Winter plan ‘not enough to prepare the emergency care system for tough winter ahead’, RCEM Northern Ireland says

5 October 2023

The winter plan published by the Department of Health Northern Ireland has been described as “disappointing” by the Royal College of Emergency Medicine.

The Winter Preparedness Plan 2023/24 published yesterday (4 October 2023) by the Department of Health Northern Ireland sets out steps to manage and mitigate winter pressures.

The Winter Preparedness Plan 2023/24 lays out the following measures:

• Ulster hospital has opened a new Emergency Department with a dedicated ambulance handover zone
• Northern Ireland Ambulance Service to provide hospital ambulance liaison officers at the main Emergency Departments to facilitate the smooth transfer of patients into hospitals
• Ambulance handovers to be completed within 15 minutes of arrival and no later than two hours, average ambulance response times should be 10 minutes for Category 1 calls and 36 minutes for Category 2 calls
• Belfast Trust has opened a 25-bed medical rapid assessment unit and will maintain 24 additional step-down beds to facilitate discharge and 19 more will be opened this winter
• An additional 48 beds have been opened in Antrim Area Hospital, an additional 45 beds opened in Ulster hospital will continue to be funded, increase in bed capacity by five at the Royal Belfast hospital for Sick Children
• Investment in alternatives to A&E, including the expansion of phone first and rapid access clinics and the pharmacy first pilot
• All Trusts have committed to discharging all simple discharges from a hospital bed within four hours of being declared fit to go home, with the target for complex discharges set at 48 hours

Dr Michael Perry, Vice Chair of the Royal College of Emergency Medicine Northern Ireland, commented:

“The emergency care system in Northern Ireland is under significant pressure.

“Our members had no respite during the warmer months, which are typically quieter.

“Patients continue to face excessively long and dangerous waits in overcrowded A&Es.

“Now, we are heading into winter, and one that we fear could be worse than the last.

“While it is right to publish a winter plan, this plan is disappointing.

“There is a welcome increase of some capacity, but there remains an urgent need for more acute beds.

“The focus on the front door by creating handover zones with liaison officers is wrong. A&E departments should not be extended.

“The walls of A&Es are not elastic, extending the department will only increase dangerous overcrowding and corridor care and stretch the workforce further.

“We welcome key performance targets, these should encourage better flow throughout our hospitals, but the omission of targets around A&E waiting times is a misstep.

“We are surprised that we were not consulted on this plan or measures around unscheduled care. And we are concerned that this plan does not go far enough to prepare the emergency care system for what will likely be a tough winter ahead.

“We urge the Department of Health to adopt our priorities to #ResuscitateEmergencyCare.”