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Rt Hon Rishi Sunak MP
Chancellor of the Exchequer
HM Treasury
1 Horse Guards Road

19 November 2020

Dear Chancellor,
I am writing to you as the President of the Royal College of Emergency Medicine.
We are very concerned about crowding in our Emergency Departments as we are seeing a return to patients waiting on trolleys in hospital corridors because of acute bed capacity problems. This is unsafe and potentially deadly with coronavirus now present in the community.

The Royal College of Emergency Medicine (RCEM) works to ensure high quality care for patients by setting and monitoring standards of care in Emergency Departments; we are the professional voice of over 9,500 A&E doctors across the UK.

A strong Urgent and Emergency Care system underpins a well-functioning National Health Service. Due to years of underinvestment, Emergency Departments now play a crucial role in sustaining other parts of the healthcare service.

For the past year, I have campaigned to end crowding and corridor care in our Emergency Departments. After we passed the peak of the first wave of the pandemic, I made it very clear that it would be unconscionable to allow crowding to return to our Emergency Departments in a coronavirus endemic world.

Unfortunately, last month’s performance data revealed that dangerous levels of crowding has now returned to our departments. We witnessed a staggering number of patients waiting twelve hours or more in our Emergency Departments.

This was unsafe before the pandemic – and now we have busy corridors whereby vulnerable patients cannot socially distance – this is indefensible.

Our Emergency Departments work effectively to maximise returns on public investment, and in recent years Emergency Department staff have had to do more with less. Failure to increase funding for the NHS would be counterintuitive for the long-term health of the country and the Prime Minister’s levelling up agenda.

We urge you to use this opportunity to invest and build a resilient, world-class health and social care system. We are calling for:

1. Increase in the NHS multiyear funding settlement to reflect the increased pressures placed on the healthcare service. At the very least, the NHS budget should increase by an average of 5% per year in real terms over the next five years.
2. Restoration of bed capacity to pre-COVID levels and open an additional 9,429 staffed beds in hospitals to maintain patient flow in Emergency Departments and achieve safe 85% hospital bed occupancy.
3. Funding for an additional 2500 WTE Emergency Medicine Consultants by 2025, deliver the 50,000 nurses commitment outlined by the Conservative Party manifesto by 2024/25 as Emergency Medicine requires 4000 WTE Emergency Nurses by this time to reach adequate staffing numbers to deliver safe care.

At the start of the pandemic you said, “whatever extra resources our NHS needs to cope with coronavirus – it will get”. We hope you stand firmly by this and work with us to make sure our Emergency Departments can provide safe care for everyone during their time of need.

Yours faithfully,
Dr Katherine Henderson MB BChir FRCP FRCEM
President of the Royal College of Emergency Medicine

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