Eight out of 10 Accident and Emergency nurses and managers fear they will be unable to cope with a sudden rise in demand this winter, according to a new survey.

More than 86% of nurses and 79% of managers were worried that measures aimed at tackling the increase in the number of casualty patients over the coming months would be inadequate, said a report in Nursing Standard magazine.

A shortage of beds and under-staffing on wards were the most common areas of concern among staff.

The BBC's Richard Hannaford reports on the bleak survey results (Dur: 41")

Three quarters of the 277 A&E nurses and managers questioned said they felt that the £300m that the Government was putting into winter initiatives would have little effect.

The survey showed that most A&E departments had plans to deal with the seasonal rise in emergencies, and identified 48 different initiatives around the country.

Number of beds worry many nurses

Around three-quarters of hospitals had appointed bed managers and almost half of the respondents said new beds were being opened in their hospitals, the report found.

Three quarters of A&E staff said their hospitals had "fast track" systems, so that a patient with, for example, a broken femur, could be taken straight to the appropriate ward.

Other plans included community initiatives to avoid admissions, and greater communication between departments to maximise beds and staff.

Two respondents said patients were being discharged earlier and one said that patients receiving respite care were sent home in an attempt to free beds.

The majority of nurses and managers still considered the number of in-patient beds insufficient and about two thirds said this was the main cause of not being able to cope.

Ineffective and delayed discharge procedures was said to be another main reason for hospital bed shortages.

Only around a quarter of nurses believed discharge procedures were handled efficiently and half believed that the problem of trolley waits was not taken seriously by the whole hospital.

Royal College of Nursing nursing practice adviser Rosie Wilkinson said: "Bed shortage is no longer a winter problem. It's a problem all year round and it causes chaos and demoralisation."

A quarter of respondents said under-staffing in wards was the most important factor affecting their ability to deal with the workload.
 

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