Casualty ward 'like army Mash unit'

JONATHAN FOSTER

Conditions on one of the three busiest casualty wards in Britain were compared yesterday to the frenzy of an army "Mash" unit, with a shortage of nurses and space compromising patients' safety.

Bradford Royal Infirmary's accident and emergency department remained safe only because staff regularly cancelled holidays and days off, or worked long overtime, managers said.

The hospital was reacting to cancellation by the city's health authority of plans to recruit at least eight more nurses at a cost of pounds 140,000. Additional space for the unit, cramped since the closure of the city's other casualty unit, and special accident and emergency provision for Bradford's young population were also postponed.

"We are OK only if everyone's here," Malcolm Poad, a hospital manager, said.

Increasing complaints about the care of patients in the unit reflected the "exhaustion of staff", Lesley Sterling Baxter,Community Health Council chief officer, said.

"It is not appropriate for one of the three busiest units in the country to be like an army 'Mash' unit, particularly when the authority was party to a plan to bring accident and emergency services up to minimum standards."

The authority had been told by officials of the Yorkshire region to find savings of pounds 2m. The Royal Infirmary was last year able to double the number of doctors in the unit, which deals annually with 90,000 patients. But it has only 34 nurses, 17 fewer than employed by the comparable unit in Leeds, which has 10,000 fewer patients.

Bradford Health Authority said some improvements planned for this year could not be funded because it had to increase by pounds 3m its payments to Bradford NHS Trust. "It is the trust's decision how they determine staffing levels in accident and emergency," it said.