"nice people, filthy place"

About: Manchester Royal Infirmary

What I liked

I walked through the A&E yesterday and I was really shocked by the posters on the wall. There are 2 posters, one of a man and one of a woman. Both have obviously been touched up with make-up to look like they have been beaten. The message on the poster is that violence will not be tolerated.

While I appreciate that these posters are there for the best of intentions, they are completely counter-productive.

Firstly the make-up - there is something really odd about using make-up to show a battered person, it somehow makes it less of a reality. For people who are actually beaten, I think it would be quite offensive. If you are sitting there with cuts and bruises on your face, having just been battered by your husband, these posters could be really quite distressing.

Secondly, and most importantly, the 'zero tolerance' tone of the poster will discourage people who have been beaten from coming to hospital. Hospital should be a safe space where you feel you can come, regardless of how you ended up getting hurt. People who are being abused are already scared, they already know that they are in a difficult situation. If they think that coming to hospital will mean more questions being asked and potentially more abuse later, they will not come on.

What could be improved

Take the posters down and have a counsellor at A&E to talk privately to people who come in with evidence of abuse. Provide the person with a follow-up telephone number they can call for help. I realise that this is more expensive, but it would be much more productive in the long run.

Anything else?

Can I also ask that you spend less money on building and more money on cleaning. Every time I come in, the hospital floors, walls and toilets are smelly and filthy. Since A&E is probably the part of the hospital that the majority of the population use, why is it not prioritised - A&E is the window onto the NHS and it isn't pretty.

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Response from Manchester Royal Infirmary

Many thanks for taking the time to comment on your perceptions of our department. I am sorry to hear that you found the department to be dirty, and would like to assure you that we strive to maintain a clean, professional environment at all times. We have recently reviewed our cleaning schedules, and one of our senior nurses is closely monitoring these changes. The building work is a vital part of our plans to improve the experience of the emergency department for both patients and visitors. We feel that the long term benefits that will be realised by this redevelopment outweigh the temporary inconvenience caused during this phase of works. We do appreciate your feedback about the posters in our department. It may be beneficial for me to explain the message of these posters in more detail. Verbal and physical abuse against staff in the emergency department is an increasing problem. Some patients and their friends or family members accompanying them are violent and aggressive towards the nursing and medical staff who are trying to help them. The posters refer to the zero tolerance policy we enforce regarding violence against members of staff. This is further reiterated in the text of the posters which states: “verbal or physical abuse will not be tolerated. 98% of assaults on staff in 2010 were successfully prosecuted” I would like to assure you that if a victim of assault presents to the emergency department for treatment, where appropriate we will offer advice and onward referral to other relevant services.

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