A&E patients at risk of death over missed medication with 70% getting their drugs late

A&E patients are at risk of dying or getting even sicker due to missed doses of prescription medicines - with almost 70 percent receiving their medication over half an hour late, a new report has claimed. The study, from the Royal College of Emergency Medicine (RCEM), found people in A&E were missing doses needed to manage their illnesses.

Time critical medicines (TCM) are prescriptions for existing conditions, such as insulin for diabetes, Parkinson's drugs, epilepsy medicines and tablets for preventing blood clots. If these drugs are delayed or missed it can be fatal, with patients at greater risk of complications.

Patients are advised to remember to bring their medications to A&E and to take them, but there is also a responsibility on staff to make sure this happens.

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Despite the recognised risk of harm, the delivery of TCM is not consistent across emergency departments, the RCEM said.

And some of the issues are made worse by long waiting times to be seen in A&E.

It comes as one in 20 ambulance workers told how patients had died in their care as a result of long delays at A&E.

Nearly 70 percent added they had seen people's health deteriorate because of hold-ups getting them admitted at hospital.

Of 600 ambulance workers quizzed by Unison five percent had watched someone die while waiting to be admitted in the last 12 months.

Across the UK, 136 emergency departments submitted data for more than 13,000 people in A&E who were on insulin injections or levodopa tablets for Parkinsons to the RCEM.

The findings showed that more than half of these patients were not identified as being on TCM within 30 minutes of their arrival in an emergency department.

In addition, 68 percent of doses were not administered within 30 minutes of the expected time.

The study focused on oral levodopa for Parkinson's and insulin for diabetes, as these are common in patients in A&E and must be given on time.

The research is part of the College's clinical Quality Improvement Programme (QIP) which aims to improve the care of A&E patients.

RCEM president-elect, Dr Ian Higginson, said: "This is an example of a problem we should not be having to fix in our emergency departments.

"It has risen to prominence because of the increasing number of our patients who are having to endure ridiculously long waits in our emergency departments - 12, 24, 48 hours and even longer.

"It is vital that ensuring patients receive TCM is identified as an issue associated with these waits.

"Missing doses of medication for illnesses such as Parkinson's or diabetes is not just inconvenient, it is dangerous; and missing multiple doses can have serious consequences.

"This first-year report reveals there is already some good work happening across the country.

"Now we just need to ensure that it is replicated in every emergency department and becomes embedded so that no one fears not being able to access their medication while in our care."

Dr Jonny Acheson, an emergency medicine consultant in Leicester who has Parkinson's, led the study. He said there has been improvements but more needs to be done.

"The findings contained in this report should serve as a call to action for both emergency medicine staff, as well as patients reliant on time critical medications, to ensure no dose is ever missed in A&E," he said.

An NHS spokesperson said: "We welcome this report and will look closely at the findings, to ensure any patient in need of time critical medicine does not lose out when in A&E and receives the medication they need or support to self-administer as they would at home.

"As the report makes clear, it is welcome to see improvements thanks to the hard work of frontline staff but more generally we know A&E waiting times are far too long and our upcoming urgent and emergency care plan will set out how we aim to bring these down ahead of next winter."