Patients 'are being warehoused' in A&E wards for days

The ordeal of a 90-year-old woman who spent four days in a hospital casualty department after hurting her right hip in a fall led to protests yesterday that patients are being "warehoused" in A&E.

A snapshot survey by the Association of Community Health Councils found that the woman was left in a bed in an observation ward attached to the casualty department of Aintree Hospital, near Liverpool.

It meant she spent 95 hours and 30 minutes in the unit without being moved to a quieter, geriatric ward which would have been "more appropriate", the ACHC said.

The watchdog carried out a spot check on 167 A&E departments in England for its annual "casualty watch", which aims to discover how long patients have to wait before receiving treatment and whether they are in beds, trolleys or chairs.

In the last such survey before community health councils are abolished by the Government, CHC members checked waiting times at their local casualty units at 4.30pm on Monday last week.

The 20 longest waits ranged from 28 hours to 95 hours at Aintree. The second longest wait was at St Peter's Hospital in Surrey, where a 66-year-old woman complaining of shortness of breath had been in A&E for more than 47 hours. The third longest was again at Aintree, where an 81-year-old woman with a swollen foot had been in the unit just over 47 hours.

Peter Walsh, the director of ACHC, said: "Some of these figures are shocking. For many people even a one- or two-hour wait in Accident and Emergency can seem like an eternity. Waits of over 24 hours are clearly unacceptable."

Of particular concern was the use of observation units to accommodate patients. These were often "little more than a cordoned off area of A&E."

"All too often patients are warehoused in Assessment and Observation Units until an appropriate bed can be found for them elsewhere," he said.

John Heyworth, president of the British Association for Accident and Emergency Medicine, said the survey represented the "tip of the iceberg". "There are many patients waiting for six, eight or 10 hours, which is far too long," he said.

The Department of Health has a target to reduce to four hours the maximum wait in A&E from arrival to admission, transfer or discharge. A spokesman said this was being met for 77 per cent of patients. Trolley waits of more than 12 hours had also been reduced by 50 per cent since 1999. But he added: "We recognise that a minority of patients still wait too long in A&E."

Aintree Hospitals NHS Trust said yesterday that it was "very misleading" to include the two patients in casualty watch. Both were admitted to the observation ward, a fully staffed area accommodating up to 10 patients. "It is quite normal practice for patients to receive clinical assessment and treatment appropriate to their needs over a number of days in the observation ward," a spokesman said.

But the trust accepted that at times people did experience long waits in its A&E unit, and so it was expanding the service with more nurses and two new consultant physicians.

Liz McLean, the director of performance at Ashford & St Peter's Hospitals NHS Trust, said a formal complaint would be sent to the ACHC about the survey. She said that the patient was placed in the observation area so she could be assessed overnight with a possibility of discharge. A new problem was diagnosed the next evening and she was moved to a ward the following day.