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As hospital activity rapidly increases, we must ensure we can meet demand, RCEM says

22 April 2021

Emergency Department performance figures published today by the Welsh Government for March 2021 show attendances at Major Emergency Departments are picking up and hospital activity is beginning to return to normal.

The data show that there were 56,473 attendances to major departments across Wales in March 2021 which represents a 30% increase when compared to the previous month and an 11% increase when compared to the previous year, March 2020.

The data also show that 8,317 patients stayed in a department for eight hours or more before being admitted. This accounts for almost 15% of all attendances to major departments, meaning more than 1 in 7 patients are delayed by eight hours or more before being admitted. Furthermore, in March 2021 4,293 patients were delayed by 12 hours or more; this is a 32% increase in long stays when compared to March 2020. However, it is a decrease of nine percentage points when compared to the previous month, February 2021.

Four-hour performance increased by 1.4 percentage points when compared to the previous month with 69.6% of patients being admitted within four hours in March 2021. However, this figure is down 3.4 percentage points compared to March 2020.

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

“As we expected we are beginning to see an increase in demand for urgent and emergency care services with more of our community patients coming to hospital to seek out care. This is made clear by the one third increase in attendances in March compared to February.

“With the increase in demand comes an increase in pressure and unfortunately this has resulted in a rise in delays and long stays. The fact that one in seven patients are delayed by more than eight hours before being admitted clearly show this.

“However, what we are seeing is just the start of a return to normal. Our fear is that those eight-hour delays will soon become 12-hour stays, leading to crowding and corridor care, posing a huge risk to patient safety, and putting intense pressure on staff and Emergency Departments.

“As hospital activity rapidly increases and more and more patients present at Emergency Departments, we must ensure we prevent a return of crowding and corridor care. No patient needs to spend more than 12 hours in a department – the pandemic highlighted the level of risk crowding and delays present.

“To prevent the return of crowding and in anticipation of this increase in demand and the threat of these practices, the College has launched its new campaign Summer to Recover: Winter-proofing Urgent and Emergency Care for 2021. This campaign outlines the actions that the Welsh Government, NHS Wales, NHS Boards and ED Leadership Teams can take to help ready their Emergency Departments and hospitals for next winter.

“We have a period of time to ready our Emergency Departments and look at how we deliver care. We can maximise the potential of alternative care, ensuring that patients have ease of access, we must look at capacity and guarantee we have enough beds. These will be key to alleviating the pressures on Emergency Departments and helping to prevent 12-hour delays in departments and crowding.

“We recognise that recovery is already presenting us with challenges, particularly as demand for services increases and we know that tackling the backlog of elective and non-urgent care is a top priority. But as part of recovery, we must ensure we also address the issues faced by Emergency Departments.

“We expect there will be a further wave of covid and as things return to normal in the late autumn, we expect seasonal viruses such as flu to spread through the community. We must be prepared for this; we have seen how lack of resources and beds left us in an extremely precarious position – we cannot let that happen again.

“Winter was extremely difficult, and it is likely staff are still feeling the effects from it. For some patients too, particularly those who faced severe delays, it may have been very uncomfortable.

“We cannot see a repeat of this winter, we must prepare ourselves, we must ensure that we can meet demand and guarantee patient safety. But action requires close co-operation with other departments and health bodies.”


Notes to Editor

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