Lack of staff could force major A&E unit to close
ONE of the largest A&E units in the country could be shut down over patient safety fears because it is staffed by too many trainee doctors.
The emergency unit at North Middlesex University Hospital will be forced to close if it doesn’t hire more experienced and competent doctors within a fortnight.
The trust has been warned by the General Medical Council and NHS bosses about junior doctors being left in charge of the unit at night.
Internal documents claim the department poses a ‘significant risk’ to patients overnight – with just two of its 26 junior doctors ever having worked in casualty before.
The GMC and Health Education England – which oversees staffing – say they will remove all 26 junior doctors from the unit at the end of the month if things don’t improve.
If that happens, there would be too few staff for the unit in Enfield, north London, to stay open, making it the first time an A&E unit has been shut on safety grounds.
Previous closures have resulted from financial pressures.
In an unprecedented move, NHS England has begun urging neighbouring hospitals to lend their senior A&E doctors to North Middlesex for six months to ease the crisis.
But so far they have signed up just five out of a minimum of ten needed – and many of these other trusts are themselves short-staffed.
Niall Dickson, chief executive of the GMC, which regulates doctors, said: ‘We are extremely concerned about the standards of training and support for trainee doctors in the emer- gency department. Without adequate support and supervision there is a serious risk that their patients are being put at risk.’
HEE has made several inspections in recent months to monitor doctors’ training. Inspectors allegedly found a ‘culture of bullying’ and ‘poor levels of clinical supervision to very young junior doctors in training’.
Last week, the unit was warned to make ‘significant improvements’ by the Care Quality Commission, which inspects hospitals. It said patients were waiting too long to be seen and there were ‘insufficient’ consultants.
‘A culture of bullying’
Trust documents seen by The Guardian state that ‘junior staff are left in charge of the department, highlighting a probable risk to patients’ and that it is a ‘significant risk’ overnight.
The A&E unit sees around 500 patients a day, making it one of the largest in the country. It serves a population of 360,000, including some of the most deprived households in the capital.
Julie Lowe, the trust’s chief executive, said more than half of consultant and middle-grade doctor posts in A&E were vacant. She added: ‘It’s a strain on our A&E team and it’s making waiting times for some patients unacceptably long.’