Clinical negligence team warns that claims will continue to increase unless staff shortages are resolved

Posted: 11/11/2013

"The Independent comments at length on the recent Monitor report on the closure of NHS walk in centres. There is a positive slant to this if steps are taken to link GP income to service provided. At the moment there is potential for GPs who provide a poor servive to push people towards walk in centres but to be paid the same as those who provide an excellent service and see these patients themselves.

"However, one of the main problems with A&E over crowding and wait times is the lack of out of hours service for what is, in reality, non-emergency care. Closing walk in centres may simply result in more people attending A&E and exacerbating the problems there. The Monitor survey found that one in five people who use the walk in centres would use A&E if the centres were not available.

"The Financial Times reports on the private hospitals who may be on standby in the event of a winter crisis. Again, this is good and bad news. On the positive side, it is provision of further resources for our over-stretched A&E departments but there are issues with this – not just of cost but of patients falling between the gaps of NHS and private care. Surely we need to focus on more community-based out of hours non-emergency care and invest in that rather than the private top up short term fix.

"A worrying story is The Times' report on A&E staffing issues. The College of Emergency Medicine has reported that 383 of 699 A&E specialist registrar posts in the last three years have been unfilled with many practitioners going abroad. This is a major concern and a root cause of why the quality of emergency care can vary and wait times can be unacceptable. There are simply too few staff available. It is hard to see a positive slant on this story as there is no quick fix. We need to look long and hard at why people do not want to work in A&E and take steps to change that.

"Of all the coverage on NHS stories, the most worrying is about emergency care provision. We see many clinical negligence cases against A&E departments – usually involving missed diagnosis of serious conditions such as heart attacks, head injury, meningitis and stroke. These errors not only devastate lives but also end up costing the NHS huge sums in follow on claims.

"While in some cases there is just no excuse for substandard care, a number need to be judged against the background of too few staff and resources. Resolving this will improve patient care and substantially reduce the burden of clinical negligence claims and their cost."

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