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A&E treatment under fire

11th October 2007

An inquiry has reported that trainee doctors are not always able to spot very ill patients on arrival at A&E.

It also suggests that consultants do not review the cases quickly enough.
The independent watchdog the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) says patients should be seen by a specialist within 12 hours but in 40% of cases examined this had not happened.

NCEPOD said that in some instances, the delay impacted upon whether the patient survived.
Other findings revealed problems with access to CT machines, with 15% of emergency units not able to offer scans 24 hours a day.

NCEPOD looked at 1,800 of the most seriously ill patients admitted to A&E departments across the country in one week in 2005, focussing on patients it was felt were “most likely to test the processes of care during their hospital stay.�

The report authors said: “There is concern that they are less able to recognise the critically ill patients and act decisively. Many examples of this were seen throughout the study.�

In a series of recommendations, the authors suggest making sure trainee doctors could recognise critically ill patients, but also ensuring that initial assessments of patients admitted as emergencies are carried out by an experienced doctor.

The Department of Health said it expected the NHS to ensure everyone had access to specialist opinion “where appropriate� but also acknowledged there was no room for complacency with the NHS needing to ensure that it delivers high quality and appropriate care to patients at all times.

 

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