Hospital's care levels `distorted', claims doctor

Statistics which showed a hosptal casualty department improvng its standards of care may have been distorted, according to a doctor who resigned from the unit in protest against under-staffing.

Donald MacKechnie resigned last July after 10 years as the consultant in charge of Bury General Hospital's accident and emergency unit in Greater Manchester. He said the department was in urgent need of extra doctors and nurses. "I am just not willing tocompromise my own professional standards any longer. Enough is enough," Mr MacKechnie, 41, said.

Management of the Bury Healthcare NHS Trust had "shown reluctance" to provide the staff necessary to reduce chances of mistaken diagnosis or "excessive" waiting for treatment. On the casualty ward with the worst staffing in Greater Manchester, some pati e nts waited for up to two hours for attention, he said.

The trust said that his criticisms were groundless, and cited the results of a monitoring exercise last June which appeared to show high standards of care. Criteria in the Patient's Charter for assessing the needs of patients arriving at the unit were shown to have been met. The figures were collected between 9am and midnight on three consecutive days. Within five minutes of arrival at the unit, 98 per cent of patients had been seen and their needs assessed, 3 percentage points more than the charter recommended.

But Mr MacKechnie and Bury Community Health Council (CHC) discovered that, for three hours before midnight, an extra nurse had been present on the ward. "Her presence enabled a colleague to assess patients and measure the time they waited," Mr MacKechniesaid yesterday.

The CHC claimed that staff rotas it had seen proved the figures may have been distorted. "We have evidence the trust has deceived the public," Paul Reynolds, chief executive of the CHC, said yesterday.

"The extra nurse on the ward enabled the assessment of patients to be done by a colleague. We've been collating our own figures, and they show nothing like the impression created by the management. We believe something like 38 per cent of patients were seen and assessed, not the 90 per cent or more they claim."

The trust yesterday admitted an extra nurse had been present, but denied that affected the figures. "She was moving from another department to work on the unit and was there to gain experience," Philip Bacon, the trust's chief executive, said.

"She had not been drafted in, and she did not distort the accuracy of the figures. A subsequent independent report has said nurse staffing levels are satisfactory," he said.

Mr Reynolds said: "We do not believe them. The independent report has actually confirmed Mr MacKechnie's claims of understaffing. It has shown low morale and an unsatisfactory mix of nursing skills.

"The statistics being gathered are becoming almost meaningless. Management and health authorities are so hell-bent on getting star ratings off the Government that there are no lengths they won't go to. It has little to do with patient care."

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