A&E Bedlam - Storm in a bed-pan?

Some of the more sensational coverage of A&E waiting times surely needs re-balancing.

To describe ‘major incidents’ as “an emergency trigger usually reserved for air crashes or terror attacks hours” (Daily Mail) looks overblown with news of the massacre at the Charlie Hebdo magazine in Paris.

It’s an unhelpful way to explain a trigger used to let hospitals hire extra staff, cancel routine operations or divert ambulances.   A&E units have few safety valves in an on-demand, walk-in service.  

For the 133,000 patients that A&E units failed to handle in the 4-hour target during the last quarter of 2014 (a 2.4% shortfall) there will be real stories of pain, fear and confusion.

Yet we need more than anecdotal evidence, given this was the worst quarterly result since this target was launched 10 years ago. 

We want the real truth of what has to be fixed and we need balanced media coverage that cuts through the political hype in the election run-up.  How do we get these two things?

We suggest two cracking essays. The first is by Telegraph columnist Robert Colvile.  His “beginner’s guide to the A&E crisis” explains discharge delays and bed-blocking   He says, think less about drunken louts and more of elderly frail patients, even granny-dumping...  

The second is Roy Lilley’s provocative, gutsy 15-point action plan.  Check his idea for trusts to design their own new posts and create organic workforces not ‘organisations’.  Could this spark a cultural revolution?   This brings me to my main point about more balanced reports.

Seemingly, we can’t just blame the problems on cash. Money is pouring into the NHS to fund 5,000 new doctors, nurses, social workers and physios and yes it needs more cash, but it also needs to stop the exodus of staff quitting the NHS.

A&E units struggle to keep burned out staff and to recruit new staff into the least glamorous healthcare jobs (it’s not ER).  Do media reports of “A&E bedlam” help morale, when the same media dismiss positive stories as PR puff-pieces? When the NHS turned 65 in 2013 there were more complaints than compliments – hardly the celebration it deserved.

Good news might give the Twitterati little to sharpen its teeth on and sell fewer papers but I’m seeing a social media backlash to one-sided ‘bad news’ in the media.

When Richard Bryant, owner of Cheltenham’s United Services social club, posted on Facebook the brilliant treatment an elderly customer got via NHS 111 on January 7, he got dozens of Likes and comments about ‘fair play’ showing a British instinct to play fairly.

We have some great hospitals with hard-working staff shaped by positive cultures.

Individual hospital managers can take a leaf from Roy Lilley and focus on staff morale.  Any feel good ripples will radiate out and even spark some good media coverage.   

They can use social media to share bad information directly, like major incidents.

They can insist on balanced coverage from the media

The NHS could copy our royal family, another institution who’ve survived repeated PR crises.   During any crisis, the ‘firm’ follow the classic crisis plan:


1. Stick together and speak with one voice

2. Keep working hard, and never ever go into hiding

3. Do ‘show and tell’ - and tell their most positive stories.  

As a result, the institution survives, changes for the good, and gets stronger. It’s time our NHS did the same.