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Gold, incentives and meh

'I was told not to speak out about the problems in A&E'

Dr Adrian Harrop

Dr Adrian Harrop - single use only

Dr Adrian Harrop - single use only

Source: Observer/Gary Calton

We have been facing a really stressful time as a team. We have been finding it very hard to deliver safe, effective and timely care to our patients. If the A&E department is not able to do that then it is unfit for purpose - and I know for a fact that Scarborough Hospital is not a unique, exceptional case.

It did get to a stage where I couldn’t guarantee that my patients within my department were safe. And that wasn’t a single, isolated incident, it was happening on a number of occasions within the last few weeks. It is the worst I’ve seen it in the last few weeks. I’ve never before been pushed up to that point.

I am prepared to deal with stressful working environment. What I do have a problem with is where I feel I am being unsupported at an executive board level and at an NHS England level, when I am raising my concerns about patient safety issues.

Every day I would raise these concerns with the consultants and to the senior nurse on the shop floor, saying ‘look, we need to get a plan together for what we are going to do when we reach capacity zero’, because we are going to get there eventually. And you raise your concern with the bed manager, whose responsibility it is to maintain flow through the hospital, I’d be saying “look what’s the plan, what are we doing?”, and they would be saying “well, there’s nothing I can do”. It just became so frustrating.

Then I came into work on 2 January and just found the department in a complete mess. The place was absolutely ram-packed, there were patients who had been waiting an inordinate amount of time to be seen, people queueing up in the corridor for 12 hours to get into an A&E cubicle. Patients sitting in the majors area of A&E waiting an extraordinary amount of time for a bed - 18, 19 hours. And I just thought, I have two choices here: either escalate this further as a doctor with a duty of candour and make sure that people know about my concern and that someone’s going to do something about it; or shut up and just crack on with the job. I decided that the only option I had, so that I could then sleep in bed at night-time, was to talk to the news.

I never wanted to gain fame and notoriety for speaking up. But then the consultant of the department came and had a word with me and said ‘Adrian, I understand you’ve been speaking to the media today. Off the record, I will say well done, I absolutely 100% support everything you’ve said and you are right. However, on the record, the trust policy is that you are not allowed to speak to the media’.

And because of the way I work at the department, as a medium to long-term locum, they added: ‘The one thing you must bear in mind Adrian, is that you are not officially a trust employee, because you are a locum. Therefore the trust is not able to take you down a disciplinary route, because you’re not an employee. However bear in mind that as a locum, and as someone who isn’t officially employed by the trust, you need to be cautious that this doesn’t put us both into a very difficult position”.

But, because I knew that everything I had done was the right thing to do, I sort of took that on the chin. In any case, I was told: ‘Do not speak to the media again’.

Dr Adrian Harrop is a GP trainee currently working in the A&E department at Scarborough Hospital

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Readers' comments (11)

  • Well done Dr Harrop for pushing back at the “learned helplessness” culture we are being sucked into in the NHS currently

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