My tears at 'appalling' A&E ward

An inquiry into the Mid-Staffordshire Hospitals Trust is due to report back to the government next week.

A damning report by the NHS watchdog the Healthcare Commission has already said patients died due to the "appalling" state of emergency care at Stafford Hospital.

Angie said working on A&E was heartbreaking

One former nurse practitioner turned whistle-blower claims the warning signs were obvious long before the commission's involvement as she told Simon Cox, of Radio 4's, The Report.

Angie (not her real name) has no doubt what caused the crisis at the hospital, part of the Mid Staffordshire trust: chronic staff shortages, an obsession with targets and the drive for foundation status.

The hospital's problems took a heavy toll on staff and patients alike.

"I would come home literally in tears sometimes because I felt I couldn't deliver the standard of nursing care that I wanted and that patients should be getting and indeed have the right to expect," she told The Report.

"There just physically wasn't enough nursing staff available to go and attend to them and get a commode, help them get changed, change the bed - anything like that - and patients would be left for any amount of time before that was seen to.

"It used to literally break my heart."

Staff shortages

Angie left Stafford Hospital last year. She was there for six years, with the last four spent in the accident and emergency department.

Throughout this time the shortage of doctors and nurses was a major problem, according to Angie.

"The nursing levels were extremely low, dangerously low.

"This issue was flagged up many, many times by myself and other colleagues through the internal incident reporting system and very little was done about it."

Bullying claims

But these issues were compounded by a target that patients should spend no more than four hours waiting in A&E.

"In principle it's a good idea," she said. "However the onus was solely on the four hour target - it was not about patient care, the comfort of a patient or the delivery of treatment."

If you said as a nurse, 'I'm not prepared to lie about this', you would be bullied and threatened Angie, former nurse at Mid-Staffordshire Hospitals Trust

Angie claimed that nurses were bullied and intimidated into pushing patients out of the ward more quickly than it was safe to do so and also to falsify the records.

"If the patient had gone over by half an hour or an hour they would backtrack so it would look on paper like they hadn't."

Cutting corners

Angie said some patients who were still unwell would receive treatment on the ward even though the records showed they were not on the ward.

"If you said as a nurse, 'I'm not prepared to lie about this', you would be bullied and threatened."

Angie claimed that the hospital's drive to attain foundation status - which gives it control its own finances - also added to the pressure on staff and saw the hospital cutting corners with patient care.

"When the issues around staffing levels were raised it was, 'We haven't got the money to take on more staff because we're basically saving money.'"

Whistle-blower

Staff at Stafford Hospital have been subject to intense criticism, not least for failing to alert the authorities to the problems they were seeing day in, day out.

Angie said when she turned whistle-blower her concerns were taken seriously initially but she received no feedback even when she was spoken to by an official investigator.

"I still don't know if the Healthcare Commission are fully aware of my reports."

A statement from the Mid Staffordshire NHS Foundation Trust said staff at the A&E department raised operational issues including the accuracy of recording waiting times.

New regime

It said, "The staff who raised the concerns did not classify themselves as whistleblowers.

"Their concerns were fully investigated in accordance with the trust's conduct and capability procedure."

The hospital is actively seeking to recruit more staff.

And even Angie acknowledges that improvements have been made.

"I do know they have taken on more doctors, and more consultants now in the department. And I know that Dr Chris Turner [the A&E consultant] is doing an excellent job and he's really trying to get the department up to standard."

The Report broadcasts on BBC Radio 4 on Thursday 16 April at 2000 BST. You can also listen via the BBC iPlayer or download the podcast.

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