When the A&E computer says “no”

4 November 2016

Most of us at some point have made our way to an A&E department unable to wait until the next day to see our GP. You may be suffering from unbearable toothache or require stiches to your finger after cutting yourself badly when drilling a hole in your wall to hang that amazing photograph you just bought in IKEA on a late Sunday afternoon.

It is perhaps not surprising that emergency services are under enormous pressure. The whole of the NHS is currently bursting at the seams. According to NHS England monthly performance statistics there were 1,931,981 attendances at A&E departments across England in August 2016 alone. A&E receptionists, who are the first point of contact, have recently come under fire in relation to providing accurate waiting times to be seen by emergency clinicians. In the first case of its kind the court has been asked to rule on holding A&E receptionists liable when providing information about waiting times for those of us requiring emergency medical care.

In the case of Darnley v Croydon Health Services NHS Trust the Claimant had been unlawfully attacked and struck on the head. He attended an A&E to be told by an on-duty receptionist that he would have to wait 4 or 5 hours to be seen by a clinician. After 19 minutes of waiting the Claimant left the A&E and went home. He hoped that going home to rest and taking Paracetamol would help the pain go away.  Shortly after arriving home his condition deteriorated and an ambulance was called. The Claimant was taken back to the Defendant hospital where a CT scan showed an extradural hematoma. He was transferred to St George’s Hospital to remove the bleeding but has suffered a left hemiplegia, a paralysis of the left side of his body.

The Claimant’s case was that had he been told by the receptionist on duty at the time that he would have been assessed within 30 minutes he would have stayed at the emergency department for assessment and not suffered paralysis.

Interestingly, and perhaps not surprisingly, neither of the receptionists that were on duty at the time the Claimant visited, remembered the Claimant although a third receptionist who was about to start her shift recalled the Claimant and his friend.

In addition to expert evidence the court considered the relevant clinical guidelines and found that it would not be fair and reasonable to blame the receptionist for the Claimant’s injury. Judge Robinson held that the main role of an A&E receptionist was to complete a registration form competently and not engage in clinical decisions which needed to be taken by healthcare professionals. The court found that it would be too far to impose responsibility on the A&E civilian receptionists for failure to provide accurate information or to provide information that is inaccurate. It would be too significant, in court’s view, to impose liability on the front desk staff to do anything else than to fill out a form that is then passed to a clinician to assess an injury. Even though the Claimant left the A&E as a result of inaccurate and incomplete information provided by the receptionist it would be too far to impose damages on the hospital in this case.

The Claimant has appealed this ruling. The appeal will be heard in February 2017.

In the meantime, the moral of this ruling is that if you think you suffered a serious injury stay at A&E until you are seen.

Kinglsey Napley’s Clinical Negligence department are currently working on a number of claims against hospitals which failed to diagnose serious and debilitating conditions when examined in A&E settings. If you think that you have not been adequately examined and suffered an injury as a result please contact us.

For further information, please contact a member of the Clinical Negligence and Personal Injury team on 020 7814 1200, or by emailing us at clinnegenquiries@kingsleynapley.co.uk.

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