Shocking lack of NHS care revealed: A&E nurses laugh about not 'hitting targets' after patient waits 46 HOURS for attention while undercover footage leaves stroke expert in disbelief at 'unacceptable' practices

Nurses at an NHS Accident and Emergency department have been caught on film laughing about how they weren't hitting targets after they admitted one of their patients had already waited 46 hours for care. 

The shocking state of NHS care was revealed after a Channel 4 Dispatches reporter went undercover at the Royal Shrewsbury Hospital's A&E, posing as a trainee healthcare assistant.

In a documentary shown this evening, nurses were caught laughing about their failure at 'hitting targets' - as the programme's footage left an expert in disbelief at the 'unacceptable' practices.  

It came as 400,000 patients across the country this year have had to wait more than 24 hours for care.

The shocking programme showed:

• Sick patients waiting overnight in the 'Fit to Sit' area, with a suspected stroke case sitting in the waiting room for 24 hours.

• A man who was forced to urinate on a trolley in full view of 30 staff, patients and members of the public.
• A dementia patient who ripped out their cannula and left a room covered in their blood when they were supposed to have been watched over. 

• A makeshift ward set up on the X-ray corridor which is isolated from doctors and nurses and which has no sinks and insufficient plug sockets.
• Shocking levels of hygiene, with dirty bedpans left by staff without being cleaned up. 

• Patients forced to wait up for up to four and a half hours in ambulance queues. Some ambulance crews who cannot wait just dump their patients in the 'Ambulance Reception Area' without a proper handover.

During the footage, one member of staff at the Shropshire hospital laughed as she admitted a patient had been waiting for 46 hours - nearly two days - before they had been seen.

Going through their waiting times list, they said: 'So... longest waiting... 46 hours is the longest one. It's meant to be four hours!

'So we're not hitting any targets.'

They added: 'I'd say we have at least like, 40 breeches a day.' 

54,000 patients spent more than 48 hours in A&E and almost 19,000 who were there for 72 hours, Freedom of Information requests by the broadcaster found.

And the numbers of people waiting more than a day for treatment are up five per cent on last year, with thousands more also waiting more than 48 hours.

In one moment, the reporter spoke to an elderly couple who said they had been waiting in the Shrewsbury hospital's 'Fit 2 Sit' area for 30 hours.

A suspected stroke victim had also been waiting for more than 24 hours on a hard chair.

Horrified at the desperate state of the situation, one nurse could be heard saying: '24 hours in Fit 2 Sit before anything's happened for her. That's disgusting care.'

Responding to footage, Professor Alf Collins, Trustee of the Patients Association and former NHS England Clinical Director for personalised care said: 'It's dreadful. People waiting just far, far too long.

'It's almost becoming acceptable now. It's almost becoming the standard of care that people expect.

'Sad to say. I don't think this is exceptional.'

And Dr Adrian Boyle, President of the Royal College of Emergency Medicine, added: 'I don't think this is unique to this hospital by any stretch of the imagination.

'The things we've seen here today are clearly not just confined to winter. It was a year-round crisis in emergency care.

'Spending two days in an emergency department is, you know, it's worse than spending two days in an airport lounge. These are people who are sitting in uncomfortable seats where the lights never go off. 

'There's constant noise, there's constant stress. There's no end in sight. People will miss their routine medications. They'll be next to people who can infect them with other diseases. You know, it's just not acceptable.'

In another horrifying moment, an elderly man was forced to urinate in a pot in front of as many as 30 people - including other patients and members of staff.

After helping him to go to the toilet in public, the horrified reporter said: 'We've got people having to go to the toilet in public in the corridor. It's not OK. 

'If that was my family member, I'd be fuming.'

Another scene shows a senior nurse reading out a list of serious complaints at the morning handover meeting. 

She tells the gathered staff that 'basic nursing care standards have fallen significantly'. 

Her list of shortcomings catalogue the team's failures, including: 'Patients on oxygen have not been monitored appropriately…patients being left in a state of partial undress and no urgency from staff to address the issue…patients being left on bedpans for too long…end of life patients not having appropriate observations.' 

Professor Alf Collins, Trustee of the Patients Association and former NHS England Clinical Director for personalised care said: 'How can you not be moved by witnessing that, that man in enormous distress, profoundly ill. 

'Having (to) to pass urine in a corridor. The very most basic standard of care that we should be delivering is not being delivered.

'It's clearly unacceptable that people should be cared for in corridors. Clearly unacceptable.'

Professor Julian Redhead, NHS England's National Clinical Director for Urgent and Emergency Care, said: 'What has been observed in Shrewsbury and Telford Hospital NHS Trust in recent weeks is not commonplace in A&Es across the country, and is not acceptable, and we are continuing to offer the Trust the highest level of national support to improve care for patients.

'While the health service is facing significant demand for services, with more people attending A&Es in England in May than any other month on record and attendances and emergency admissions up almost 20 per cent on a decade ago, the NHS has a detailed plan to overhaul urgent care services, including offering greater use of same day emergency care and urgent community response teams, and by delivering an extra 5,000 core beds in hospitals.

'Thanks to these measures and the dedication of NHS staff, latest data shows 20% more patients were seen in A&Es within four hours in May compared with the same month last year – and the NHS will continue to work closely with the most challenged trusts and colleagues in local authorities to help speed up discharge and free up beds for those who need them most.'

A spokesperson for the Shrewsbury and Telford Hospital NHS Trust, said: 'As with other hospitals, our Trust is facing significant challenges with urgent and emergency care. 

'We understand our challenges and are investing in our services and making steady improvements as a Trust, as noted in our recent CQC report. However, there is still much more to do; we do not want to be in a position where we are caring for patients on corridors. 

'We are very sorry that our patients have experienced anything less than the quality care we strive for, and we are determined, working with partners, to improve the care and experience for everyone. 

'Our colleagues are working incredibly hard to maintain safe services and we are grateful for everything they are doing to support our patients in this difficult working environment.

'Whilst we dispute some of the claims made in the Dispatches programme, we will fully investigate all of the claims to identify and embed any learning into our continuous improvement work. 

'We remain committed to being open and transparent with our patients and staff and encourage anyone with concerns to contact our PALS team.'

Dispatches' Undercover A&E: NHS in Crisis was shown on Channel 4 on Monday June 24, at 9pm.