Clitheroe girl's six-hour casualty wait with broken arm

10:08pm Wednesday 21st May 2008

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By Camilla Sutcliffe »

A FIVE-year-old girl had to wait six-and-a-half hours at casualty for treatment to a broken arm.

Morgann Garner was left distressed and in pain' before her right arm was finally put in a splint at 1.30am, her mum said.

And her nightmare continued the next day when she had to return to the Royal Blackburn Hospital after doctors called to say the bone had been set wrongly.

A GP said the wait at the Royal Blackburn Hospital was disgraceful and inhumane' And an MP urged the hospital to review its procedures so such an incident could never happen again'.

Health chiefs said Morgann had received the most appropriate' level of care.

They said that they had hit the national standard as Morgann was assessed after 180 minutes - an hour before the target time.

However there is no regulation governing the amount of time for full treatment to be administered.

Mrs Garner, of Eastmoor Drive, Clitheroe, said there was something "very wrong with a system" that set targets to assessment but not treatment.

She said: "She's a little girl who's normally in bed by half past seven, so she was very agitated and crying, saying she just wanted to go home.

"The triage nurse had given her some Calpol and the paramedics put her arm in a sling, but she was still in pain and it's very difficult to explain to a five-year-old that you just have to wait.

"The nurses were brilliant and we're happy with the care she got, but there is something very wrong with the system."

Morgann was taken by ambulance to the hospital's emergency department after falling off a low wall while playing on Sunday evening.

When she arrived at the hospital, just before 7pm, she was sent to wait at the hospital's urgent care centre.

Morgann's X-ray was taken just before 10pm. She was then referred to an orthopaedic doctor and told to wait again in the urgent care centre.

She was there for three-and-a-half hours before getting treatment, leaving the hospital at 2am.

But despite the seven hour total, she was still recorded as having been dealt with within the Government four-hour limit to be assessed by the casualty department.

It is understood an oversight by the hospital may have added to the Morgann's wait as the family should have been told to wait in Orthopaedic department, rather than the urgent care centre.

On Monday morning, Morgann's mother Sarah was contacted to say the bone in her forearm had been set wrongly. She had to return to the hospital on Tuesday to have the bone reset again and a pot fitted.

Under the targets, introduced in in 2002, 98 per cent of patients should be seen within four hours.

East Lancashire Hospitals NHS Trust is hitting this, but Helen Hedges, vice chairman of the trust's former Public and Patient Involvement Forum, said patients found they were often at the hospital for longer.

She said: "Even four hours is a long time for a child that age. It doesn't matter what label you put on it. If you are in a waiting room for seven hours, you will never be convinced that you have been seen within the four-hour target."

Ribble Valley MP Nigel Evans said the hospital trust needed to review its procedures to make sure the problem never happened again.

He said: "To wait so long and then get treatment that has to be corrected later is simply not good enough.

"Everybody accepts that there is a triage system and you have to wait your turn, but they are interested in real care, not artificial targets that can be artificially met."

Dr Tom Smith, Lancashire Telegraph columnist, agreed that the hospital needed to review its procedures, saying: "There is no way in which a wait that long can be considered humane, and it should not be able to be covered up by saying it met the target.

"A broken arm is very painful and distressing for anyone, let alone a five-year-old, and what happened to her was disgraceful. There's no other word for it."

A study by the British Medical Journal last year showed that a third of doctors believed figures were being manipulated to make A and E departments across the country conform to targets, while 75 per cent of nurses told the Royal College of Nursing that patients were regularly being referred to other departments just conform.

Royal College of Nursing chief executive Dr Peter Carter said A and E nurses throughout England were under pressure to meet the needs of targets rather than patients.

Blackburn MP Jack Straw said he was unable to comment on Megann's case, but said targets, when used carefully, could improve services.

He said: "You have always got to monitor and ensure they are not leading people to aim for the target rather than the purpose behind it, but by setting targets, inefficiencies can be identified and eradicated.

"The four-hour A and E target has made some big improvements and people are waiting for much less time than they were 10 years ago.

Val Bertenshaw, director of operations for East Lancashire Hospitals NHS Trust, said she could not comment on individual cases.

She said: "We are measured against a 4-hour departmental national standard and there has been no record of a breach of this standard in the emergency department relating to this type of case.

"We would like to offer assurance that the most appropriate care was offered by a senior clinician and we are satisfied that the correct treatment was given. It is a routine procedure to review x-rays and if further treatment is required to ask a patient to return for further treatment and this was explained to Morgann's family.

"As ever if a patient or relative feels unhappy with any element of care received, we would advise them to speak to a member of staff who will be able to offer information and support for satisfactory resolution to their concerns."