BOLTON'S accident and emergency unit needs at least eight more doctors and 13 more nurses to cope with a rising tide of patients. An independent external audit report into the funding and staffing levels of Royal Bolton Hospital unit reveals a chronic shortage of staff which is pushing the department to the limit. The Audit Commission report reckons at least eight senior house officers and 13 nurses are required to cope with the massive increase in A and E attendances at the hospital.

It says the department should have 18.25 senior house officers - based on a national doctor-patient formula. In fact it has 9.9.

The formula is based on the number of doctors for the total number of patients seen.

It should have 41.38 nurses - again based on nurse-patient ratios. But it needs another 13.26 full time nurses to make that total. As reported in the BEN, Wigan and Bolton Health Authority has found extra money for the service.

According to a source at the Bolton hospital, the Royal Preston Hospital sees 20,000 fewer patients, but has FIVE more doctors.

From last April an extra £150,000 was pumped into the unit and paid for a full time consultant and three additional nurse practitioners. Despite that sum, however, and an agreed additional cash boost of £140,000 from April this year, there are still not enough staff to deal with the number of patients. The auditors' report reveals that the number of patients from outside Bolton has rocketed. There has been a massive 80pc increase in the number of patients from the Leigh area arriving at Bolton and 48pc increase from Salford and Trafford. The surge in the number of patients arriving as emergencies puts more pressure on the department's resources because those patients require immediate, intensive care and this lengthens the waiting time for the less seriously ill or injured.

As already reported in the BEN, hospital bosses are looking to recruit one full time consultant to work on the unit and increase the number of nurses.

Graham Hewitt, director of finance with Bolton Hospitals NHS Trust said: "We are obviously very grateful for the monies received so far. But this report, which is wholly independent, reveals we are still understaffed compared with other units across the country.

"And although we appreciate the extra monies so far we hope they represent just the first stage of further increases."

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