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Emergency care crisis putting patients at risk as they face longest waits on record

14 April 2022

Responding to publication of Urgent and Emergency Care performance figures for March 2022 by NHS England, Dr Ian Higginson, Vice President of The Royal College of Emergency Medicine, said:

“Once again Emergency Departments have recorded the worst performance on record, the worst four-hour performance and the highest number of 12-hour waits. Patients are waiting for increasingly long periods for an ambulance, in the back of an ambulance and in crowded Emergency Departments. We know that long waits in Emergency Departments can lead to associated harm and even death. Recent solutions have only attempted to tackle symptoms of wider, long-term problems rather than treat the underlying cause – the core problem of exit block.

“There have been reports this week that medics have been moved from tackling the elective care backlog to tackling the crisis in emergency care. We have previously expressed concerns that the elective care recovery plan is isolationist, and that a failure to address emergency care will simply derail elective care. Elective care and emergency care are inextricably linked and equally important, it is right to tackle the elective care backlog but this must be tackled in tandem with emergency care.

“There are severe delays throughout the health system, exacerbated by widespread staff shortages and a shortfall of 10,000 beds. Added to these, the crisis in social care – an underpaid and understaffed workforce – is leading to elderly and vulnerable patients remaining in hospital for longer than medically necessary. While there is an attempt to improve delayed discharges by NHS England, bed occupancy in hospitals is still high; full hospitals cannot function efficiently. Without the expansion of social care provision, elderly and vulnerable patients will continue to occupy hospital beds that could be used by emergency or elective care patients.

“The government must take action to address the lamentable performance and patient harm in emergency care. The government must publish an urgent and emergency care recovery plan as well as take meaningful action to tackle the social care crisis. It is also critical that the government publish a fully funded long-term NHS workforce plan and open 10,000 beds across the UK.”

Commenting on the upcoming Easter Bank Holiday weekend, public health and infection prevention control measures, Dr Higginson continued:

“Emergency Departments are in a critical situation, covid remains rife with covid-related staff absences sweeping across the UK. We know crowded Emergency Departments are a high-risk space for covid infection, particularly for the vulnerable and elderly.

“We cannot risk removing infection prevention control measures in Emergency Departments or hospitals; mask-wearing and social distancing must continue to the best of staff’s ability in order to protect patients.

“The NHS is facing a deepening crisis, to limit the spread of covid in the community and to limit pressures on Emergency Departments public health measures are our best defence. With the upcoming bank holiday weekend and the improving weather if people are attending parties, gatherings, or ‘work events’ we would urge prudence and caution – wear a mask, wash your hands to protect yourself, the elderly and the vulnerable.”


Notes to editor

The latest monthly performance figures published by NHS England for March 2022 for show:

  • There were 1,419,896 attendances at major Emergency Departments
    • The fourth highest number of attendances on record
    • The highest number of attendances since July 2021
  • 22,506 patients were delayed for 12 hours or more from decision to admit to admission
    • This is the highest number of 12-hour waits on record, the previous highest being 16,558 in January 2022
    • This is nearly a 40% increase in 12-hour waits compared to the previous month, February 2022
  • Four-hour performance at major Emergency Departments was 58.6%, this is the worst four-hour performance on record
    • More than 2 in 5 patients were delayed by four-hours or more
  • 136,297 patients spent more than four hours in an Emergency Department from decision to admit to admission
    • This means that more than one in three emergency admissions experienced waits of four hours or more from decision to admit (often referred to as ‘trolley waits’), representing the highest proportion on record
  • One in four booked appointments were not seen within four hours at major Emergency Departments, this is the worst booked appointment data on record

The latest annual performance figures published by NHS England for 2021-2022 show:

  • There were 24,394,650 attendances
  • There were 16,137,958 attendances at major Emergency Departments
  • Average four-hour performance at major Emergency Departments was 66.1%
  • A total of 1,199,140 patients waited four-hours or more at major Emergency Departments from decision to admit, often referred to as ‘trolley waits’
    • This figure is nearly double the last pre-pandemic year, 2018-2019
  • A total of 98,686 patients waited for 12-hours or more from decision to admit in major Emergency Departments
    • The number of 12-hour waits in 2021-2022 (98,686 12-hour waits) is 30 times the amount of 12-hour waits in the last pre-pandemic year, 2018-2019 (3,260 12-hour waits)
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