Fall in A&E performance ‘deeply worrying’ as winter looms

24 August 2023

New data which shows more people experienced long waits in Welsh A&Es last month has been described as ‘deeply worrying’ by the Royal College of Emergency Medicine.

The statistics – Emergency Department performance figures for July 2023 – published by the Welsh government today (24 August 2023), show:

• 68,086 people attended major A&Es, 0.4% less than the previous month (68,330) and 2.8% more than in July 2022 (66,231).
• Overall, 60.3% of patients in major A&Es were admitted, transferred, or discharged within four hours from arrival.
  • This is a 2.2 percentage-point decrease on last month. And a 5.1 percentage-point increase on July 2022.
• 22% of major A&E attendances waited more than eight hours (14,900 patients)
  • This means that more than 1 in 5 patients were delayed eight hours or more at a major A&E.
• 4% of major A&E attendances waited more than 12 hours (9,102 patients).
  • This means nearly 1 in 7 patients were delayed by 12-hours or more.
• According to the Stats Wales website data about hospital bed occupancy will no longer be updated, the most recent data we have is for the period 28 June – 19 July:
  • For this period, there was a daily average of 6,417 general and acute beds in service, 26 fewer than the previous month.
  • Average bed occupancy was 94.7%. This is 9.7 percentage points above the recommended safe level of 85%.
  • When we compare with July last year, there has been an average decrease of 55 general and acute beds in service. By comparison there has been an increase of 24 general and acute beds occupied.
  • This demonstrates that the number of beds in service is not keeping up with patient needs.

Responding Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said: “These data show a fall in four-hour, eight-hour and 12-hour performance in July when compared to June – despite fewer people attending Emergency Departments.

“This means more patients waited longer in major A&Es in Wales in July. This is deeply worrying for this time of year as the summer months are traditionally considered ‘quieter’.

“We are almost in September, and effective winter planning must be put in place to ensure we are fully prepared as the colder months loom.

“This must focus on discharging those people who are well enough to leave hospital to free up beds and help to reduce dangerous overcrowding and delays in A&Es.

“To plan and prepare for the winter ahead, we urge the Welsh Government to adopt our Five Priorities to #ResuscicateEmergencyCare.”

The length of stay data does not paint a full picture, some patients who experience 12-hour waits are excluded from the data. These are known as ‘breach exemptions’.

RCEM Wales continues to call on the Welsh Government to publish fully transparent and meaningful data so that no patient is hidden and the true scale of long waits can be properly assessed.