COVID19: Resetting Emergency Department Care

The coronavirus pandemic continues to pose unprecedented challenges to our health service. As we progress beyond the first peak of the outbreak and core health services restart, radical changes need to be made to the delivery of care to ensure that COVID-19 can be managed safely in our Emergency Departments.

Corridor care must never return to our hospitals again. Crowding and COVID-19 are fundamentally incompatible, we cannot maintain safe social distancing and infection control in overcrowded departments. The challenge this represents cannot be underestimated; managing the risk of hospital-acquired COVID-19 in Emergency Departments requires a systemic transformation across our health and care service.

Policymakers must act now to keep patients safe from COVID-19 in Emergency Departments. Our campaign, Resetting Emergency Care, outlines three key areas of focus for the Government to help Emergency Departments provide safe care and prevent unnecessary deaths.

Read the MP brief and our full position statement below.

• RCEM Guidance: Key Questions for Clinical Leads
• COVID-19: Resetting Emergency Department Care
• Resetting Emergency Care - a briefing for MPs
• Resetting Emergency Care - FAQs for Clinical Leads
• What to do if your ED is becoming crowded again after the initial COVID period (September 2020)
• EMJ Supplement blog from RCEM President and VP Policy: 'COVID-19: resetting ED care'
• Position statement: Governance responsibilities for patients who do not attend booked appointments in Emergency Departments (October 2020)
• RCEM submission to the government's Comprehensive Spending Review (September 2020)
• Letter to Chancellor of the Exchequer Rishi Sunak regarding the Comprehensive Spending Review (19 November 2020)
• Letter to MPs on Tiers (30 November 2020)
• RCEM & College of Paramedics Joint Statement: Ambulances Handover Delays - Options Appraisal to Support Good Decision Making (January 2021)

• RCEM Scotland Position Statement: The Four-Hour Emergency Access Standard

Crowding after the initial COVID period

With crowding returning to many Emergency Departments after the first phase of the Covid pandemic, we’ve released guidance on what to do if your department is becoming crowded again.

Crowding is a real concern to patients and staff alike and we must do all that we can to eliminate it.

Our guidance aims to support leaders in systems, organisations, and Emergency Medicine to consider their current position, and work together in the face of this re-emerging problem.

‘What to do if your ED is becoming crowded again after the initial COVID period’ outlines the questions Departments should ask to ensure that they have adopted relevant good practice and whether the organisation is doing everything it can to reduce crowding.

It also provides key points around advocacy and explores what local EM leaders should do if they feel that organisations are not responding effectively.

As well as the guide, you can watch a presentation by RCEM Vice President Dr Ian Higginson, on the actions to be taken and the questions to be asked.

RCEM National ED Snapshot Survey

Every two weeks from October onwards, we are asking Clinical Leads to help us build a picture of how EDs are coping. Our snapshot surveys will provide real time feedback for the College around key issues which can be used in our advocacy efforts, particularly during covid. 

We are asking three core questions each week and will add in supplementary questions where required according to changes to the situation. The core questions will initially focus on crowding. They are: 

• How often has your ED been holding ambulances in the last week?
• How often have you been providing care for patients in non-designated areas such as corridors in the last week?
• How often have you been unable to maintain social distancing for patients within your overall footprint in the last week (including waiting and clinical areas)?

Reports can be found below. For further information on our snapshot survey please contact vicepresident@rcem.ac.uk

• Snapshot Survey 1
• Snapshot Survey 2
• Snapshot Survey 3

Key data from Survey 3