9 December 2019
The first publication of data from the Royal College of Emergency Medicine’s 2019-20 Winter Flow Project shows that existing data does not reflect the true scale of the problem of 12 hour stays in A&E.
RCEM data shows that in the first week of December over 5,000 patients waited for longer than 12 hours in the Emergency Departments of 50 Trusts and Boards across the UK.
The sample of trusts and boards from across the UK is the equivalent to a third of the acute bed base in England.
From the beginning of October 2019 over 38,000 patients have waited longer than 12 hours for a bed at the sampled sites across the UK – yet data from NHS England reports that in England alone a total of only 13,025 patients experienced waits over 12 hours since 2011-12.
President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “In a nine-week period, at only a third of trusts across the UK, we’ve seen nearly three times the number of 12 hour waits than has been officially reported in eight years in England. This must be fixed.
“The key difference in the data is the way in which it is reported. Our data measures the number of patients waiting over 12 hours from the moment they arrive at an ED, whereas NHS England (unlike Wales, Scotland and Northern Ireland) start the clock at the point at which a decision to admit is made – meaning that a patient could already have been waiting hours before this.
“The way in which it has historically been reported does our patients a disservice and hides the true scale of the problem of corridor care.
“These figures are truly shocking and are terrible for patients and staff alike. Many patients are now getting often life changing news while stranded on a trolley in a corridor. This cannot be right, and we must strive to put an end to ‘corridor care’.
“But we can only do that if we acknowledge the true scale of the problem.
“We understand NHSE/I accept the need to monitor corridor care. The Clinical Review of Standards absolutely must change the way in which 12-hour waits are measured to be in-line with how the devolved nations report it. This is such a vital measurement and indicator of safety that whatever else comes out of the review process, a true measurement of how many patients are being kept waiting for over half a day is essential.”
The first Winter Flow report of 2019/20 also shows that just 68.79% of patients were seen within four hours at the reporting sites – the worst performance in the five-year history of the Winter Flow Project.
Dr Henderson said: “We are clearly in the worst state we’ve ever been in as we enter the true winter season. Norovirus and the ongoing pensions taxation issue will not have helped, but this decline has been long in the making.
“We are deeply concerned that one of the areas of the health service most valued by patients – the Emergency Departments – are, year on year, struggling to cope and increasingly difficult places for staff to deliver the standard of care they want to. Emergency Departments are the NHS safety net and the safety net is buckling.
“The number one priority for the incoming Government must be to address this and we welcome any opportunity to speak to the next Secretary of State for Health and Social Care, to help remedy the situation.”
Notes to Editors
The Winter Flow Project runs from October 2019 to March 2020. Anonymised data from 50 sites will be published on a weekly basis.
In addition to four-hour performance – a metric the College believes is an invaluable system indicator, but not the whole story – the project collects a wider range of data to explore the other factors that affect Emergency Departments and patient ‘flow’.
In addition to type one four hour performance figures, Trusts are asked to submit on a weekly basis data on:
• the number of acute beds in service
• the number of cancelled elective operations
• the number of patients in their trust who no longer medically need to be in hospital
• the number of unplanned attendances at EDs
• the number of patients spending more than 12 hours in an Emergency Department from arrival to departure.
The full 2018/19 report and data, along with weekly reports for 2019/20, is published at rcem.ac.uk/winterflow