Emergency Care is in crisis

6 January 2017

The Royal College of Emergency Medicine has for a number of years urged the NHS to tackle the ever increasing problems facing emergency and urgent care.

Despite frequent and repeated warnings, the situation has steadily deteriorated and we now face the worst four hour performance in almost 15 years. Emergency care is in a state of crisis.


The figures bear this out. In the week leading up to Christmas there were 332,118 attendances in England alone, but an average of 87.6% of all beds were occupied – above the recommended safety limit. The number of patients experiencing delayed transfers of care has risen by 28% in the space of a year.

Our own Winter Flow data suggests that average four hour performance was around 77% with some Trusts struggling in the 50-60% range. Our expert view is that this type of performance leads to serious safety issues. Data so far also suggests a year on year drop in performance in the range of 4 to 11%.

Figures though cannot account for untold patient misery. Overcrowded departments, overflowing with patients, can result in avoidable deaths.

The situation is intolerable for both staff and patients who are all too often left in the undignified position of waiting on a trolley in a corridor for bed to become free. 

Dr Taj Hassan, President of the College said: “The emergency care system is on its knees, despite the huge efforts of staff who are struggling to cope with the intense demands being put upon them. 

“Internal major incidents are being declared in many systems around the country – every hospital in Essex has been on ‘black alert’ – and staff in Emergency Departments (EDs) are working at and beyond their capabilities. This cannot be allowed to continue.

“The scale of the crisis affecting emergency care systems has reached new heights, as we predicted, mainly due to a lack of investment in both social and acute health care beds, as well ED staffing. 

“While at a local level there may be a case to be made around the need for better service planning, the ultimate problem is a national one – our emergency care system is clearly underfunded.

“A correction to the funding of both the NHS and social care has never been more vital, and further cuts in the form of Sustainability and Transformation plans in England, if carried through, would be potentially catastrophic.

“However I am reassured by the very constructive meeting with Simon Stevens & Jim Mackey yesterday that this issue will be given the highest priority. We must have immediate action in key areas and then build a safe and sustainable plan for the future.”