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As patient demand increases we must be ready for a new phase of challenges, RCEM says

29 March 2021

The latest data from RCEM’s Winter Flow Project show that increasing numbers of patients are beginning to return to EDs, with 71,722 attendances recorded in the third week of March – exceeding the previous highest total set in week one of the Project in October 2020.

Throughout the pandemic demand at Emergency Departments (EDs) has been significantly lower than previous years. Lockdowns have also meant that the public were at less risk of accidents that might require attendance at an ED, while the use of masks and increased hygiene practices minimised the spread of other seasonal illnesses, such as flu.

Now as attendances have risen 12-hour stays have also increased once again. However, as a proportion, 12-hour stays remain low suggesting that the rise in attendances has not led to an increase in very long waits as yet.

Even as patients begin to attend EDs in larger numbers, the level of available beds continues to be largely static, partly due to the practical difficulties of opening additional beds while maintaining infection prevention protocols.

Commenting on RCEM’s latest Winter Flow Project report Vice President of the Royal College of Emergency Medicine, Dr Adrian Boyle, said:

“While the NHS is manifestly in need of a recovery period, there are already indications that there may be little respite. We expect hospital activity to increase in the coming weeks and months as NHS services return to normal.

“Despite the ongoing success of the vaccine rollout, we know that we are not out of this yet.  One trust has forecasted that June could see a surge in Covid patients on a par with the April 2020 peak. We are worried about this prospect and we are worried about potential variants coming into the country and spreading through the community. We would like everyone to continue to follow the rules and not become complacent. Unfortunately, without any time to recover and rest, NHS staff must once again be ready to face this if it comes.

“The College has consistently outlined the need for more staff, more beds and more resourcing for EDs, all of which may be needed as never before as Emergency Departments potentially attempt to juggle another wave of covid in addition to returning NHS services and activity to normal, all while maintaining proper infection prevention control measures.

“EDs have proved astoundingly resilient but that resilience will be stretched incredibly thin unless they receive the support they will undoubtedly need in the next few months.

“That being said NHS England’s operational planning guidance is most welcome. This outlines the top priorities for the year ahead and includes sufficient focus on the urgent and emergency care pathway. We particularly welcome the plans to expand capacity, introduce the collection of new data and ensure expansion of alternative care including SDEC and NHS 111.

“We have no doubt that we are once again facing an incredibly challenging phase, but NHS England’s latest guidance will be a welcome relief to many healthcare workers.”

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