Casualty nurses at Oxford's John Radcliffe Hospital are threatening industrial action over their fears for patient safety.

Staff say patients endure little privacy or dignity because of cramped conditions and staff shortages. Nurses also have little time to give essential care, like providing meals and drinks.

The Royal College of Nursing (RCN) says two years of talks with managers have not eased the pressures and the union will now decide whether its members can vote to take action.

Casualty nurses will not strike at the Headington-based hospital and they say patient care will not be affected by their protests.

Instead, more than 60 RCN members, about 90 per cent of A&E staff, could refuse to treat patients in unsuitable conditions - such as corridors.

They could also work to rule by taking meal breaks and leaving promptly at the end of their shifts, or they could refuse to work overtime.

Oxfordshire RCN spokesman Patricia Marquis said: "Our aim is not to harm patients, so we don't know what action the nurses will take if a ballot is successful. We are not expecting things to change over night, but we want to see some improvements.

"The department is very small and when nurses have two or three times the number of patients it was specified for, it gets very difficult to give the right standards of care.

"People wait as long as 31 hours. Our nurses work in that situation day in, day out."

The A&E department has suffered problems for more than a year. "Red alerts" have been called on numerous occasions when the unit is at bursting point and unable to cope with any more admissions.

The NHS South East Regional Office recently published a report criticising the department. Even its clinical director, Dr Philip Hormbrey, has warned that patients are not safe.

Managers at the Oxford Radcliffe Hospitals NHS Trust, which oversees the JR, said they would ensure patients were not affected if nurses took action.

Chief executive David Highton said: "I understand the frustrations of our accident and emergency staff and I am deeply concerned about the difficulties they face.

"I will continue to talk to the RCN and to our own staff about how we can work together to relieve some of the pressures and improve the system."

The RCN Council will consider authorising a ballot for industrial action at the JR within the next fortnight. The move was recommended by the union's industrial action sub-committee.

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