Manifesto 2017 - Emergency care: Challenges and Solutions
In reaction to the 2017 General Election we outlined what we believe should be done to fix and deliver safer, quality emergency care. Below is our guide for parliamentary candidates and their parties to the problems facing emergency medicine and what we need - and what they can help do - to solve them.
The problems facing emergency care
The NHS’s emergency medical workforce face a significant challenge to meet the health needs of a growing and ageing population with increasingly complex needs. Emergency Departments (EDs) are at the very heart of our emergency care systems and, as one of the few places in the NHS to offer a 24-hours a day, 7 days a week service, there is an increasing demand from patients to access Emergency Departments in time of need.
Since 2010-11 attendances in England have increased by 1,031,164 (7.4%)
- equivalent to the workload of 10 medium sized departments – and this number is set to rise. Patients rightly expect to be seen, treated, and admitted or discharged in under four hours. Without the workforce and resources to meet this demand, emergency care staff are working to the very limits of their abilities, 12-hour waits have increased, performance has declined to the worst for fifteen years
and safety is increasingly being compromised.
What we need to deliver safer care and quality
To enable Emergency Departments to effectively treat patients, emergency care needs the right Staffing, Systems and Support:
- Staffing: an increase in the workforce to provide sufficient doctors with the skill and with the necessary number of senior decision makers (consultants) to treat patients effectively, safely and in a timely fashion.
- Systems: the elimination of ‘exit block’ and crowding in Emergency Departments to facilitate delivering quality patient care. Departments need appropriate resources to maintain patient flow through the hospital system whilst also ensuring appropriate care at the right time.
- Support: Improving best practice through using support systems and data that can inform the delivery of better patient outcomes.
How this can be achieved
- Consultant expansion: We require an additional 2,200 new consultants in Emergency Medicine in England alone to achieve safe and sustainable staffing levels . Posts must be structured to allow good recruitment, retention and prevent career ‘burnout’.
- Training: Emergency Medicine physician training posts should be increased by 100 places per annum for 4 years.
- Hospital beds: to combat ‘exit block’ and overcrowding in Emergency Departments more hospital beds are required. We estimate that we have a shortfall of at least 5,065 beds in England alone . In addition better social care provision and community care packages will help maintain flow in the hospital system.
- The ‘Integrated Front Door’: The College has produced clear guidance on how to cost effectively support and resource Emergency Departments with other vital care facilities including frailty teams, pharmacists, mental health specialists and GPs for minor illness using an integrated front door model.
- Emergency Care Transformation Programme: To achieve all of the above will require a robust and practical workforce plan that over a four-year period will help reduce the £464m being spent annually on locum agency staff.
Please click here to download the General Election 2017 - Emergency Medicine Information Pack
The Royal College of Emergency Medicine’s Policy and Communications team works with politicians and policymakers in Westminster, Scotland, Wales and Northern Ireland. We are the first port of call for enquiries on all matters relating to health and emergency medicine policy.
For further details or to discuss the points listed above please contact us on firstname.lastname@example.org or 020 7067 4814.
 Based on 2015-16 attendance figures we have banded EDs groups and then allocated numbers of consultants to deliver a service.
 5,065 extra beds would achieve a safe bed occupancy level of 85%.