A&E performance figures “don’t fully reflect how bad the situation has become”

9 February 2017

The Royal College of Emergency Medicine responds to the latest set of performance figures.

Dr Lisa Munro-Davies, Vice President of the College, said: “These figures come as no surprise and are reflected in our own Winter Flow data which has clearly demonstrated that performance has been deteriorating for some time.

“We have repeatedly highlighted the dire situation for patients and staff in Emergency Departments. Policy makers need to recognise the reality of the situation, and provide the resources and changes that are so clearly needed in order to improve care for patients and working conditions for staff. 

“Emergency Departments are barometers of pressure in the wider health and social care system. What this means is all parts of the healthcare system must work together to improve performance for patients.

“Bed occupancy rates continue to run at levels which we know are unsafe. This obstructs patient flow and is a direct reflection of insufficient capacity in both acute hospital and community settings. 

“Demand in unscheduled care has increased and become ever more acute as our population is ageing. In the UK we have the lowest number of acute care beds per capita in Europe so overcrowding in EDs and Exit Block is inevitable.

“Many years of bed closures have been based on the assumption that demand reduction plans work. It has been evident for some time that this is not the case – reduced demand has failed to appear and is unlikely ever to do so. 

“Crowded departments are unsafe for patients and staff. Working at the limits of their capabilities results in medical professionals suffering from burnout and ill health, with many often seeking to leave the specialty or quit medicine altogether. Staff shortages exacerbate the challenges faced every day by those that remain.

“Whilst there is a historical understaffing in Emergency Departments, unless the issues of overcrowding and Exit Block are addressed, any further drive to recruit and retain staff is unlikely to be successful. 

“In our view the figures obtained by the BBC don’t fully reflect how bad the situation has become. Our own data suggests the average performance at major departments was actually around 79% in January. We would echo the Nuffield Trust’s view that the number of patients trapped in hospital despite being fit to leave is three times higher than official data and is a major factor in performance.  

“An urgent correction of funding to both emergency medicine and social care is imperative to get our EDs back to providing safe and dignified care for patients at a sustainable level.

“More beds in acute and community care are now essential, as is an increase in staff numbers to improve both care for patients and working conditions for staff.”