‘The focus is on patients’ clinical needs and distress’

Casualty Watch was started in south London in the early 1990s by Southwark Community Health Council, at a time when many patients using King's College Hospital experienced inadequate and inappropriate emergency care because the accident and emergency department was physically unsuited to the increasing demand for its services. Casualty Watch is a rapid, systematic method of collecting data on patient waiting times on trolleys and beds in emergency departments simultaneously over any chosen area. The data are faxed to a data collection point, analysed, and then distributed back to the local community health council, hospitals, health authorities, health ministers, and the media within days, providing a picture of the state of emergency care across the country. The data include patients' length of wait from arrival, age, sex, presumptive diagnosis, and action plan.

The trained “casualty watchers,” who collect the data, are local people appointed to the statutory community health councils to monitor local health services and are committed to improving the quality of emergency services in their area. Many have personal experiences of receiving treatment in the department they are monitoring and see Casualty Watch as a way of improving services for the whole community.

The casualty watchers simultaneously arrive at their local …