Patient safety at risk as Health Care service in Wales faces crisis

20 January 2022

The latest Emergency Department performance figures for December 2021 published by the Welsh government show:

• There were 57,761 attendances to major Emergency Departments (a decrease of 6% on the previous month, November 2021)
• Four-hour performance at major Emergency Departments was 58.2%, a 0.6 percentage point drop compared to the previous month, November 2021
  • December 2021 recorded the second worst four-hour performance since records began
• One in seven patients were delayed by 12 hours or more at a major Emergency Department, equal to 8,497 patients
• More than two in five patients were delayed by four hours or more at a major Emergency Department, equal to 24,127 patients
• Nearly one in four patients were delayed by eight hours or more at a major Emergency Department, equal to 13,818 patients

Responding to these figures, Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said:

“The performance figures display yet again the severity of the crisis facing the health service in Wales. While shocking, the data hide real patient stories such as: a report of an elderly patient waiting for 10 hours in an ambulance following a stroke; or another patient waiting four nights for a bed in an A&E with a severe skin infection. These are just two cases of many that will be all too familiar to urgent and emergency care workers.

“The combination of a shortage of both staff and beds and difficulties in discharging vulnerable patients when they’ve completed treated is causing ‘exit block’ – where patients are unable to be moved through the system. This leads to long waiting times in the Emergency Department – many up to 12 hours or more – and ambulance queues outside the Emergency Department, leaving ambulance crews unable to return to the community and respond to emergency calls. The crisis is detailed in incredibly distressing patient stories like the ones above. We know long waits, dangerous crowding and corridor care cause serious harm to patients and contribute to a risk of death.

“Staff are working tirelessly in the face of these immense pressures; they are committed to keeping patients safe and delivering effective care. But they are simply burnt out and overwhelmed, and many face moral injury in the present circumstances.

“A recent report by the Welsh Conservatives detailed the widespread Emergency Medicine consultant shortages (up to 50%) across Wales. The government must take heed from the current crisis and commit to publishing a long-term workforce plan that includes measures to retain existing staff and recruit new staff.

“The social care crisis means that the most vulnerable patients are unable to return to the community. It is vital that the government address this as a matter of urgency and provide much needed resources to social care, so that these vulnerable patients can be supported and return home following their treatment. This would reduce long-stays for patients, promote flow throughout the system, and free up beds.”