Civitas

The study was conducted by Dr Susanne Mason, a clinical senior lecturer in emergency admission. She is quoted as having said: “ We found that with patients admitted and discharged there is a sudden leap in the number dealt with …[in] the last 20 minutes before the target is missed and suggests that these patients are being moved out of the department at the last minute in order to ensure that the targets are met.”

Lest anyone wonder whether the apparent last-minute flurry of activity by A& E staff gives genuine cause for concern, the Daily Telegraph notes that ‘it is increasingly being claimed that patients are being admitted to wards inappropriately as a result’.

The newspaper report ends quoting Dr Mason saying of her study that it ‘certainly raises a number of questions about how time targets contribute to the quality of patient care’,

As a coda to this statement of Dr Mason’s, I cannot forebear mentioning what I overheard said by the duty-doctor at the very same A & E department of my local hospital last Friday afternoon, after my GP had instructed me to take myself there for an ECG after I had 'phoned her earlier that day to express concern about persistent chest pains from which I had been suffering in the context of a family history of heart disease. It was too late for me to go to outpatients of the cardiology department which had already closed for the week-end!

As I was sitting in A & E waiting to receive my ECG, I heard the duty-doctor say of the fellow-patient sitting next to me to a nurse whilst gesturing anxiously to a clock on the wall, “Hurry up! He’s got to be out of here in 15 minutes".

The fellow patient of mine of whom this was remarked was a young African man whose manifest discomfort at the time was so acute as to enable the doctor to make this remark without fear of his hearing it.

I could not help overhear the same doctor subsequently tell the same young man that what he was suffering from that was causing his pain was a blood-clot in his lower right leg. The patient was told he would need reassessment of his condition after a three-day course of treatment consisting of anti-coagulant tablets plus daily injections at the hospital, plus pain-killers.

The patient was offered the choice of being admitted to hospital or coming in each day as an out-patient to receive the injections, which latter course was what the doctor recommended since, as he told the young man, “You are a fit young man and have no need to stay here”.

The young man was, to me at least, in no fit condition to do anything other than do as the doctor suggested, and so dutifully submitted to his first injection. Because he found the injection unpleasant – administered in his stomach, as he sat there next to me! -- he turned to me for what little comfort and reassurance I could give him.

Afterwards, just as he had started his slow and painful exit from the A & E department, I could not resist asking him in light of what I had overheard was ailing him whether he had recently been on a flight.

“Oh yes”, he said to me in a tone of incredulity suggesting he had not been asked that question by anyone there or even knew its significance. “Six days ago, I came here from Africa on an eight hour flight.”

As I said, there is little solace to be gained from knowing that one is not alone in receiving short-shrift by A & E.

As to the pains in my chest, after establishing to their satisfaction I had not suffered a heart-attack, A & E sent me on my way, saying it was probably just anxiety but that I should see my GP again.

My GP said I should see a cardiologist immediately, which I duly did, privately and at my own expense. Apart from his informing the A& E were in breach of protocol, he informed me blood tests reveal I have worringly high cholesterol and must come back and see him tomorrow.

Next installment of my health saga to follow soon... I sincerely hope!!!