Dire situation in Northern Ireland Emergency Departments as one in seven patients delayed by 12+ hours in December 2021

11 February 2022

Quarterly Emergency Department performance figures published today by the Department of Health Northern Ireland show:

• There were 56,031 attendances in October 2021, this is a 31% increase compared to the same month last year, October 2020
• There were 52,300 attendances in November 2021, this is a 38% increase compared to the same month last year, November 2020
• There were 51,872 attendances in December 2021, this is a 33% increase compared to the same month last year, December 2020

Quarter 3 saw the highest number of 12-hour waits on record:

• In October 2021 there were 7,825 12-hour waits, this is a 61% increase compared to the same month last year, October 2020
• In November 2021 there were 7,080 12-hour waits, this is a 70% increase compared to the same month last year, November 2020
• In December 2021 there were 7,506 12-hour waits, this is a 45% increase compared to the same month last year, December 2020

In Quarter 3 four-hour performance remained at incredibly low levels:

• In October 2021 four-hour performance was 49.6% compared to 57.1% in the same month last year, October 2020
• In November 2021 four-hour performance was 50.4% compared to 59.2% in the same month last year, November 2020
• In December 2021 four-hour performance was 47.7% (the second lowest ever recorded) compared to 55.1% in the same month last year

As the data show we have returned to high numbers of attendances and have seen both a decrease in performance and an increase in long-waiting times. In December 2021 as more than half of all patients were delayed by four-hours or more, more than one in seven patients were delayed by 12 hours or more.

Dr Paul Kerr, Vice President of the Royal College of Emergency Medicine Northern Ireland, said:

“The situation in Emergency Departments in Northern Ireland is dire, the data show that it is very bad indeed. The reality is that patient care is now regularly being compromised, their safety is at risk. Dangerous crowding and unsafe corridor care are well and truly back, and these practices put all patients, but particularly our most vulnerable patients, at great risk.

“Four-hour performance in December sank again to a shockingly low 47.7%, meaning over half of all patients attending an Emergency Department were waiting for four hours or more before being admitted, transferred or discharged. While the 12-hour data are shocking, in December more than one in seven patients were delayed by 12 hours or more in an Emergency Department before being admitted or discharged.

“We know that delays and long-waits in Emergency Departments are closely associated with patient harm and poor outcomes. The Royal College’s report ‘Crowding and its Consequences’ found that one in 67 patients waiting for 12 hours or more are associated with avoidable harm or potential death within 30 days.

“We are deeply concerned about the situation in Northern Ireland. Staff are struggling to deliver the quality of care they wish, but they are doing their best to keep patients safe. Crowded Emergency Departments mean that hospital acquired (nosocomial) infection is a significant risk and, in December, with the spread of Omicron this risk increased substantially. In some Emergency Departments staff continue to wear full PPE to protect themselves and their patients. The current circumstances make moving patients through the system and keeping them safe extremely challenging.

“Urgent and Emergency Care continues to be in a deep crisis. While elective care is suffering too and rightly needs an action plan, it is vital that any plan includes actions to tackle both the elective care backlog as well as the crisis in unscheduled care. The government must look at this data and recognise the harm that is coming to patients and take effective action in publishing an unscheduled care recovery plan. We would welcome the opportunity to discuss the situation and actions that can be taken in the short-, medium-, and long-term to alleviate system pressures.”