Patients discharged from A&E before they had been properly assessed or stabilised

Current government guidelines state that 97% of patients should be seen, treated and discharged from A&E within four hours of being admitted. The result? Almost half the casualty units in England told the British Medical Association that pressure to meet this target meant patients were moved inappropriately.

One hundred and sixty-three of England's 200 casualty units responded to the BMA's survey:

-52% said patients were moved to inappropriate areas or wards
-40% said patients were discharged from A&E before they had been properly assessed or stabilised.
-27% said care of seriously ill or injured patients was compromised by pressure to meet the target.
-18% said patients were "admitted" to A&E instead of to a ward so they could be counted as being transferred.

The chairman of the BMA's A&E committee commented that he was appalled to hear that some A&E staff are being put under intolerable pressure, even bullied, by their trusts as they attempt to treat and discharge patients within four hours. Is he really surprised with the current political climate where medical decisions are being overseen by bureaucrats?

Health Minister John Hutton responded that any doctor with a genuine concern about patient care or fiddling of figures had a clinical duty to speak to trust managers, their Strategic Health Authority or the Department of Health. Oh yes? Just look at what happens when doctors speak out - they will almost certainly be ignored, or even suspended as trouble makers. Do you remember the case of Nick Overton, Consultant Obstetrician and Gynaecologist in Wales, who was recently suspended for daring to speak out against ward closures? He is not the only one.

This is a prime example of the erosion of our professionalism where the care of our patients is being compromised for political sound bites. When will we stand up and stop this madness?