16/09/2013 Inside Out West

Hello from Taunton where we have

Hello from Taunton where we have a

Hello from Taunton where we have a special programme looking at the

special programme looking at the

special programme looking at the state of our Accident and Emergency

state of our Accident and Emergency

state of our Accident and Emergency units. Tonight, with the pressure

state of our Accident and Emergency units. Tonight, with the pressure of

units. Tonight, with the pressure of

units. Tonight, with the pressure of a million more patients than three

a million more patients than three

a million more patients than three years ago we ask what the future

years ago we ask what the future

years ago we ask what the future looks like. We are in the worst

looks like. We are in the worst

looks like. We are in the worst position we have ever been. We

looks like. We are in the worst position we have ever been. We have

position we have ever been. We have

position we have ever been. We have a real crisis. How long can we

position we have ever been. We have a real crisis. How long can we carry

a real crisis. How long can we carry

a real crisis. How long can we carry on working like this? There needs

a real crisis. How long can we carry on working like this? There needs to

on working like this? There needs to

on working like this? There needs to be light at the end of the tunnel.

be light at the end of the tunnel.

be light at the end of the tunnel. And we spend 12 hours following

And we spend 12 hours following

And we spend 12 hours following events at A&E here at Musgrove

And we spend 12 hours following events at A&E here at Musgrove Park

events at A&E here at Musgrove Park

events at A&E here at Musgrove Park Hospital. It is nonstop. There

events at A&E here at Musgrove Park Hospital. It is nonstop. There is

Hospital. It is nonstop. There is

Hospital. It is nonstop. There is always going to be someone else

always going to be someone else

always going to be someone else coming in and that is the service

always going to be someone else coming in and that is the service we

coming in and that is the service we

coming in and that is the service we provide. I'm Alastair McKee and

stories of this year. What is going

stories of this year. What is going on with our hospital accident and

on with our hospital accident and

on with our hospital accident and emergency departments? To find

on with our hospital accident and emergency departments? To find out

emergency departments? To find out

emergency departments? To find out for ourselves Inside Out cameras

for ourselves Inside Out cameras

for ourselves Inside Out cameras spent a full 12 hour shift in the

spent a full 12 hour shift in the

spent a full 12 hour shift in the A&E unit here at Musgrove Hospital.

This man's been in a road accident.

This man's been in a road accident. The medics treat him with extreme

The medics treat him with extreme

The medics treat him with extreme care because they don't know what

care because they don't know what

care because they don't know what his injuries are. It's emotional

care because they don't know what his injuries are. It's emotional to

his injuries are. It's emotional to

his injuries are. It's emotional to Musgrove Park it's another day

his injuries are. It's emotional to Musgrove Park it's another day on

Musgrove Park it's another day on

Musgrove Park it's another day on A&E. Over half a million people

Musgrove Park it's another day on treated here last year. That's

Musgrove Park it's another day on treated here last year. That's an

treated here last year. That's an

treated here last year. That's an service is under pressure like

treated here last year. That's an service is under pressure like never

service is under pressure like never

service is under pressure like never before. More and more people are

before. More and more people are

before. More and more people are using it, but not for accidents

before. More and more people are emergencies. My daughter got her

emergencies. My daughter got her

emergencies. My daughter got her finger pulled back last week and

emergencies. My daughter got her finger pulled back last week and it

finger pulled back last week and it

finger pulled back last week and it is a bit swollen. She can't bend

finger pulled back last week and it is a bit swollen. She can't bend it

is a bit swollen. She can't bend it

is a bit swollen. She can't bend it checked out because she is back

is a bit swollen. She can't bend it school next week. Our cameras have

school next week. Our cameras have

school next week. Our cameras have been allowed inside to see the

been allowed inside to see the

been allowed inside to see the pressures they're under. We'll

been allowed inside to see the pressures they're under. We'll be

pressures they're under. We'll be

following the staff and patients pressures they're under. We'll be

following the staff and patients during a 12 hour period to see

following the staff and patients during a 12 hour period to see what

during a 12 hour period to see what

during a 12 hour period to see what it's really like for Somerset's

It's 8am and the day's beginning

It's 8am and the day's beginning for

It's 8am and the day's beginning for the nursing staff we're following.

the nursing staff we're following.

the nursing staff we're following. They're briefed about any on—going

They're briefed about any on—going

They're briefed about any on—going issues from the previous shift

They're briefed about any on—going issues from the previous shift in

issues from the previous shift in

issues from the previous shift in the hand—over meeting. James Gagg

issues from the previous shift in the hand—over meeting. James Gagg is

the hand—over meeting. James Gagg is

the hand—over meeting. James Gagg is the Consultant on duty today. He's

the Consultant on duty today. He's

the Consultant on duty today. He's in overall charge of the department.

in overall charge of the department.

in overall charge of the department. 14 patients waiting to be seen

in overall charge of the department. 14 patients waiting to be seen in

14 patients waiting to be seen in

14 patients waiting to be seen in the department at the moment and

14 patients waiting to be seen in the department at the moment and two

the department at the moment and two

the department at the moment and two ambulances coming in. We'll just

ambulances coming in. We'll just

ambulances coming in. We'll just wait to see what they are. The

wait to see what they are. The

wait to see what they are. The hospital's pretty full. We had

wait to see what they are. The hospital's pretty full. We had an

hospital's pretty full. We had an

hospital's pretty full. We had an extremely busy day yesterday with

hospital's pretty full. We had an extremely busy day yesterday with a

extremely busy day yesterday with a

extremely busy day yesterday with a walk—in attendances coming in and

walk—in attendances coming in and

walk—in attendances coming in and ofcourse that has an effect on

walk—in attendances coming in and ofcourse that has an effect on the

ofcourse that has an effect on the

ofcourse that has an effect on the hospital as a whole and that's

hospital as a whole and that's

hospital as a whole and that's potentially going to have a knock—on

potentially going to have a knock—on

potentially going to have a knock—on effect today depending on how busy

effect today depending on how busy

effect today depending on how busy we are and how many patients we

effect today depending on how busy to bring into the hospital. Karen

to bring into the hospital. Karen

to bring into the hospital. Karen Caburn is the lead nurse on duty.

Caburn is the lead nurse on duty.

Caburn is the lead nurse on duty. One of her first jobs is to check

One of her first jobs is to check

One of her first jobs is to check how many beds are available for

One of her first jobs is to check patients in the main hospital.

One of her first jobs is to check patients in the main hospital. We've

patients in the main hospital. We've

patients in the main hospital. We've got a few to come up to you. Are

patients in the main hospital. We've got a few to come up to you. Are you

got a few to come up to you. Are you

got a few to come up to you. Are you happy to put it on the screen when

happy to put it on the screen when

happy to put it on the screen when beds come up? She also organises

beds come up? She also organises

beds come up? She also organises staff cover for the day. I'm just

staff cover for the day. I'm just

staff cover for the day. I'm just doing the allocation now. We just

doing the allocation now. We just

doing the allocation now. We just split the department into Majors

doing the allocation now. We just split the department into Majors and

split the department into Majors and

split the department into Majors and emergencies has arrived at the

emergencies has arrived at the

emergencies has arrived at the Majors end of the department. Colin

Majors end of the department. Colin

Majors end of the department. Colin Morgan has had a fall and has been

Morgan has had a fall and has been

Morgan has had a fall and has been brought from Minehead. Things are

Morgan has had a fall and has been brought from Minehead. Things are a

brought from Minehead. Things are a

brought from Minehead. Things are a little different at the other end

brought from Minehead. Things are a little different at the other end of

little different at the other end of

little different at the other end of the department. James has discovered

the department. James has discovered

the department. James has discovered some news that could impact on

the department. James has discovered some news that could impact on the

some news that could impact on the

some news that could impact on the types of patients they see today

some news that could impact on the types of patients they see today and

types of patients they see today and

types of patients they see today and briefs another doctor about this.

briefs another doctor about this.

briefs another doctor about this. There's no out of ours GP service

briefs another doctor about this. There's no out of ours GP service in

There's no out of ours GP service in

There's no out of ours GP service in Taunton or Bridgwater for the next

Taunton or Bridgwater for the next

Taunton or Bridgwater for the next 24 hours so that might have an

24 hours so that might have an

24 hours so that might have an impact on the sort of patients

impact on the sort of patients

impact on the sort of patients you're seeing down at that end

impact on the sort of patients you're seeing down at that end of

you're seeing down at that end of

you're seeing down at that end of the department as the day goes

you're seeing down at that end of the department as the day goes on

the department as the day goes on

the department as the day goes on but lets see what happens. The

but lets see what happens. The

but lets see what happens. The waiting room is starting to fill

but lets see what happens. The waiting room is starting to fill up.

waiting room is starting to fill up.

waiting room is starting to fill up. And the lack of an out of hours

waiting room is starting to fill up. service appears to be having an

service appears to be having an

service appears to be having an impact. Lee's been suffering from

service appears to be having an impact. Lee's been suffering from a

impact. Lee's been suffering from a

impact. Lee's been suffering from a stye in his eye over the past few

stye in his eye over the past few

stye in his eye over the past few weeks and today he had a nasty

weeks and today he had a nasty

weeks and today he had a nasty surprise. I woke up this morning

weeks and today he had a nasty surprise. I woke up this morning and

surprise. I woke up this morning and

surprise. I woke up this morning and it had puffed right up. Let's have

surprise. I woke up this morning and it had puffed right up. Let's have a

it had puffed right up. Let's have a

self—employed so taking time off

self—employed so taking time off work is always a bit tricky so

self—employed so taking time off work is always a bit tricky so I

work is always a bit tricky so I

work is always a bit tricky so I the only day I have off in the

work is always a bit tricky so I the only day I have off in the week.

the only day I have off in the week.

the only day I have off in the week. I could have gone to my local GP

I could have gone to my local GP

I could have gone to my local GP with this if he was open on a Sunday

with this if he was open on a Sunday

with this if he was open on a Sunday but my local GP's not open on a

but my local GP's not open on a

but my local GP's not open on a Sunday and A&E was the best option.

Sunday and A&E was the best option.

Sunday and A&E was the best option. Lee's one of an increasing number

Lee's one of an increasing number of Lee's one of an increasing number

Lee's one of an increasing number of people who for whatever reason

Lee's one of an increasing number of people who for whatever reason are

people who for whatever reason are

people who for whatever reason are using A&E instead of their local

people who for whatever reason are using A&E instead of their local GP.

using A&E instead of their local GP.

using A&E instead of their local GP. department a real emergency has

department a real emergency has

department a real emergency has arrived. Barry Reed's been in a

department a real emergency has accident. What's happened? Barry

department a real emergency has accident. What's happened? Barry was

accident. What's happened? Barry was

accident. What's happened? Barry was on a push—bike. The paramedics

accident. What's happened? Barry was on a push—bike. The paramedics are

on a push—bike. The paramedics are

on a push—bike. The paramedics are concerned about his neck and that's

concerned about his neck and that's

concerned about his neck and that's why he's come in with blocks. He's

why he's come in with blocks. He's

why he's come in with blocks. He's fully conscious but he's got a

why he's come in with blocks. He's fully conscious but he's got a bit

fully conscious but he's got a bit

fully conscious but he's got a bit of pain in his chest and difficulty

of pain in his chest and difficulty

of pain in his chest and difficulty with his breathing. Back in the

with his breathing. Back in the

with his breathing. Back in the waiting room and a tale of a lesser

waiting room and a tale of a lesser

waiting room and a tale of a lesser casualty is emerging. Michael Norman

casualty is emerging. Michael Norman

casualty is emerging. Michael Norman Jnr was playing in the garden half

Jnr was playing in the garden half

Jnr was playing in the garden half an hour ago. He's hurt his toe.

Jnr was playing in the garden half an hour ago. He's hurt his toe. He

an hour ago. He's hurt his toe. He

an hour ago. He's hurt his toe. He was playing football with his shoes

was playing football with his shoes

was playing football with his shoes off. Are you a wounded soldier,

was playing football with his shoes did you do this? Playing football.

did you do this? Playing football.

department and we're finding out

department and we're finding out what happened to Colin from his

department and we're finding out Sheila. We were going into church

department and we're finding out Sheila. We were going into church in

Sheila. We were going into church in

Sheila. We were going into church in Minehead and he has a walker because

Minehead and he has a walker because

Minehead and he has a walker because he's had lots of operations and

he's had lots of operations and

he's had lots of operations and somehow he went onto a very hard

somehow he went onto a very hard

somehow he went onto a very hard tiled floor there was a big crash

tiled floor there was a big crash

The nurses take a first look at

The nurses take a first look at injuries. Colin ,you've cut your

injuries. Colin ,you've cut your

injuries. Colin ,you've cut your finger as well. Badly, you might

finger as well. Badly, you might

finger as well. Badly, you might need a stitch in that as well Karen.

need a stitch in that as well Karen.

need a stitch in that as well Karen. injury is being revealed. He caught

injury is being revealed. He caught

injury is being revealed. He caught his toe on a stick in the garden.

his toe on a stick in the garden.

his toe on a stick in the garden. Was it your garden? No, it was

Was it your garden? No, it was

Was it your garden? No, it was Grandads. We'll give it a good

Was it your garden? No, it was Grandads. We'll give it a good clean

Grandads. We'll give it a good clean

Grandads. We'll give it a good clean to makes sure the's no dirt in

to makes sure the's no dirt in

to makes sure the's no dirt in there. I think he has peeled some

to makes sure the's no dirt in there. I think he has peeled some of

there. I think he has peeled some of

there. I think he has peeled some of the skin back. Dad has put that

there. I think he has peeled some of and it has stayed in place. That

there. I think he has peeled some of and it has stayed in place. That was

and it has stayed in place. That was

and it has stayed in place. That was the main worry, that there was

and it has stayed in place. That was the main worry, that there was going

the main worry, that there was going

the main worry, that there was going to be some dirt in there and it

to be some dirt in there and it

to be some dirt in there and it would be easier for them to do

to be some dirt in there and it would be easier for them to do it

would be easier for them to do it

would be easier for them to do it rather than him screaming if we

It's been ten minutes since Barry

It's been ten minutes since Barry who was knocked off his bike was

who was knocked off his bike was

who was knocked off his bike was admitted. James is trying to find

admitted. James is trying to find

We often find they may be harbouring

We often find they may be harbouring a number of injuries at multiple

a number of injuries at multiple

a number of injuries at multiple levels in the body and we have

a number of injuries at multiple levels in the body and we have to

a number of injuries at multiple levels in the body and we have to be

levels in the body and we have to be

levels in the body and we have to be quite aggressive to find out what

levels in the body and we have to be quite aggressive to find out what is

quite aggressive to find out what is

quite aggressive to find out what is the actual injury and what is going

the actual injury and what is going

the actual injury and what is going on. You will feel a scratch in

the actual injury and what is going on. You will feel a scratch in your

on. You will feel a scratch in your

on. You will feel a scratch in your arm now. Back in the waiting room

arm now. Back in the waiting room

arm now. Back in the waiting room and Jennifer Smith has arrived

arm now. Back in the waiting room and Jennifer Smith has arrived with

and Jennifer Smith has arrived with

and Jennifer Smith has arrived with what looks like a minor injury.

and Jennifer Smith has arrived with what looks like a minor injury. I

what looks like a minor injury. I

what looks like a minor injury. I was playing with my grandson in

what looks like a minor injury. I son's garden hide and seek and

what looks like a minor injury. I son's garden hide and seek and on

what looks like a minor injury. I son's garden hide and seek and on my

son's garden hide and seek and on my

son's garden hide and seek and on my last game before I went home I

last game before I went home I fell last game before I went home I

last game before I went home I fell in the garden and landed on a stone.

in the garden and landed on a stone.

in the garden and landed on a stone. My son decided he should bring

in the garden and landed on a stone. My son decided he should bring me

in the garden and landed on a stone. My son decided he should bring me to

My son decided he should bring me to

My son decided he should bring me to A&E. I'm 66 and it's the first

My son decided he should bring me to A&E. I'm 66 and it's the first time

A&E. I'm 66 and it's the first time

A&E. I'm 66 and it's the first time I've been to A&E. It turns out

A&E. I'm 66 and it's the first time I've been to A&E. It turns out her

I've been to A&E. It turns out her

I've been to A&E. It turns out her she first thought. That cut needed

she first thought. That cut needed

she first thought. That cut needed stiches. And that's not all. She's

stiches. And that's not all. She's

stiches. And that's not all. She's fractured her wrist. Six weeks

fractured her wrist. Six weeks in fractured her wrist. Six weeks

fractured her wrist. Six weeks in plaster it's not good. It's an

plaster it's not good. It's an

plaster it's not good. It's an experience, can't fault them at

James has come back to examine

James has come back to examine Colin

James has come back to examine Colin who was admitted after falling

James has come back to examine Colin who was admitted after falling down

who was admitted after falling down

who was admitted after falling down at church. We need to get under

who was admitted after falling down bandage and see what's happening

bandage and see what's happening

bandage and see what's happening pretty quickly. Can you see my

pretty quickly. Can you see my

pretty quickly. Can you see my finger? It'll take some time to

finger? It'll take some time to

finger? It'll take some time to uncover the full extent of Colin's

uncover the full extent of Colin's

uncover the full extent of Colin's injuries. And Barry's are also

uncover the full extent of Colin's injuries. And Barry's are also not

injuries. And Barry's are also not

I can't breathe. We will get an

We will be checking on the progress

We will be checking on the progress but first a scale of the problem

but first a scale of the problem

but first a scale of the problem facing A&E departments. Last year

facing A&E departments. Last year

facing A&E departments. Last year they dealt with over a million

facing A&E departments. Last year they dealt with over a million more

they dealt with over a million more

they dealt with over a million more patients than three years ago and

patients than three years ago and

patients than three years ago and announced a fund to bail out the

announced a fund to bail out the

announced a fund to bail out the areas. Will it be enough? Jamie

areas. Will it be enough? Jamie

areas. Will it be enough? Jamie Coulson looks at what's gone wrong

Coulson looks at what's gone wrong

Coulson looks at what's gone wrong and what the cure might be. Jamie

and what the cure might be. Jamie

and what the cure might be. Jamie Coulson looks at what's gone wrong

Coulson looks at what's gone wrong

Coulson looks at what's gone wrong and what the cure might be. The

and what the cure might be. The

and what the cure might be. The prospect of arriving here at A&E

and what the cure might be. The prospect of arriving here at A&E is

prospect of arriving here at A&E is

prospect of arriving here at A&E is never a pleasant one. We are in

prospect of arriving here at A&E is worst position we have ever been

prospect of arriving here at A&E is worst position we have ever been in.

worst position we have ever been in.

worst position we have ever been in. There needs to be light at the

worst position we have ever been in. There needs to be light at the end

There needs to be light at the end

There needs to be light at the end of the tunnel. And at the moment

of the tunnel. And at the moment

of the tunnel. And at the moment there isn't. So how did such a

of the tunnel. And at the moment there isn't. So how did such a vital

there isn't. So how did such a vital

there isn't. So how did such a vital organ of the NHS become such a

organ of the NHS become such a

organ of the NHS become such a problem and what can be done to

organ of the NHS become such a it? These patients are seeing their

it? These patients are seeing their

it? These patients are seeing their English was what? Fried egg, bacon,

English was what? Fried egg, bacon,

English was what? Fried egg, bacon, sausages, the lot. Maureen Lloyd

English was what? Fried egg, bacon, sausages, the lot. Maureen Lloyd was

sausages, the lot. Maureen Lloyd was

sausages, the lot. Maureen Lloyd was once very likely to have become

sausages, the lot. Maureen Lloyd was department. Along withher fellow

department. Along withher fellow

department. Along withher fellow patients, at risk of diabetes,

department. Along withher fellow patients, at risk of diabetes, she

patients, at risk of diabetes, she

patients, at risk of diabetes, she faced a future of chronic health

faced a future of chronic health

faced a future of chronic health problems. I started watching my

faced a future of chronic health better and from the practise I

faced a future of chronic health better and from the practise I was

better and from the practise I was

better and from the practise I was prescription. Today we're going

better and from the practise I was do a few rounds of boxing, get

better and from the practise I was do a few rounds of boxing, get your

do a few rounds of boxing, get your

do a few rounds of boxing, get your heart rate up on the boxing. She's

heart rate up on the boxing. She's

heart rate up on the boxing. She's gone from being a poorly controlled

gone from being a poorly controlled

gone from being a poorly controlled diabetic to having no diabetes

gone from being a poorly controlled diabetic to having no diabetes in

diabetic to having no diabetes in

diabetic to having no diabetes in the pre—diabetes stage. Emergency

the pre—diabetes stage. Emergency

the pre—diabetes stage. Emergency hospital admissions from patients

hospital admissions from patients

hospital admissions from patients Smethwick in the West Midlands

hospital admissions from patients Smethwick in the West Midlands are

Smethwick in the West Midlands are

Smethwick in the West Midlands are 18 months. I simply won't have

Smethwick in the West Midlands are 18 months. I simply won't have an

18 months. I simply won't have an

18 months. I simply won't have an hour or two to spend with every

hour or two to spend with every

hour or two to spend with every patient and that's what they need

hour or two to spend with every patient and that's what they need so

patient and that's what they need so

patient and that's what they need so I can spend time with 18 or 19

I can spend time with 18 or 19

I can spend time with 18 or 19 patients together and patients

I can spend time with 18 or 19 patients together and patients with

patients together and patients with

patients together and patients with lifestyle related illnesses relate

lifestyle related illnesses relate

lifestyle related illnesses relate better to their peers than doctors

better to their peers than doctors

better to their peers than doctors or nurses. Do you want to share

better to their peers than doctors us what's he been doing? Bring

better to their peers than doctors us what's he been doing? Bring it

us what's he been doing? Bring it

us what's he been doing? Bring it down? Has it been unusual talking

down? Has it been unusual talking

down? Has it been unusual talking about something so personal? Yeah,

about something so personal? Yeah,

about something so personal? Yeah, it's unusual. I think the first

it's unusual. I think the first

it's unusual. I think the first one's the hardest and then the

it's unusual. I think the first one's the hardest and then the next

one's the hardest and then the next

one's the hardest and then the next one more at ease with it and by

one's the hardest and then the next third one you discuss everything

third one you discuss everything

third one you discuss everything that needs to be discussed. Do

third one you discuss everything that needs to be discussed. Do you

that needs to be discussed. Do you

that needs to be discussed. Do you think you would have done this

think you would have done this

think you would have done this anyway? I doubt it, I don't think

think you would have done this anyway? I doubt it, I don't think I

anyway? I doubt it, I don't think I

would. What we've seen with Maureen anyway? I doubt it, I don't think I

would. What we've seen with Maureen is a bit unusual and a different

is a bit unusual and a different

is a bit unusual and a different approach but ultimately it's about

approach but ultimately it's about

approach but ultimately it's about trying to keep people out of here.

trying to keep people out of here.

trying to keep people out of here. The patient, the person has to

The patient, the person has to

The patient, the person has to manage themselves 24 hours a day.

The patient, the person has to manage themselves 24 hours a day. So

manage themselves 24 hours a day. So

manage themselves 24 hours a day. So if we can get people to understand

if we can get people to understand

if we can get people to understand quarter of the people we see have

quarter of the people we see have

quarter of the people we see have actually take more than a quarter

quarter of the people we see have actually take more than a quarter of

actually take more than a quarter of

actually take more than a quarter of the time because there often quite

the time because there often quite

the time because there often quite complex. Generally speaking where

complex. Generally speaking where

complex. Generally speaking where access to GP services is good,

access to GP services is good,

access to GP services is good, attendance at A& E departments

access to GP services is good, attendance at A& E departments is

attendance at A& E departments is

attendance at A& E departments is lower. So it seems your family

lower. So it seems your family

lower. So it seems your family doctor has a major role in helping

doctor has a major role in helping

doctor has a major role in helping ease the pressure on emergency

ease the pressure on emergency

ease the pressure on emergency departments. The last Department

ease the pressure on emergency departments. The last Department of

departments. The last Department of

departments. The last Department of Health figures show that annually

Health figures show that annually

Health figures show that annually over one million more people visited

over one million more people visited

over one million more people visited This recent report published by

over one million more people visited England admits A&E services had

England admits A&E services had

England admits A&E services had deteriorated significantly. The

deteriorated significantly. The

deteriorated significantly. The number of hospitals failing to

deteriorated significantly. The number of hospitals failing to treat

number of hospitals failing to treat

number of hospitals failing to treat and discharge 95% of patients within

and discharge 95% of patients within

and discharge 95% of patients within four hours doubled in six months.

four hours doubled in six months.

four hours doubled in six months. Inside Out has filmed at ten A&E's

Inside Out has filmed at ten A&E's

Inside Out has filmed at ten A&E's across England on the same day.

Inside Out has filmed at ten A&E's government's waiting time target.

government's waiting time target.

government's waiting time target. Our figures are just a snapshot

government's waiting time target. hospital trusts are measured weekly,

hospital trusts are measured weekly,

Great Yarmouth in Norfolk. It's

Great Yarmouth in Norfolk. It's early morning before the tourists

early morning before the tourists

early morning before the tourists hit the beach. The resort attracts

hit the beach. The resort attracts

hit the beach. The resort attracts holiday—makers in their thousands

holiday—makers in their thousands

holiday—makers in their thousands over the summer. But a few miles

over the summer. But a few miles

over the summer. But a few miles from the seafront the local A&E

from the seafront the local A&E

from the seafront the local A&E department struggles to cope with

department struggles to cope with

department struggles to cope with the demands of the town's population

the demands of the town's population

the demands of the town's population even before the season influx of

even before the season influx of

even before the season influx of tourists. Now this hospital is

even before the season influx of tourists. Now this hospital is in

even before the season influx of tourists. Now this hospital is in a

tourists. Now this hospital is in a

tourists. Now this hospital is in a struggles to recruit enough A&E

struggles to recruit enough A&E

struggles to recruit enough A&E doctors. Here they're just coming

struggles to recruit enough A&E doctors. Here they're just coming to

doctors. Here they're just coming to

doctors. Here they're just coming to the end of busy holiday season

doctors. Here they're just coming to the end of busy holiday season but

the end of busy holiday season but

the end of busy holiday season but there's no respite with winter

the end of busy holiday season but there's no respite with winter just

there's no respite with winter just

there's no respite with winter just just worked 15 out of the last

there's no respite with winter just days. The scan shows a kidney stone

days. The scan shows a kidney stone

days. The scan shows a kidney stone that's down in the bladder now.

that's down in the bladder now.

that's down in the bladder now. Staff shortages in A&E have become

that's down in the bladder now. Staff shortages in A&E have become a

Staff shortages in A&E have become a

Staff shortages in A&E have become a way of life here at the James Paget

way of life here at the James Paget

way of life here at the James Paget Hospital. We've got eight posts

Hospital. We've got eight posts

Hospital. We've got eight posts filled out of 42 posts this year.

filled out of 42 posts this year.

filled out of 42 posts this year. Which means 34 gaps across the

filled out of 42 posts this year. Which means 34 gaps across the East

Which means 34 gaps across the East

Which means 34 gaps across the East of England from Peterborough through

of England from Peterborough through

of England from Peterborough through Consultants are having to work

of England from Peterborough through Consultants are having to work a

of England from Peterborough through Consultants are having to work a lot

Consultants are having to work a lot

Consultants are having to work a lot harder to fill those gaps so are

Consultants are having to work a lot harder to fill those gaps so are the

harder to fill those gaps so are the

harder to fill those gaps so are the junior doctors who are here as

harder to fill those gaps so are the junior doctors who are here as part

junior doctors who are here as part

junior doctors who are here as part of their rotations and they look

junior doctors who are here as part of their rotations and they look at

of their rotations and they look at

of their rotations and they look at breaking point just to keep things

breaking point just to keep things

breaking point just to keep things ticking over and say, well, I don't

ticking over and say, well, I don't

ticking over and say, well, I don't want to be doing that for the rest

want to be doing that for the rest

want to be doing that for the rest themselves something less stressful.

themselves something less stressful.

themselves something less stressful. Medicine's London headquarters,

Medicine's London headquarters,

Medicine's London headquarters, there's alarm about the situation

Medicine's London headquarters, there's alarm about the situation in

there's alarm about the situation in

there's alarm about the situation in A&E departments up and down the

A&E departments up and down the

A&E departments up and down the patients be? We're coming to the

patients be? We're coming to the

patients be? We're coming to the point where the situation will

point where the situation will

point where the situation will episodes where patient care and

episodes where patient care and

episodes where patient care and safety is compromised due to a

episodes where patient care and safety is compromised due to a lack

safety is compromised due to a lack

safety is compromised due to a lack of emergency care doctors. So you're

of emergency care doctors. So you're

of emergency care doctors. So you're situations? If you have a problem

situations? If you have a problem

situations? If you have a problem for which a time critical element

situations? If you have a problem for which a time critical element is

for which a time critical element is

for which a time critical element is relevant and that's true for many

relevant and that's true for many

relevant and that's true for many conditions that present to emergency

conditions that present to emergency

conditions that present to emergency departments, that increase in time

departments, that increase in time

departments, that increase in time will self—evidently compromise

departments, that increase in time will self—evidently compromise the

will self—evidently compromise the

will self—evidently compromise the care of that patient. I can't move

care of that patient. I can't move

care of that patient. I can't move my wrist very well. Dr Tamer Okasha

my wrist very well. Dr Tamer Okasha

my wrist very well. Dr Tamer Okasha divides his working week between

divides his working week between

divides his working week between shifts as an A&E consultant at

divides his working week between shifts as an A&E consultant at Great

shifts as an A&E consultant at Great

shifts as an A&E consultant at Great he simultaneously specialises in

he simultaneously specialises in

he simultaneously specialises in both primary care and emergency

both primary care and emergency

both primary care and emergency medicine. How many patients do

both primary care and emergency medicine. How many patients do you

medicine. How many patients do you

medicine. How many patients do you see here in A&E that you could

see here in A&E that you could

see here in A&E that you could perhaps deal with as a GP? You

see here in A&E that you could perhaps deal with as a GP? You might

perhaps deal with as a GP? You might

perhaps deal with as a GP? You might get up to 60% patients could have

get up to 60% patients could have

get up to 60% patients could have still need A & E consultants of

still need A & E consultants of

still need A & E consultants of course to run the department but

still need A & E consultants of course to run the department but you

course to run the department but you

course to run the department but you can still find a place for primary

can still find a place for primary

can still find a place for primary care trained doctors for patients

care trained doctors for patients

care trained doctors for patients who come in with a primary care

who come in with a primary care

who come in with a primary care presentation. Many patients who

who come in with a primary care to the emergency department simply

to the emergency department simply

to the emergency department simply don't need to be here. A&E's were

don't need to be here. A&E's were

don't need to be here. A&E's were never meant to be an access point

never meant to be an access point

The 111 phone line was introduced,

The 111 phone line was introduced, patients. But in some cases it

The 111 phone line was introduced, patients. But in some cases it had

patients. But in some cases it had

patients. But in some cases it had the opposite effect. Call centre

the opposite effect. Call centre

the opposite effect. Call centre staff with minimal training ended

the opposite effect. Call centre staff with minimal training ended up

staff with minimal training ended up

staff with minimal training ended up dispatching ambulances too readily.

dispatching ambulances too readily.

dispatching ambulances too readily. medication that has been prescribed

medication that has been prescribed

medication that has been prescribed for anybody else. OK? Here in Derby

for anybody else. OK? Here in Derby

for anybody else. OK? Here in Derby the new service has been a success.

the new service has been a success.

the new service has been a success. received six weeks training have

received six weeks training have

received six weeks training have medical experts on hand to intervene

medical experts on hand to intervene

medical experts on hand to intervene at any stage of a call. 111 works

medical experts on hand to intervene at any stage of a call. 111 works in

at any stage of a call. 111 works in

at any stage of a call. 111 works in our area because we are a GP led

our area because we are a GP led

our area because we are a GP led organisation and we are not for

organisation and we are not for

organisation and we are not for profit. 70% of the time the 111

profit. 70% of the time the 111

profit. 70% of the time the 111 service is first service they will

service is first service they will

service is first service they will service has to be aware of the

service has to be aware of the

service has to be aware of the effect on the A&E department and

effect on the A&E department and

effect on the A&E department and work with them. The Secretary of

work with them. The Secretary of

work with them. The Secretary of now starting to work. We did have

now starting to work. We did have

now starting to work. We did have some teething problems with 111

now starting to work. We did have you're always going to have some

you're always going to have some

you're always going to have some people who are not doctors and

people who are not doctors and

people who are not doctors and nurses who will handle the call

nurses who will handle the call

nurses who will handle the call right at the very start of the

right at the very start of the

right at the very start of the process but what we need to do is,

process but what we need to do is,

process but what we need to do is, if you need to talk to a doctor

process but what we need to do is, nurse you get put through to them

nurse you get put through to them

nurse you get put through to them very quickly. A&E departments will

very quickly. A&E departments will

very quickly. A&E departments will be given an additional £500 million

be given an additional £500 million

be given an additional £500 million over the next two years to deal

be given an additional £500 million seasonal pressures. And Jeremy

be given an additional £500 million seasonal pressures. And Jeremy Hunt

seasonal pressures. And Jeremy Hunt

seasonal pressures. And Jeremy Hunt for A&E departments. But a report

seasonal pressures. And Jeremy Hunt for A&E departments. But a report on

for A&E departments. But a report on

for A&E departments. But a report on the future shape of urgent and

the future shape of urgent and

the future shape of urgent and emergency care provision is due

the future shape of urgent and redesign the service across England.

redesign the service across England.

redesign the service across England. I've heard a lot of people talking

I've heard a lot of people talking

I've heard a lot of people talking about sticking plasters for that.

about sticking plasters for that.

about sticking plasters for that. sticking plasters is a bit emotive

sticking plasters is a bit emotive

sticking plasters is a bit emotive but that the NHS is very grateful

but that the NHS is very grateful

but that the NHS is very grateful for that money from the Department

for that money from the Department

for that money from the Department of Health. What we have to do with

of Health. What we have to do with

of Health. What we have to do with that is to optimise this current

that is to optimise this current

that is to optimise this current model of care that we have to reduce

model of care that we have to reduce

model of care that we have to reduce the pressues over the next two

the pressues over the next two

the pressues over the next two moment? At the moment our figures

moment? At the moment our figures

moment? At the moment our figures for the summer period look very

for the summer period look very

for the summer period look very good. We are monitoring safety.

for the summer period look very can't give you a prediction of

for the summer period look very can't give you a prediction of what

can't give you a prediction of what

can't give you a prediction of what will happen. What I can guarantee

will happen. What I can guarantee

will happen. What I can guarantee though is that the local areas

will happen. What I can guarantee though is that the local areas are

though is that the local areas are

though is that the local areas are doing everything they can to create

doing everything they can to create

doing everything they can to create a system going forward that has

doing everything they can to create many safeguards in it as possible.

many safeguards in it as possible.

many safeguards in it as possible. emergency care in England is due

many safeguards in it as possible. emergency care in England is due out

emergency care in England is due out

emergency care in England is due out this autumn. In the tools with

this autumn. In the tools with

this autumn. In the tools with I am still here outside Musgrove

I am still here outside Musgrove

I am still here outside Musgrove Park hospital in Taunton, so let's

Park hospital in Taunton, so let's

Park hospital in Taunton, so let's go back inside for the second part

go back inside for the second part

go back inside for the second part The staff have been kept busy all

The staff have been kept busy all

The staff have been kept busy all day, but it seems some patients

day, but it seems some patients

day, but it seems some patients There have been things that have

There have been things that have

There have been things that have come through that could have been

come through that could have been

come through that could have been dealt with by the GP or the out

come through that could have been hours doctor, especially when it

hours doctor, especially when it

hours doctor, especially when it comes to things like pain relief

hours doctor, especially when it comes to things like pain relief or

comes to things like pain relief or

comes to things like pain relief or simple ailments, something we would

simple ailments, something we would

simple ailments, something we would It's something that has been echoed

It's something that has been echoed

It's something that has been echoed by the clinical director for, care

by the clinical director for, care

by the clinical director for, care NHS England, who said last week

by the clinical director for, care up to of patients in A&E should

by the clinical director for, care treated by GPs. But for Colin,

by the clinical director for, care treated by GPs. But for Colin, that

treated by GPs. But for Colin, that

treated by GPs. But for Colin, that is not the case. He was brought

treated by GPs. But for Colin, that by ambulance after falling down

treated by GPs. But for Colin, that church. His head and hand were

treated by GPs. But for Colin, that church. His head and hand were badly

church. His head and hand were badly

church. His head and hand were badly dressed. There are still important

dressed. There are still important

dressed. There are still important decisions to be made about his

decisions to be made about his

decisions to be made about his We have to assess what is mobility

We have to assess what is mobility

We have to assess what is mobility is like, because he needs his hand

is like, because he needs his hand

is like, because he needs his hand to use his Walker. The question

is like, because he needs his hand what is the safest place for him

is like, because he needs his hand what is the safest place for him to

what is the safest place for him to

what is the safest place for him to be cared for in the next day or

what is the safest place for him to And Barry, who came in after being

And Barry, who came in after being

And Barry, who came in after being knocked off his bicycle, is still

And Barry, who came in after being knocked off his bicycle, is still in

knocked off his bicycle, is still in

knocked off his bicycle, is still in the resuscitation. The nurses giving

the resuscitation. The nurses giving

the resuscitation. The nurses giving him morphine for the pain. Full

him morphine for the pain. Full

him morphine for the pain. Full extent of his injuries are still

him morphine for the pain. Full extent of his injuries are still not

extent of his injuries are still not

extent of his injuries are still not known. As the day goes on, a variety

known. As the day goes on, a variety

known. As the day goes on, a variety of them is Beryl K, whose year

known. As the day goes on, a variety of them is Beryl K, whose year after

of them is Beryl K, whose year after

of them is Beryl K, whose year after I was eating a piece of skate,

of them is Beryl K, whose year after I was eating a piece of skate, and

of them is Beryl K, whose year after I was eating a piece of skate, and I

I was eating a piece of skate, and I

I was eating a piece of skate, and I thought I had a ball in court in

I was eating a piece of skate, and I thought I had a ball in court in my

thought I had a ball in court in my

thought I had a ball in court in my throat. I was not sure whether

thought I had a ball in court in my throat. I was not sure whether the

throat. I was not sure whether the

throat. I was not sure whether the bone was still in my throat, so

throat. I was not sure whether the It varies as to the kind of fish

It varies as to the kind of fish

It varies as to the kind of fish whether the bone shows up on x—ray,

whether the bone shows up on x—ray,

whether the bone shows up on x—ray, and skate is difficult to see,

whether the bone shows up on x—ray, and skate is difficult to see, so

and skate is difficult to see, so

and skate is difficult to see, so I'm not expecting to see anything

and skate is difficult to see, so I'm not expecting to see anything on

I'm not expecting to see anything on

I'm not expecting to see anything on here, but the other thing is that

here, but the other thing is that

here, but the other thing is that she has had major surgery on her

she has had major surgery on her

she has had major surgery on her neck a few weeks ago. I can see

neck a few weeks ago. I can see

neck a few weeks ago. I can see evidence of the bone there, but

neck a few weeks ago. I can see it may not show up on x—ray, I

neck a few weeks ago. I can see it may not show up on x—ray, I can't

it may not show up on x—ray, I can't

it may not show up on x—ray, I can't The x—ray does not get to the bottom

The x—ray does not get to the bottom

The x—ray does not get to the bottom referred to the ear, nose and throat

referred to the ear, nose and throat

referred to the ear, nose and throat specialist. At the other end of

referred to the ear, nose and throat department, there is a new arrival.

department, there is a new arrival.

department, there is a new arrival. Sheila has come in suffering from

Sheila has come in suffering from

Sheila has come in suffering from shortness of breath. She had her

shortness of breath. She had her

shortness of breath. She had her pacemaker replaced a few days ago,

pacemaker replaced a few days ago,

pacemaker replaced a few days ago, and is worried it is not working

and is worried it is not working

and is worried it is not working Your pacemaker was originally fitted

Your pacemaker was originally fitted

Your pacemaker was originally fitted I had a heart attack, but that

Your pacemaker was originally fitted I had a heart attack, but that have

I had a heart attack, but that have

I had a heart attack, but that have been perfect for eight years. This

been perfect for eight years. This

been perfect for eight years. This I been trying to get breath, this

I been trying to get breath, this

I been trying to get breath, this morning it has been really bad.

morning it has been really bad.

morning it has been really bad. Her family week with her for the

Her family week with her for the

Her family week with her for the results. When they come, it turns

results. When they come, it turns

results. When they come, it turns out the problem is not what is

results. When they come, it turns out the problem is not what is first

out the problem is not what is first

out the problem is not what is first The cardiologist has said it is

out the problem is not what is first related to the pacemaker, but to

out the problem is not what is first related to the pacemaker, but to the

related to the pacemaker, but to the

related to the pacemaker, but to the underlying heart problem she has.

underlying heart problem she has.

underlying heart problem she has. She has got to be admitted on to

underlying heart problem she has. She has got to be admitted on to the

She has got to be admitted on to the

She has got to be admitted on to the cardiology ward to have some fluid

cardiology ward to have some fluid

cardiology ward to have some fluid removed from around her heart.

removed from around her heart.

removed from around her heart. They're going to fit a catheter

removed from around her heart. drain it out. And I can tell you

removed from around her heart. drain it out. And I can tell you all

drain it out. And I can tell you all

drain it out. And I can tell you all off, then. One of the staff takes

drain it out. And I can tell you all off, then. One of the staff takes a

off, then. One of the staff takes a

off, then. One of the staff takes a call from someone who needs advice

call from someone who needs advice

call from someone who needs advice after seeing there out of hours

call from someone who needs advice out of hours can't help you we

call from someone who needs advice out of hours can't help you we can

out of hours can't help you we can

out of hours can't help you we can have a look at you in hospital.

out of hours can't help you we can It happened sometimes, usually

out of hours can't help you we can It happened sometimes, usually you

It happened sometimes, usually you

It happened sometimes, usually you can redirect them to 111, but it

can redirect them to 111, but it

can redirect them to 111, but it It's been 20 minutes since Barry

It's been 20 minutes since Barry

It's been 20 minutes since Barry came in. He is stable enough to

It's been 20 minutes since Barry x—rayed. They are about to find

It's been 20 minutes since Barry the extent of his injuries so they

the extent of his injuries so they

the extent of his injuries so they can decide how best to treat him.

can decide how best to treat him.

can decide how best to treat him. Meanwhile, Colin is doing a little

Meanwhile, Colin is doing a little

Meanwhile, Colin is doing a little better and has had some good news.

better and has had some good news.

better and has had some good news. He has been patched up and staff

He has been patched up and staff

He has been patched up and staff have found him in bed near his

He has been patched up and staff have found him in bed near his wife

have found him in bed near his wife

have found him in bed near his wife hospital where he can go through

have found him in bed near his wife hospital where he can go through the

hospital where he can go through the

hospital where he can go through the rehabilitation was at home, which

hospital where he can go through the rehabilitation was at home, which is

rehabilitation was at home, which is

rehabilitation was at home, which is Today is a last day of the school

Today is a last day of the school

Today is a last day of the school holidays, and Charlotte Jenkins

Today is a last day of the school brought her daughter, Ellen. She

Today is a last day of the school brought her daughter, Ellen. She has

brought her daughter, Ellen. She has

brought her daughter, Ellen. She has got a problem that needs sorting

brought her daughter, Ellen. She has got a problem that needs sorting out

got a problem that needs sorting out

got a problem that needs sorting out My daughter got her finger pulled

My daughter got her finger pulled

My daughter got her finger pulled back last week and it is a bit

back last week and it is a bit

back last week and it is a bit swollen. She can't bend it, so

back last week and it is a bit swollen. She can't bend it, so we

swollen. She can't bend it, so we

swollen. She can't bend it, so we thought we would get it checked

swollen. She can't bend it, so we because she has got school next

because she has got school next

because she has got school next She has had the finger x—rayed

because she has got school next She has had the finger x—rayed and

She has had the finger x—rayed and

She has had the finger x—rayed and Ellen Jenkins. Good news. Nothing

Ellen Jenkins. Good news. Nothing

Ellen Jenkins. Good news. Nothing broken. So it's just the quicker

Ellen Jenkins. Good news. Nothing broken. So it's just the quicker you

broken. So it's just the quicker you

broken. So it's just the quicker you can get it moving again, the quicker

can get it moving again, the quicker

can get it moving again, the quicker If you have any major problems,

can get it moving again, the quicker Down the corridor, something a

can get it moving again, the quicker Down the corridor, something a bit

Down the corridor, something a bit

Down the corridor, something a bit more serious is happening. Mary

Down the corridor, something a bit been brought in from a nursing

Down the corridor, something a bit been brought in from a nursing home

been brought in from a nursing home

been brought in from a nursing home suffering from pains in her chest.

suffering from pains in her chest.

suffering from pains in her chest. arthritis or a problem with her

arthritis or a problem with her

arthritis or a problem with her heart. We test for blood to find

heart. We test for blood to find

heart. We test for blood to find We got blood tests back for Mary.

We got blood tests back for Mary.

We got blood tests back for Mary. The one specifically we wanted

We got blood tests back for Mary. The one specifically we wanted to

The one specifically we wanted to

The one specifically we wanted to check to give the reassurance,

check to give the reassurance,

check to give the reassurance, looking at the heart, has come

check to give the reassurance, looking at the heart, has come back

looking at the heart, has come back

looking at the heart, has come back normal, so it can be sure this

looking at the heart, has come back normal, so it can be sure this is

normal, so it can be sure this is

normal, so it can be sure this is not a heart attack she has had,

normal, so it can be sure this is the pain she is getting his more

the pain she is getting his more

the pain she is getting his more related to her arthritis. We will

related to her arthritis. We will

related to her arthritis. We will get her back to the care home just

get her back to the care home just

get her back to the care home just with some additional medicines.

get her back to the care home just doctor says she is happy if we

get her back to the care home just doctor says she is happy if we can

doctor says she is happy if we can

doctor says she is happy if we can get the wheelchair to get her to

get the wheelchair to get her to the get the wheelchair to get her to

get the wheelchair to get her to the car, then she will take her from

car, then she will take her from

car, then she will take her from It is a welcome relief for her

It is a welcome relief for her

It is a welcome relief for her And things are starting to look

It is a welcome relief for her We have x—rayed his entire spine,

We have x—rayed his entire spine,

We have x—rayed his entire spine, which looks fine. We looked at

We have x—rayed his entire spine, which looks fine. We looked at his

which looks fine. We looked at his

which looks fine. We looked at his chest because he was complaining

which looks fine. We looked at his chest because he was complaining of

chest because he was complaining of

chest because he was complaining of pain is again, that looks fine

chest because he was complaining of pain is again, that looks fine and

pain is again, that looks fine and

pain is again, that looks fine and there is no major injury. The only

there is no major injury. The only

there is no major injury. The only thing we have picked up is that

there is no major injury. The only right side side of his pelvis has

there is no major injury. The only right side side of his pelvis has a

right side side of his pelvis has a

right side side of his pelvis has a hairline fracture. We can at least

hairline fracture. We can at least

hairline fracture. We can at least supports that he isn't, because

hairline fracture. We can at least uncomfortable things for a patient

uncomfortable things for a patient

uncomfortable things for a patient who is conscious and listed, so

uncomfortable things for a patient can free him up now that we know

uncomfortable things for a patient can free him up now that we know his

can free him up now that we know his

can free him up now that we know his neck is OK. But we will have to

neck is OK. But we will have to

neck is OK. But we will have to speak to the orthopaedic surgeon

speak to the orthopaedic surgeon

speak to the orthopaedic surgeon It is 8pm. The 12 hour shift is

It is 8pm. The 12 hour shift is

It is 8pm. The 12 hour shift is finishing. The new team is starting

finishing. The new team is starting

finishing. The new team is starting with a handover meeting. Over the

with a handover meeting. Over the

with a handover meeting. Over the course of both shifts, staff will

course of both shifts, staff will

course of both shifts, staff will treat 188 patients. 50 will stay

course of both shifts, staff will treat 188 patients. 50 will stay in

treat 188 patients. 50 will stay in

treat 188 patients. 50 will stay in hospital, and the Department will

hospital, and the Department will

hospital, and the Department will meet all its targets for the day.

meet all its targets for the day.

meet all its targets for the day. One of the key things are working

meet all its targets for the day. One of the key things are working in

One of the key things are working in

One of the key things are working in a knee is that it is nonstop. It

One of the key things are working in a knee is that it is nonstop. It is

a knee is that it is nonstop. It is

a knee is that it is nonstop. It is service. When we look at a shift

service. When we look at a shift

service. When we look at a shift that the staff work, have to work

service. When we look at a shift that the staff work, have to work on

that the staff work, have to work on

that the staff work, have to work on the basis that you're never going

that the staff work, have to work on the basis that you're never going to

the basis that you're never going to

the basis that you're never going to clear the Department, the result

the basis that you're never going to clear the Department, the result is

clear the Department, the result is

clear the Department, the result is someone else coming in. And that

clear the Department, the result is someone else coming in. And that is

someone else coming in. And that is

someone else coming in. And that is And if you would like to join the

And if you would like to join the

And if you would like to join the debate on the future of A&E come

debate on the future of A&E come

debate on the future of A&E come then starting right now on your

debate on the future of A&E come local radio station. That is just

local radio station. That is just

local radio station. That is just about all for tonight. You can

local radio station. That is just about all for tonight. You can keep

about all for tonight. You can keep

about all for tonight. You can keep in touch with what we're up to

about all for tonight. You can keep in touch with what we're up to on

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in touch with what we're up to on Twitter, or e—mail us at the address

Twitter, or e—mail us at the address

Twitter, or e—mail us at the address Taunton, thanks for watching. Good

Taunton, thanks for watching. Good

Taunton, thanks for watching. Good night. Next week, with more than

night. Next week, with more than

night. Next week, with more than 16,000 children in the West of

16,000 children in the West of

16,000 children in the West of England excluded from school last

England excluded from school last

England excluded from school last year, we find out what happened

England excluded from school last some of them. And we ask whether

England excluded from school last some of them. And we ask whether one

some of them. And we ask whether one

some of them. And we ask whether one of the schools now teaching them

some of them. And we ask whether one of the schools now teaching them is

of the schools now teaching them is