A health trust says it is finding it difficult to employ more doctors in its struggling accident and emergency departments because they are put off by how busy it is.
Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) was recently rated as the slowest in London for treating A&E patients.
And bosses blame the poor performance on a high number of vacancies in emergency departments.
The trust, which runs King George Hospital in Goodmayes and Queen’s Hospital in Romford, fell short of a government target of admitting, transferring or discharging 95 per cent of A&E patients within four hours.
The trust achieved a figure of 86.4 per cent.
A trust spokeswoman told the Guardian that A&E doctors can pick and choose where they want to work due to a shortage, so they generally choose to work in less stressful places, rather than one of the busiest, such as Queen’s.
It was reported earlier this month that BHRUT had 129 vacancies in its emergency departments – the most in the country.
Vacancies comprised 43 per cent of total staff, including 12 consultant posts, 41 doctors and 75 nurses.
Providing a service update at Redbridge Council’s Health Scrutiny Committee meeting this week, BHRUT Chief Executive Averil Dongworth blamed poor A&E performance on the trust’s staffing situation.
She admitted that recruiting and retaining high quality, permanent doctors in the emergency department has been a major challenge, and that using temporary staff can harm performance.
“Dedicated work to improve the situation has seen our overall vacancy rate for emergency care staff drop from 45 per cent to 30 per cent in recent months, however this rate does fluctuate,” she added in a statement.
“Our emergency service is among the busiest in the country, with Queen’s Hospital receiving up to 150 ambulances a day.
“That means that staff have to work in a particularly demanding and pressurised environment.
“With A&E consultants largely able to pick and choose their employer, this can make it difficult to attract permanent staff.”
She says the trust are exploring options such as offering joint consultant posts in partnership with Barts Health NHS Trust, who she acknowledged as having facilities more likely to tempt consultant staff.
Dr Paul Flynn, Chair of the BMA Consultants Committee said: "Emergency departments are facing a real recruitment crisis and urgent action is needed to address the high number of vacancies in emergency medicine.
"A&E staff face some of the most challenging and high pressured work environments in the NHS, often with limited resources, so it's understandable that many doctors and nurses chose to work in other specialities.
"However we urgently need to look at how we can make emergency medicine more attractive to increase staff recruitment and retention, because at the moment existing A&E doctors are having to work flat out to meet rising demand."
The trust says it will ensure all A&E shifts are fully staffed using locum and agency cover.