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| 'Manipulation' of waiting times 'putting hospital patients at risk' | 'Manipulation' of waiting times 'putting hospital patients at risk' |
| (about 3 hours later) | |
| Surgeons are being banned from seeing people in accident and emergency so one of Scotland's biggest hospitals can meet waiting time targets, a whistleblower has claimed. | Surgeons are being banned from seeing people in accident and emergency so one of Scotland's biggest hospitals can meet waiting time targets, a whistleblower has claimed. |
| The doctor at Dundee's Ninewells Hospital told BBC Scotland that surgical teams were prevented from seeing patients to manipulate figures. | The doctor at Dundee's Ninewells Hospital told BBC Scotland that surgical teams were prevented from seeing patients to manipulate figures. |
| The whistleblower said the system was putting patients at risk. | The whistleblower said the system was putting patients at risk. |
| NHS Tayside said patient safety was its "overriding priority". | NHS Tayside said patient safety was its "overriding priority". |
| Scottish Labour has called for an immediate government investigation into the "very serious allegations". | Scottish Labour has called for an immediate government investigation into the "very serious allegations". |
| However, health Secretary Shona Robison said the Scottish government had been assured by NHS Tayside "that their ways of working are effective and safe". | However, health Secretary Shona Robison said the Scottish government had been assured by NHS Tayside "that their ways of working are effective and safe". |
| For several years, NHS Tayside has boasted the lowest accident and emergency waits in Scotland, with 99% of patients treated in four hours. | For several years, NHS Tayside has boasted the lowest accident and emergency waits in Scotland, with 99% of patients treated in four hours. |
| However the whistleblower, who wants to remain anonymous, said surgical teams were being bullied and prevented from seeing potentially seriously ill patients in order to manipulate the figures. | However the whistleblower, who wants to remain anonymous, said surgical teams were being bullied and prevented from seeing potentially seriously ill patients in order to manipulate the figures. |
| The doctor, a member of the general surgical team at Ninewells Hospital, said patients were not allowed to be assessed by surgeons until they are moved to the surgical department. This, he claimed, is so hospital managers can tick a box saying the patient has been discharged from accident and emergency, and the waiting time 'clock' stops. | The doctor, a member of the general surgical team at Ninewells Hospital, said patients were not allowed to be assessed by surgeons until they are moved to the surgical department. This, he claimed, is so hospital managers can tick a box saying the patient has been discharged from accident and emergency, and the waiting time 'clock' stops. |
| "On paper, it would seem that the patient was in the A&E department for a short time," the doctor told BBC Scotland. | "On paper, it would seem that the patient was in the A&E department for a short time," the doctor told BBC Scotland. |
| "The surgical service is often actively barred from assessing sometimes critically ill patients in A&E, as this would increase the time spent by the patient in A&E. | "The surgical service is often actively barred from assessing sometimes critically ill patients in A&E, as this would increase the time spent by the patient in A&E. |
| "Patients presenting to A&E with abdominal pain - the bulk of surgical patients - are not treated there in any way. They are quickly seen by a junior doctor, who then discusses the case with a consultant. | "Patients presenting to A&E with abdominal pain - the bulk of surgical patients - are not treated there in any way. They are quickly seen by a junior doctor, who then discusses the case with a consultant. |
| "The patient is then referred to the surgical ward where actual assessment, investigations and treatment takes place." | "The patient is then referred to the surgical ward where actual assessment, investigations and treatment takes place." |
| It is claimed surgical specialists are not allowed to order blood or imaging tests on the patient in the emergency department, as they would normally do, in case this causes delays. | It is claimed surgical specialists are not allowed to order blood or imaging tests on the patient in the emergency department, as they would normally do, in case this causes delays. |
| This is despite the fact that the department which carries out the imaging tests is next to A&E, and patients often have to be transported back again. | This is despite the fact that the department which carries out the imaging tests is next to A&E, and patients often have to be transported back again. |
| Government targets | Government targets |
| Across Scotland, the NHS is still not meeting the Scottish government's interim target for 95% of people to be treated and discharged within four hours. The last figures, published on Tuesday, suggested that 93% of people were seen and treated within this time frame. | Across Scotland, the NHS is still not meeting the Scottish government's interim target for 95% of people to be treated and discharged within four hours. The last figures, published on Tuesday, suggested that 93% of people were seen and treated within this time frame. |
| Staff at NHS Tayside raised the alleged manipulation of waiting time figures with the General Medical Council (GMC) last year. | |
| The GMC is carrying out visits to hospitals following a rise in the number of trainee doctors reporting bullying or undermining. | The GMC is carrying out visits to hospitals following a rise in the number of trainee doctors reporting bullying or undermining. |
| A report of a visit to Ninewells in October stated: "We heard from all groups that we met that there may be issues with interaction with other departments such as emergency medicine. We also heard that doctors in training feel unable to attend the emergency medicine department unless they are explicitly asked to do so by staff in that department. | A report of a visit to Ninewells in October stated: "We heard from all groups that we met that there may be issues with interaction with other departments such as emergency medicine. We also heard that doctors in training feel unable to attend the emergency medicine department unless they are explicitly asked to do so by staff in that department. |
| "Additionally when they do attend we heard examples of when they were undermined and/or bullied." | "Additionally when they do attend we heard examples of when they were undermined and/or bullied." |
| It was raised again earlier this year, this time in a report on the quality of surgical training at the hospital by NHS Education. | It was raised again earlier this year, this time in a report on the quality of surgical training at the hospital by NHS Education. |
| However, NHS Tayside insisted patient safety is its "overriding priority". | However, NHS Tayside insisted patient safety is its "overriding priority". |
| A spokeswoman said senior clinicians see patients as soon as possible, and where the input of senior clinicians from other specialties would benefit patients, they are encouraged to attend. | A spokeswoman said senior clinicians see patients as soon as possible, and where the input of senior clinicians from other specialties would benefit patients, they are encouraged to attend. |
| She added that tests and treatment are carried out within the emergency department, and said: "Waiting time targets do not form any part of our primary consideration." | She added that tests and treatment are carried out within the emergency department, and said: "Waiting time targets do not form any part of our primary consideration." |
| 'Thorough investigation' | 'Thorough investigation' |
| Scottish Labour health spokeswoman Jenny Marra called for an "immediate investigation" from the Scottish government. | Scottish Labour health spokeswoman Jenny Marra called for an "immediate investigation" from the Scottish government. |
| She said: "A member of the medical staff at Ninewells has made very serious allegations about the management of A&E, and these must be fully investigated immediately by the government. | She said: "A member of the medical staff at Ninewells has made very serious allegations about the management of A&E, and these must be fully investigated immediately by the government. |
| "These allegations are not the first to be raised about the manipulation of waiting times figures at Ninewells. Of course it is important that waiting times are kept as low as possible, but patient safety is paramount, and staff must feel able to work in a safe and professional environment. | "These allegations are not the first to be raised about the manipulation of waiting times figures at Ninewells. Of course it is important that waiting times are kept as low as possible, but patient safety is paramount, and staff must feel able to work in a safe and professional environment. |
| "The SNP Health Minister should not simply accept the assurance of NHS Tayside that everything is fine. That is not good enough. It is in the interests of patient safety, transparency and public confidence that she orders a thorough investigation." | "The SNP Health Minister should not simply accept the assurance of NHS Tayside that everything is fine. That is not good enough. It is in the interests of patient safety, transparency and public confidence that she orders a thorough investigation." |
| Conservative health spokesman Jackson Carlaw echoed the call for an investigation, saying "there could be extremely serious questions for the Scottish Government to answer", while his Liberal Democrat counterpart Jim Hume said NHS staff shouldn't "carry the can for SNP mismanagement". | Conservative health spokesman Jackson Carlaw echoed the call for an investigation, saying "there could be extremely serious questions for the Scottish Government to answer", while his Liberal Democrat counterpart Jim Hume said NHS staff shouldn't "carry the can for SNP mismanagement". |
| 'Safe and effective' | 'Safe and effective' |
| Health Secretary Shona Robison said: "We have been in contact with NHS Tayside on this issue and have been assured by the board that the first priority in A&E is always the safe and effective treatment of the patient. | Health Secretary Shona Robison said: "We have been in contact with NHS Tayside on this issue and have been assured by the board that the first priority in A&E is always the safe and effective treatment of the patient. |
| "Our guidance makes clear this should always be the case where targets are set and the four-hour A&E target is no different. Indeed the key driver of this target is to ensure patients receive safe, effective care as quickly as possible and are not subjected to long waits." | "Our guidance makes clear this should always be the case where targets are set and the four-hour A&E target is no different. Indeed the key driver of this target is to ensure patients receive safe, effective care as quickly as possible and are not subjected to long waits." |
| Ms Robison added: "There is absolutely no place for bullying in our NHS and we are completely committed to a culture of openness where staff of any level can raise concerns. | Ms Robison added: "There is absolutely no place for bullying in our NHS and we are completely committed to a culture of openness where staff of any level can raise concerns. |
| "On that basis, staff working at NHS Tayside should feel able to bring forward issues to management at the health board. I would encourage anyone with concerns to raise them in line with advice provided to all staff and allow the issues to be thoroughly investigated." | "On that basis, staff working at NHS Tayside should feel able to bring forward issues to management at the health board. I would encourage anyone with concerns to raise them in line with advice provided to all staff and allow the issues to be thoroughly investigated." |