Report from BHRUT board meeting: Exit Block Kills at Queens and King George A&E

The 1st October Board papers are here The following correspondence stands out..

Dr Mann, President of the College of Emergency Medicine wrote to BHRUT om 9th September the below on why exit block kills patients. Exit block happens when a patient cannot be moved from A&E into a bed because there is no bed available.


Matthew Hopkins, the Chief Executive of BHRUT  wrote back the following:


Mr Hopkins writes “overcrowding in the Emergency Department kills patients”. A&E four hour waiting times are a key indicator of exit block. Parliamentary research here shows BHRUT  coming 144th out of 145 trusts for 4 hour waits for the year for 4 hour waiting times. The CQC cited 4 hour waits as being a factor when describing KGH and QH A&Es unsafe last year.

BHRUT is seeking money from the Department of Health to bring down waiting lists. Reducing waiting lists seems bound to impact on A&E waits as it is likely to prevent those on the list presenting at A&E as an emergency. At the meeting it was unclear if BHRUT would get the funding it needs.

Bed occupancy impacts on exit block, the CQC write of a recommended safe level of 85%. Could Queens and King George be underfunded in comparison with other hospitals and consequently have higher bed occupancies than the recommended 85%? Using a Freedom of Information request I wrote to BHRUT seeking information on bed occupancy rates and A&E waits at our hospitals on 3 September. BHRUT had a duty to reply by 1st October, but have not disclosed the information. I chased the figures yesterday and have still heard nothing back.

BHRUT is also breaching serious incident report deadlines. Twenty one serious incident reports are at listed at pages 269 and 270 as overdue. These include two unexpected deaths in A&E in February of this year and a child death reported in April. These reports are important to families, elected representatives, regulators and the public. Long delays in producing the reports could mean that any necessary corrective measures are also being unduly delayed so  risking patient care. BHRUT are putting additional resources into tackling the problem and page 271 indicates that every “open case delayed  over 3 months” is to be closed by the end of October.











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