A&Es to have makeovers to stop attacks

[smokinaces]

link here

Not sure this is the right move. I wonder how many attacks are due to drink and drugs, and whether the money could be better spent?

opinions?

I support any move that makes A&E departments less prone to attacks. They can't be fortresses, that's the trouble - they're public places and they have to be accessible. According to a friend, drugs are at the bottom of most of the cases he sees - either people suffering from the effects of taking them or gang violence around dealing them. Attacks on staff often do stem from frustration and impatience (as suggested in the article) but he has also had attackers charge into the building and try to finish off the patient they stabbed earlier!

Such people are vile - usually underclass types - and should have their right to medical aid withdrawn.

It won't work. According to FalseEconomy the government is set to cut 50,000 posts by 2015; to include Doctors and Nurses. I am certain this will include closing/merging A&E Departments. How they can then
even pose this question "And it'll also consider the service package; how can A&E services be improved to make them more efficient, timely and better for both patients and staff?" is just nonsensical.

Interestingly, people never talk about another source of assaults; distressed/impatient or just plain unreasonable relatives who think it is perfectly alright to hit you if you refuse to make them a cup of tea or a sandwich .

You are right, LadyFanny. GPs who are leading the first shadow commissioning consortia are talking quite openly about shutting A&E departments (at least, talking to the BMJ).

Edam, do you by any chance know who owns/runs/regulates the GP consortia? I know that GPs are not employed by the NHS employees but are actually independent contractors. Therefore are they independent contractors who have control of the NHS budget? and if so, who will regulate them?

Confusing!

LF - I'm not entirely clear about that, tbh. Monitor will be the economic regulator ensuring there is competition (and price competition, which is a scary prospect) and the CQC the quality one. There will be an NHS Commissioning Board that does specialist commissioning (maternity and cancer).

Oh, and local authorities will have some sort of overview/scrutiny function. GP consortia will have to work with them on commissioning/public health (public health function of PCTs is going over to councils) and LAs will house Health Watch, the new public involvement bodies (replacing LINks). BUT LAs will also pay for Health Watch. DH funds HW via councils but it's not ring-fenced. So it's not clear how independent Health Watch will be - would you be honest about the failings of your LA in public health or NHS scrutiny if they were paying your bills?

GP consortia don't have to have any specified number of members of the public on the board or anything. They can just decide for themselves.

(Suspect consortia will be set up as social enterprise companies - although KPMG has just got a massive contract to run NHS London on behalf of all the GP consortia.)

Thanks Edam.

No chance of this happening at my local A&E....it's closing.

IMO the money could be better spent on security guard presence. Four full time security guards, specifically for A&E would be far cheaper than a renovation/redevelopment. Most of the staff who are assaulted are nurses, and most nurses are women. People who attack hospital staff are generally drunk bullies, who wouldn't dream of behaving the same way, if a burley security guard was around. Although a fair few attackers are confused, frail elderly patients . At one of my local hospitals, attacks on A&E staff dropped dramatically, when a couple of younger, bigger security guards were employed, and the security office was relocated to within the A&E reception (with a met police sign above the door?).

Very worrying to think even more A&E depts will be closing.

agree with you annamolly - and it puts people in regular employment - where the attackers are drunken bullies they do not give a s**t as to where they are and only some strong presence is likely to deter them

wonder whether people who work in A&E would want security guards, or not?

My sister's a nurse - not A&E - and IIRC one of the assaults by patients was because the guy was frightened and in pain (had LDs, my sister had some sympathy for him). The other one attacked her quite deliberately in order to get the police called because he wanted to be taken into custody. Not entirely sure security guards would have helped in either situation - but I'd have to ask her.

I'm an A&E nurse and we have security - its essential and we feel much safer when they're around. In my experience the majority of abuse and attacks are caused through alcohol rather than drugs and i'm sure these people wouldn't behave any different if the department was designed in a more appealing way. We're pretty strict and have a low tolerance for abusive patients, they get carted off very quickly - its a scary, dangerous place to work at times particulary when rival gangs stabbing/shootings are involved. We don't get the danger money we deserve!!!

I worked in A&E for six years.

It was definately not just 'underclass types' who were a problem.

The majority were drunk but getting pissed is not the preserve of the lower classes.

The main reason, apart from the drink, was the amount of time people had to wait. Sitting in a cold waiting room with other pissed people, on nailed down chairs just increased the tension.

I dont condone any violence against staff obviously but I could see why people got wound up.

They attempted some safety measures when I was still there. They put a sort of plastic gaurd round the reception desk. Only problem was it was high enough to impede communication but low enough for someone to reach over and clap you one if they felt like it.

I had guns pointed at me, was threatened with rape, stabbing etc. It was a daily occourance. As a receptionist I was blamed for any delay and accused of doing it 'on purpose'.

This was before triage was introduced, it did get better once they got to see a nurse within a few minutes but not much.

There were the regulars who wanted to be admitted. The psych patients who had to wait 10hrs plus to see a psych, diabetics who were having hypos and who were terribly embarressed about any offence once they were sorted, people who complained because they thought it was 'first come first served' and got pissed off that someone went infront of them (even if that person was having a heart attack).

It was certainly and interesting job