‘The system has to change’ as A&E staff and patients continue to suffer due to overcrowding – RCEM

5 April 2024

Overcrowding and ambulance delays continue to pose “extreme challenges” for A&E staff and patients, says The Royal College of Emergency Medicine (RCEM).

That’s the response to the final weekly winter ‘situation report’ figures released by NHS England today (5 April 2024) which cover 25 – 31 March 2024 and show that major hospitals are dangerously full.

The average bed occupancy across the week was 93.3%, which far exceeds the level considered to be “safe” (85%).

The figure peaked on 27 March 2024 when almost 19 out of every 20 beds across the country were occupied – many taken up by people who were well enough to go home but unable to because of the lack of appropriate support.

Extremely high bed occupancy leads to delays in patients being admitted from Emergency Departments which can result in overcrowding and people having to endure extremely long waits often in corridors on trolleys, as well as delays in ambulances being able to move their patients into A&Es; effectively causing the system to grind to a halt.

Dr Adrian Boyle, President of The Royal College of Emergency Medicine (RCEM) said:

“The extremely high level of bed occupancy continues to be a serious concern. Much more needs to be done to address it and to support those patients who should be leaving hospital and returning home to ensure the flow through the hospital functions as it should.

“Ambulance handovers are not nearly at an acceptable level and there are still too many delays.

“Our members and their colleagues face extreme challenges during the winter period and do all they can to improve the patient experience in extremely busy Emergency Departments, but clearly the system has to change to enable them to do so safely and effectively.”

The data also showed:

• This week, a total of 18,628 hours were lost to ambulance delays over 30 minutes, which is equivalent to more than two years. So far this year, a total of 294,971 hours has been lost to delays over 30 minutes
• The number of patients who no longer met the ‘criteria to reside’ – which means they were considered well enough to be able to go home – but remained in hospital was 84,104. That means fewer than half of people (47%) who were well enough to be discharged did go home- equating to more than 12,000 a day
• A daily average of 18,466 patients occupied a bed for 21 or more days
• The daily average of beds occupied by flu patients was 801, a decrease of 197 patients compared with last week but an increase of 564 compared with the same week last year.

The latest data comes in the same week that RCEM published analysis looking at the progress made against the Government and NHSE’s Delivery plan for recovering urgent and emergency care services which was launched in January 2023.

It examined several issues such as bed occupancy and ambulance handovers – and also revealed there were almost 300 deaths a week associated with A&E waits of more than 12 hours before admission in England in 2023.

RCEM will continue to monitor ED performance across the UK via the regular data release – more detail of which can be found here.

Graphs illustrating the latest sit-rep data can be found here.

RCEM continues to urge those in Government to support its manifesto which sets out what is needed and how it can #ResuscitateEmergencyCare.