Royal College of Emergency Medicine Menu Menu

As attendances soar performance plummets, putting patient safety at risk

17 June 2021

Emergency Department performance figures published today by the Welsh Government for May 2021 show the highest number of attendances since the pandemic began, while four-hour performance is the second lowest ever recorded.

The data show in May 2021 there were 67,631 attendances to major Emergency Departments. This is an increase of 6.5%, equal to over 4,000 patients, when compared to April 2021, and an increase of 35% when compared to May 2020. It is the highest number of attendances since December 2019.

Four-hour performance is the second lowest ever recorded at 63.5% for May 2021, a decrease of 3.5 percentage points when compared to April 2021. And second only to December 2020 when it was 63%.

The data show that in May 2021 5,594 patients were delayed by 12 hours on more in major departments across Wales, an increase of 22% when compared to the previous month, April 2021. This is the worst ever 12-hour performance (91.7%) for the month of May, and it is the worst 12-hour performance since February 2021.

Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said:

“Right now, we are becoming increasingly concerned about patient safety. We are seeing a very high number of attendances in what is usually, a quieter summer period. The demand for urgent and emergency care has risen incredibly fast and staff and departments are struggling to cope.

“As the data show performance is suffering, with nearly 25,000 patients, or over one third of all patients delayed by over four-hours.

“We simply do not have the capacity to manage these intense pressures effectively. We are maintaining essential infection prevention control measures but that means we are operating with a reduced number of beds.

“Patient safety is paramount, but the current surge in demand is leading to long delays for patients. Ambulance crews must be able to offload patients quickly and effectively so they can return to urgent and emergency calls in the community. But many Emergency Departments are reporting an increase in dangerous crowding and corridor care, along with ambulance handover delays and poor flow, a likely result of reduced capacity meeting increased demand.

“At the moment beds are desperately needed for urgent and emergency care patients, for elective care patients, and for potential covid admissions. This is an issue of capacity. We support the efforts to tackle the elective backlog, but this must be done in tandem with the recovery of unscheduled care. Any approach must recognise the connection between the two. We know there is a correlation between an increase in emergency admissions and cancelled elective operations.

“We do not want to derail elective care but as demand rises in Emergency Departments, we may find ourselves in a position where, once again, operations need to be postponed to manage unscheduled care.

“With demand on the rise and performance deteriorating once again, the current intensity and pressures on the system are not sustainable, especially as existing staff are exhausted and burned out after 16 months of this challenging work.

“We desperately need some support and a clear plan to manage these pressures. Whether that is expanding capacity safely, improving communication between specialties and departments to manage flow, or improving alternative care – we urgently need action.

“We are deeply concerned, and as we approach winter it is likely that these pressures will significantly intensify. We must prepare for that, and ready our Emergency Departments for a tough winter.

“If we fail to act, patient safety may be at risk. We urgently need a plan to manage current demand, and beyond that a plan to cope with the upcoming winter.”


Notes to editor – Summer to Recover: Senedd Wales Briefing

Back to top Back to top