Published Wed, 2011-03-02 17:23; updated 4 years ago.

A senior medical doctor at Stafford Hospital has revealed that he was so concerned about poor staffing levels in A&E that he worked “weekend after weekend” to provide more care for patients.

Dr Shaun Nakash, who first joined the Mid Staffordshire NHS Foundation Trust in 1995, and became clinical lead for emergency care in 2007, was giving evidence to the public inquiry into standards of care at the hospital between 2005 and 2009.

He said he was asked to support the accident and emergency team in April and May 2008, at about the time that the Healthcare Commission published a critical report into standards at Stafford Hospital.

Dr Nakash told the inquiry: "It was a difficult job that I was asked to look after, I must admit.

"The first thing was to ensure that we had sufficient medical and nursing staff on the shop floor to look after patients, and following that we would look at audit as well."

Dr Nakash, who was previously clinical lead for acute medicine, responded to questions by accepting that staffing numbers in accident and emergency were "very low" and that nursing staff and medical staff needed significant support.

"So I spent many, many hours providing that support on the shop floor, looking after patients and carers and relatives, and then when I did have the opportunity I would go up to these (staff consultant committee) meetings and also voice my concerns or support, whatever arrangements or whatever was required to give at that time."

Dr Nakash was asked how conscious he was that staffing levels were low.

"Well, I'd been unhappy with the staffing levels in the accident and emergency department, both medical and nursing, for some time and I had voiced my concerns for some time."

He told the inquiry that he asked for, and was given, four A&E consultants, several middle grades, and more nursing staff after raising his concerns.

"I quickly drew together a model of emergency care for Stafford, looking at the way in which we care for patients that come through the department, and this included minimum staffing numbers, and I submitted this to the team at that time and they agreed to address the issues that I'd raised, and so we recruited more nursing staff, middle grade staff, and went on to recruit accident and emergency staff as well."

Dr Nakash said he specifically raised the issue of insufficient middle grade doctors on several occasions, adding "that's why I spent hour after hour, weekend after weekend in that A&E department looking after patients".

The inquiry was told that the Healthcare Commission regarded the system of identifying serious untoward incident (SUI) reports as poor, with the suggestion that they may also have been downgraded.

Dr Nakash said he could not recall mentioning or having to report a serious untoward incident between 2005 and 2007.

The Inquiry resumed on Tuesday 1 March.