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As Emergency Departments become overwhelmed, patient safety is put at risk

10 June 2021

Emergency Department performance figures published today by NHS England for May 2021 show 1,396,193 patients attended Type 1 Emergency Departments, the second highest figure ever recorded.

Data also show that nearly one third of these patients, equal to 411,262 patients, were admitted via Type 1 Emergency Departments, the fourth highest figure ever recorded. And nearly 700 patients were delayed by 12-hours or more, a one-third increase on the previous month, April 2021.

While data on Ambulance Quality Indicators published by NHS England for May 2021 show the highest number of incidents ever recorded with 800,094 contacts.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“Emergency Departments are becoming overwhelmed. Across the country we are hearing that sites are reporting record breaking numbers of patients. The sheer volume is putting severe pressures on staff and departments, which are struggling to cope.

“The pressures on Emergency Departments are paralleled in the ambulance service data which show that May 2021 saw the highest number of contacts ever recorded.

“We are in real trouble; the College has warned for months about the urgent need for a safe management of the exit from the pandemic. We desperately need action and leadership. If pressures continue to rise, patient safety will likely be put at serious risk.

“We are seeing an increase in very sick patients, patients who require ambulances. But when Emergency Departments are facing severe demand, ambulances can be delayed, unable to offload patients into the Emergency Department and then unable to return to the community and respond to urgent and emergency calls. This is a grave threat to the health of patients, especially those that are vulnerable and in a critical condition.

“Emergency Departments have seen a significant rise in the number of 12-hour delays, with nearly 700 patients staying in an Emergency Department for 12 hours or more. Long-stays increase crowding in our departments and forces clinicians to administer care in corridors. These are dangerous practices and must not be allowed to happen – especially with covid still present in the community – but when there is no capacity for vulnerable patients no other choice remains.

“It is not sustainable. Continued intense pressures on existing staff within an understaffed workforce could lead to a mass exodus of either junior staff and/or senior clinicians. A workforce survey of our members is currently underway, and the responses we have seen so far show, unsurprisingly, a workforce with low-morale and under severe strain.

“We have repeatedly called for a safe expansion of capacity; the only viable short-term option that would likely ease the severest of pressures and help to reduce the dangerously high bed occupancy figures that many Trusts are currently managing.

“Expanding capacity requires a joined-up approach. Working closely with social care to protect the most vulnerable patients and ensure they are treated swiftly and effectively, and handling transportation to and from hospital.

“Inter-departmental and cross-specialty communication can help flow through the hospital and help prevent exit block. While same day emergency care (SDEC) is a vital service that can be expanded so lower acuity patients can be treated effectively without being admitted.

“Patient safety is always the top priority for all health care workers. But the increase of crowding in Emergency Departments; the potential derailing of urgent elective care (for the now 5.1 million patients waiting for treatment); and the strains across the entire health system; are putting patient safety at risk. We need urgent action now to manage these pressures.”

Notes to editor

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