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HSC report further highlights risk of backlog growing if urgent and emergency care and the wider health system is overlooked

6 January 2022

Responding to the report by the Health and Social Care Committee, Clearing the backlog caused by the pandemic, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“We are pleased to see our core point that any hope of clearing the backlog depends on seeing the health system as a whole is accepted by the committee. Ignoring the pressures in the urgent and emergency care pathway, starting in Primary care and ending back out in the community risks patient harm and further destabilising healthcare. The success of any recovery plan must clearly include long delayed patients getting the treatment they need but also a functional emergency care system. In the past we have relied on cancelling elective care to cope with emergency pressures. This was not right and now is no longer doable.

“The acknowledgement of the scale of challenges facing the health service is welcome and we support the recommendations within this report. Many of the problems we face now are the result of the lack of capacity before the pandemic hit. Before the pandemic services across the system were struggling to meet demand, and Emergency Department performance had been declining for years. We need a sense of how we move forward from this position, reverse the decline and again offer patients responsive safe emergency care.

“The system is interconnected, significant pressures on Emergency Care can critically derail elective care and further delay patients waiting for surgery unless the capacity issues – workforce and beds are addressed. But as recognised in the report, mental health care, primary care and community care have also faced serious pressures. Strong Primary Care services are the heart of a successful healthcare system and our colleagues in Primary care have been under immense pressure. It is vital that long-term planning is holistic and recognises how each part of the system links to one another. We are particularly pleased to see the recommendation that an evaluation of the NHS 111 system is published so that future service decisions are evidence based. With tight resources we need to know we are backing the right horses. We welcome the report’s acknowledgement of the need to improve and adequately fund the social care system, whose patients present across all parts of the health service. This is critical and must be a priority in any long-term planning.

“This HSC report makes clear that long-term planning and publishing a long-term workforce plan is vital for the future of the NHS. A long-term plan would provide a vision and hope for the future to existing health workers. Any workforce plan must include measures to retain existing staff – who are stretched more thinly on each shift and have been battling burnout for some time – as well as the recruitment of new staff. Across the UK in Emergency Medicine there is a shortfall of 2,000-2,500 WTE Consultants, and extreme shortages of crucial Emergency Medicine nurses, as well as junior and supporting Emergency Medicine staff.

“Morale is low among staff as the health service is under an enormous amount of strain right now. The coming weeks will present further challenges. The Government must be realistic and honest about the scale of the pressures.”

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