Emergency Department Crowding

Emergency Department Crowding

Emergency Department (ED) crowding represents the greatest threat to the timely delivery of emergency care in the UK and across the world. It is present to a greater or lesser extent in many healthcare systems. Although not a new phenomenon, it has been steadily worsening over time. This does not make it inevitable.

Causes of crowding are complex and can vary between different health systems, hospitals, and over different time periods. It is a source of considerable frustration to Emergency Physicians when crowding is framed as an “ED problem.” The consistent factor in ED crowding is that the causes are in the unscheduled healthcare system, and that the solutions lie, for the most part, outside of the ED.

• RCEM & College of Paramedics Joint Statement: Ambulance Handover Delays – Options Appraisal to Reduce Harm (August 2024)
• See the 2024 RCEM crowding guidance. Its objective is to assist in the understanding of the causes and effects of crowding and to provide options for health systems. It also contains recommendations for policy and research.
  View only version: 2024 RCEM crowding guidance | Downloadable version: 2024 RCEM crowding guidance
• See the RCEM Insight document on crowding. This provides a policy perspective.
• The RCEM document Right Place, Right Time is a collaborative document examines some of the issues around providing patient care in a stretched system.
• See the report from IFEM’s Emergency Department Crowding and Access Block Task Force.