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Last Updated: Wednesday, 24 March, 2004, 13:09 GMT
A&E staffing shortfall revealed
Eleven of the province's A&E units do not meet guidelines
A majority of hospital casualty units in Northern Ireland do not meet staffing levels recommended by experts, the BBC has learned.

The province has 14 units which run 24 hours a day, seven days a week.

However, it has emerged that 11 units do not meet staffing guidelines laid down by the British Association of Accident and Emergency Medicine.

The recommendation is that each unit should have a middle grade doctor on duty in the hospital not just during the day, but at nights and weekends too.

A middle grade doctor is either a registrar or a staff grade doctor but most hospital trusts in the province admit its A&E falls short of this.

Delia van der Lenden of the consumer watchdog body, the Southern Health Council, said they would be in favour of the phased introduction of the higher staffing standards.

"I think there are many things that contribute to a good standard of care," she said.

There is also a shortage of doctors available at the moment so in practical terms it may be difficult to find the recruits to fill these posts
Michael McCann
Associate specialist in A&E medicine

"Certainly, the expertise of the medical staff is one very important part of ensuring good quality care.

"We are confident that the standard of care, generally, across our hospitals is fairly good.

"So although these recommendations have not yet been implemented we wouldn't want to suggest to patients that in fact they might expect anything other than a fairly good quality of care in all our hospitals at the moment."

One of the units that does not meet the recommended guidelines is Northern Ireland's trauma centre in A&E at the Royal Victoria Hospital in Belfast.

Currently it has a middle grade doctor on duty from 0800 GMT to midnight on weekdays and for about eight hours on Saturdays and Sundays.

Doctor Laurence Rocke is the clinical director of the hospital's emergency unit.

He says any move to ensure more experienced staff are in the hospital at all times has a big hurdle to overcome.

"At the minute we do not have enough bodies, if you like," he said.

Laurence Rocke, clinical specialist
Dr Rocke said adequate funding could solve the problem

"We actually have a business case in at the moment for an extra four staff grade doctors," he said.

"If we are successful over the next couple of years in getting funding and filling, those posts would give us enough people to have a middle grade doctor in the department 24 hours a day, seven days a week."

Michael McCann of the BMA is an associate specialist in accident and emergency medicine.

He says having more middle grade doctors on duty is a sensible recommendation, but it needs more money.

"It will obviously require that the Department of Health fund this adequately and certainly we have been aware that the funding has not been made available to increase the number of doctors at middle grade and at senior consultant grade available in accident and emergency departments," he said.

"There is also a shortage of doctors available at the moment so in practical terms it may be difficult to find the recruits to fill these posts."

Northern Ireland is undoubtedly moving towards having middle grade doctors available around the clock in accident and emergency departments across the province.

However, the price is likely to be the closure of many of the smaller units across the province.

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