RCEM cautious on next steps towards Forward View delivery

31 March 2017

The Royal College of Emergency Medicine broadly welcomes elements of today’s plan from NHS England on the next steps towards delivering the Five Year Forward View but remains cautious due to workforce issues. 

President of the College, Dr Taj Hassan said: “Many of the proposals for emergency medicine make sense from the perspective of patients, practitioners and providers. 

“It is pleasing that the £100 million announced in the recent Budget will be tailored towards improving ‘clinical streaming’. This will allow patients with minor illness or those with other ambulatory care needs that can be managed by clinicians in a timely fashion and prevents their need to be admitted to hospital. 

“The other proposals will also help to ensure patients are cared for in the right environment, and receive treatment appropriate to their needs, in a timely manner. These approaches align well with the RCEM’s 3S strategy of ensuring that Systems, Staff & Support structures in emergency care are fit for the needs of our patients.

“However, one of the major issues that has not been addressed at all thus far is our workforce. We need to ensure that emergency medicine has the right number of senior staff as decision makers working in one of the most intense environments in healthcare to help deliver safe, high quality care. We also need to have the right junior clinical workforce as well as having the right training environment so that they can be both attracted and retained to completion of training.

“Not having enough consultants and other staff is badly damaging the day to day function of Emergency Departments (EDs). Too many EDs are currently reliant on very expensive locum spend and that cannot be allowed to continue. We desperately need a more coherent, stable and intelligently resourced approach to senior staffing. 

“The ever increasing demand and complexity of work with an aging population often requires two, three or even four consultants at any one time in major EDs working shifts out of hours, weekends and at night. Good systems have this but they are in the small minority. Of equal concern are smaller departments that are struggling and incapable of delivering the very basic service of a single consultant being present 16 hours a day on the shopfloor to support junior staff.

“Levels of staffing must be resourced appropriately otherwise we will not attract or retain the talent in the UK that our emergency care systems so badly need. 

“The College is pleased to continue working with various parties to help develop and deliver a model that is truly ‘fit for purpose’ but time is not on our side and we need urgent action in this area if our emergency care systems are to return to stability.”