Regulators to introduce 'A&E special measures' regime

23 March 2017

The news today that Regulators are to introduce 'A&E special measures' regime risks missing the fundamental need to address the chronic under resourcing of our emergency departments.  

After the worst winter for 15 years, what we need is investment in staffing and systems that are properly integrated. Our major problem is we simply don’t have enough doctors working in emergency departments and the resulting locum spend to cover this deficiency is now huge. 
This College welcomes the focus on performance and the wider discussion on better quality indicators: patients expect and deserve to see the four hour standard being met and our Members and Fellows work hard in very difficult circumstances to provide the best possible emergency care.  

There are long standing issues however which together build pressure on emergency departments and compromise care. These include a shortage of emergency physicians, insufficient acute care beds and problems with social care capacity which means that hospitals are operating with high bed occupancy levels leading to overcrowding and harm. 

Simply introducing special measures regimes on their own will not transform these fundamental issues and more needs to be done. 
RCEM President, Dr Taj Hassan, commented: “Whilst there are systems that may well benefit from best practice and this proposed special measures regime, we have been taking that approach for a long time and remain on a chronic spiral downwards. 

“There are fundamental challenges that need addressing to provide sufficient emergency physicians to staff our Emergency Departments to meet the increasing demands and complexity of work they are expected to manage. At a time when staff are doing their utmost, recruitment and retention is a continuing struggle, what we don’t need is a ‘big stick’ approach to management.  

“The key to creating stability is to create the right vision, culture and leadership supported by intelligent use of resources to transform the large locum spend budget into high quality permanent emergency physicians. 

“Failure to do that will neither attract nor retain the expertise we need on the frontline of emergency care in this country”.