative. It's silly. 

"One example was a child who knocked his head. The child sits here for two hours because it is busy and when we try to find the child, the mum can't catch him because he is running around being wild and playing games. 

"People no longer say 'he is running about the place, he's having a laugh, he's jumping about - surely his brain is working so let's go home'

"We have started to become so, so dependent and it is sad.

"The service is not free - it is paid for by everybody and the innappropriate use of it is costing us more because we are taking the service away from people who need it."

Plea to use common sense

Between 30 and 40 patients coming into Bournemouth's emergency department each day could be treated with over-the-counter medication, according to Dr Hassan. 

He said: "Please check your urgency with the triage nurse, your waiting time and if something can be dealt with outside the hospital, please go outside, talk to your pharmacist, wait for your GP and exercise some tolerance to the waiting time. 

"Appreciate that your GP knows you well and if they want to see you in two days, a week or three weeks, they know what they are doing and do not need to be seen straight away. 

"If you have a real emergency, you don't need a waiting time, we don't need a four-hour target, be assured you will be dealt with in the most efficient manner."