Hospitals remain at unsafe levels of bed occupancy, as one in nine faced 12 hour waits in A&Es in December

11 January 2024

Latest data show that hospital bed occupancy remains at unsafe levels (93%) as one in nine patients faced 12 hour waits in A&Es in December in England. The Royal College of Emergency Medicine (RCEM) has described it is a ‘shameful, distressing and deeply saddening’ situation.

Today (11 January 2024) two sets of data published by NHS England, have been released: the latest Urgent and Emergency Care (UEC) Daily Situation Reports 2023-24 (also known as Winter Sitrep); and monthly A&E performance figures for December 2023.

The data:

• The latest weekly sitrep data show bed occupancy stood at 93%, (safe bed occupancy level is 85%).
  • Based on the data for this month, 9,353 more beds required to bring bed occupancy down to 85%.
• In January 2023, as part of the urgent and emergency care delivery plan the government announced that 5,000 new beds would be made available by winter 2023/23.
  • According to the latest sitrep data, since October 2022 (when there were 97,287 beds), there has only been an increase of 3,296 G&A beds, meaning one year on since the UEC recovery plan was published, the 5,000 bed target has still not been met.
• Monthly A&E performance figures for December 2023 show that 151,295 patients faced a 12-hour wait in A&E from their time of arrival, this is equal to more than one in nine patients.
  • This is the highest number of 12-hour waits measured from the time of arrival in NHS England’s publication of the data dating back to February 2023.
• Four-hour performance stood at 54.7%. This is the third lowest on record.
• 44,0445 patients faced waits of 12-hours or more from when the decision to admit was made. This is the third highest number of 12-hour DTA waits on record.

Dr Adrian Boyle, President of the Royal College of Emergency Medicine said:

“While these data show marginal improvements on last December 2022, the reality is that there has been little to no improvement in emergency care. There certainly has not been the meaningful improvement we would have expected one year on from the publication of the the Government’s urgent and emergency care recovery plan.

“Hospitals remain at unsafe levels of bed occupancy, which presents a significant risk to patient safety. The knock-on effect of ‘exit block’ (whereby we are unable to discharge patients and beds remain occupied for long periods of time) on emergency care is detrimental to patients and their care.

“One year on from the UEC recovery plan and nearly all of our membership will feel that nothing has changed. They have continued to see full hospitals, corridors crammed with patients, A&Es with ‘elastic walls’ stretched to the limit and queues of ambulances outside. This is their reality.

“12-hour waits were once non-existent and categorically unacceptable, now they are so normalised, with December’s data showing one in nine patients waited 12 hours in A&E.

“There is an association between delays in emergency care and excess deaths – yet the number of 12-hour waits has not been brought down and we are not seeing the concern or the necessary, urgent action that any potential ‘excess deaths’ should warrant. The mortality risk alone should demand a zero-tolerance policy on 12-hour waits.

“It is a shameful, distressing and deeply saddening situation. The system is failing patients – and in the under-bedded, understaffed, underfunded and under-resourced system – it is existing staff who are stretching, breaking and burning themselves out to ensure patients receive the quality care they deserve.

“A few extra beds and new initiatives will not resolve this deep-rooted and systemic problem, we have laid out our priorities to #ResuscitateEmergencyCare, these must be adopted to see real and tangible improvement, transformation and change in emergency care.”

The figures come as research by the University of Bath, in collaboration with the Royal College of Emergency Medicine, finds that burnout and retention crisis in Emergency Medicine threatens the safe delivery of emergency care.