RCEM deeply concerned by worst ever performance figures but encouraged by government action

9 March 2017

Today’s figures once again highlight the dire situation our emergency departments are in. Despite a slightly lower number of attendances from the same month last year, four-hour performance has deteriorated to its worst ever level. 

This will come as no surprise to our staff or patients. It is reassuring that the gravity of the situation has now been recognised by the government. 

President of the Royal College of Emergency Medicine, Dr Taj Hassan said: “These figures are deeply worrying but it is good to see action is now being taken to begin fixing some of the problems.

“Yesterday’s boost to social care funding will undoubtedly help relieve some of the pressure on our emergency departments, and while the £100m for triage schemes is very welcome, it will only solve a small part of the problem and is not necessarily the correct way to spend it. 

“The College has argued that primary care services – where there is a significant primary care casemix – should be co-located around the emergency department, including general practice. This is different to having a GP triage patients in an ED. While this is unlikely to have a negative impact on patients, it is also unlikely to make much of a difference to performance. 

“As such, this scheme should be the first step towards co-locating more services, including frailty teams and out-of-hours mental health teams, around the emergency department. By creating a hub of services, patients can be swiftly directed to the treatment or service most appropriate for their needs, without the need to travel elsewhere or book another appointment. 

“More importantly, there is still a clear lack of acute care beds, and inadequate numbers of experienced clinicians to treat the sick patients requiring admission. Addressing these issues will help to fix the current crisis. 

“We estimate that the NHS in England is short of approximately 2200 emergency medicine consultants, and if we are to reach safe levels of bed occupancy we will need to increase the number of beds available by around 10% - something STPs, based on current evidence, will do the opposite of.

“Together with NHS Improvement, the College is now beginning to develop a funded programme that will focus on expanding and supporting our workforce, and establishing a more cohesive clinical operating model to support the system through the next year.

“Stakeholders are working closely together to make the best of a bad situation, and while yesterday’s news was a step in the right direction, it is clear that a lot more will be required if our departments are to meet and maintain performance of 95% again by March 2018, as mooted by the Secretary of State.

“Only then will we begin to get back to the exemplary levels of safety and quality of service our patients deserve.”