"Dirty, dangerous and disorganised"

Was referred by the out of hours GP service at St Pancras to A&E for an urgent blood test and possible DVT scan. As St Pancras has no A&E of it's own, we had a choice of several local A&Es and foolishly thought that the Royal Free might be the best bet. When we arrived, the entrance to A&E was through the middle of a building site, and when we reached the waiting area it was filthy, with spilled liquids all over the floor, ground-in dirt and dirty paintwork and few spaces left on the hard, metal benches. Even the vending machines were either jammed or almost empty. While queuing to register, a group of teens came in with man with dog bite wounds and started shouting and swearing at everyone, insisting on immediate treatment and threatening to kill anyone who got in their way. Despite jumping the queue and threatening the reception staff with violence, the on-site security guards stood back and didn't bother to intervene until the group started trying to kick their way through the locked doors into the treatment area. At this point four security guards and some medical staff had to physically restrain them. This then set off a psychotic episode in another patient who started running around the treatment area, seemingly screaming for her life. It was a scene of complete bedlam and several patients left without treatment as they were too scared to continue waiting. After all the excitement, all that was left was an 80 minute wait to see a triage nurse (despite being referred with a doctor's assessment which should have bypassed the triage process), a 20 minute wait for a blood test, and then two hour wait for the results. Total time from registering to being discharged- three and a half hours, though as no-one spoke more than a dozen words to us throughout, or gave us an idea of the waiting time, it felt much, much longer. The main problem seemed to be that massive shortage of staff (only two doctors on the ward) and the fact that the waiting area is so uncomfortable and unpleasant that many patients wandered off to find less painful benches to sit on, and so missed being called by the nurse, delaying things for everyone. Communication was non-existant, the one member of staff on reception seemed at their wit's end and completely demoralised and the doctor we saw looked like they'd worked several days without sleep. We visited on a Monday night and the department was overwhelmed- I hate to think how bad it gets on a Friday night. The Royal Free Accident and Emergency service is the NHS at its most stretched, and God knows what motivates the staff to continue doing such essential work until such appalling circumstances. I hope never to attend this hospital again, and I can only sympathise with the medical professionals who have to drag themselves into this grot-hole day in, day out.