Casualties wait overnight for hospital beds: Minister considers time limits on finding space for emergency patients. Nicholas Timmins reports

HOSPITALS MAY face time limits on finding beds for emergency patients after a critical survey found that many had to wait overnight, some on trolleys.

Tom Sackville, the junior health minister, announced the move yesterday in the wake of a survey by the Royal College of Nursing that showed nearly one-third of hospital casualty departments - and half the casualty departments in London - regularly have patients waiting overnight for a bed.

The survey of 76 accident and emergency departments, 31 in London, showed that almost half had had patients waiting overnight for admission, and nearly one-third did so regularly. The average time for admission to a bed outside London was over five hours. One department reported: 'Two to eight people stay overnight in the department every night; the waiting room has become a mini-ward. Most patients wait 24 hours for a bed. Recently the problem has become worse due to bed closures.'

Another told the college: 'Clients usually stay in the department overnight; this happens about four times a week.' Such comments, the college said, were 'typical' in London, while more than one in five units outside London reported patients waiting overnight.

Mr Sackville said: 'Patients should not have to wait around on trolleys overnight until a bed can be found for them in the morning. This is unacceptable. We are presently considering whether all health authorities should be setting local standards on the maximum time which a patient should wait before being admitted to a hospital bed.'

New targets could be met by more efficient use of hospital beds, but he added: 'This does not mean kicking patients out of bed early.'

The survey was carried out last month, with some respondents saying flu and other winter ailments had worsened the situation. The college said it was worried that long waits were affecting patient care and creating pressures on staff.

Some hospitals have created 'admissions wards' with patients placed in a proper bed there until one became free in the main body of the hospital. There was, however, a temptation to turn the emergency admissions ward into an acute medical ward, the college said.

A stroke victim said last night that he was forced to spend more than 22 hours on a trolley while waiting for a hospital bed. Ken Hunter, 51, endured a sleepless night at Birmingham's Heartlands hospital as he was continually wheeled round the casualty ward. He is the latest victim of the city's bed crisis which has led the region's health chiefs to make cash available for 100 more emergency beds.

Mr Hunter was admitted to the hospital about 5.30pm on Thursday, and was forced to wait until 4pm the next day for a bed to be made available. His wife, June, said: 'The hospital staff were all working like Trojans, but they just didn't know where the next patient was going to go. If there had been a full-scale emergency or a bad accident, then God only knows where they would have attended to the injured. It was chaos.'

The director of finance for Heartlands hospital, David Poynton, said: 'I am aware of Mr Hunter's situation and we will be looking into it.'