Transparency of data key to tackling alarming Emergency Care crisis in Wales

18 November 2022

Responding to the latest Emergency Department performance figures for Wales, Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said:

“The Emergency Care system is in crisis. The reported data show nearly half of all patients waiting more than four-hours to be seen, one in four patients waiting eight hours or more, and nearly one in six patients waiting 12-hours or more. However, this is not the full picture. There are many more patients who wait for over 12-hours that are masked by clinical and operational exclusions, classified as breach exemptions. We have written to the Health Minister, Eluned Morgan MS, to ask that these real patients, facing exceptionally long waits, are included in the data. It is vital that the Welsh government are transparent about the number of patients facing these harmful long waits for the sake of patient safety, and so we can begin tackling the root of the issues facing the system.

“Extremely long waits are distressing for patients; they can affect their condition and their care. Studies show long waits are associated with patient harm and morbidity. Our hardworking Emergency Medicine staff are doing their utmost to keep patients safe and doing all they can to continue delivering effective care. However, the crisis and the conditions are contributing to widespread staff burnout and exhaustion. Morale remains very low among the workforce.

“We are deeply concerned at the incredibly high-levels of bed occupancy, up to nearly 96% in some cases, far exceeding the recommended 85%. Many patients reside in hospital who are medically fit to be discharged but are unable to be due to a lack of social care support in Wales. Staying in hospital once treatment is complete can be uncomfortable and can carry risk for patients. Ultimately, patients staying in hospital beyond their care creates a ‘traffic jam’ in the system leading to queues of patients waiting to be admitted, waiting in Emergency Departments, waiting in ambulances outside EDs and waiting in the community for ambulances. The system is not functioning as it should, and we know patients are coming to harm as a result.

“The Government must urgently bolster the social care workforce so that patients who are ready to be discharged can be discharged in a timely way. They must also look at expanding capacity where safely possible. Today we have co-signed an open letter to the Welsh government calling for an update and timeline on the publication of the workforce implementation plan. It is vital that the government increase staffing numbers in the NHS in Wales and ensure we retain existing hard-working, skilled staff, and that they feel valued, supported and respected.”

-ENDS-

Notes to editor

The latest Emergency Department performance figures for October 2022 published by the Welsh government show:

• There were 67,982 attendances at major Emergency Departments
• Four-hour performance at major Emergency Departments was 56.8%
  • Almost half of all patients were delayed by four hours or more at a major Emergency Department, equal to nearly 30,000 patients
• More than one in four patients were delayed by eight hours or more at a major Emergency Department, more than 17,000 patients
• 10,923 patients were delayed by 12 hours or more at a major Emergency Department, equal to over one in six patients
• A monthly average of 94.57% of all general and acute beds were occupied in October 2022, this is the highest monthly bed occupancy figure on record
• In October 2022, the maximum percentage of bed occupancy recorded on a given day was 95.72%, which is the new highest level of bed occupancy recorded on a day since the start of the pandemic.
  • The minimum level of occupancy was 92.22%, 7.35 percentage points above the 85% recommendation to ensure patient flow and hospital capacity.