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

01 March 2021

Dear Chancellor,

I am writing to you as the President of the Royal College of Emergency Medicine.
We are very concerned about staffing pressures in Emergency Departments. A year ago, you said “whatever extra resources our NHS needs to cope with coronavirus – it
will get”. We hope you stand firmly by this commitment as we begin to approach recovering from the pandemic.

Coronavirus has exacerbated the pre-existing problems associated with chronic understaffing of Emergency Departments, especially as the peak of the second wave coincided with winter pressures.

Our staff have worked tirelessly to deliver care in challenging circumstances in under-resourced Emergency Departments. The impact of this is well evidenced by the COVID-19 Emergency Response Assessment (CERA) study published last month. Their findings show that nearly half (45%) of doctors working in emergency medicine, anaesthetics & intensive care doctors reported psychological distress, far in excess of the general population.

Emergency Departments are the only part of the healthcare service open to all, 24 hours a day, seven days a week. There will be no respite or period of rest and recuperation for our staff.

In addition, we know those living in more deprived areas rely on emergency care more than others. If we want to truly level up the country, we must ensure our departments are adequately staffed and able to provide timely care to all. Failure to do so could result in costly and avoidable litigation. NHS Resolution accounts reveal in 2019/20 Emergency Department claims represented the highest volume of
We urge you to use this Budget to build a robust and world-class health and social care system by growing our workforce. We are calling for:
1. An additional 2500 WTE Emergency Medicine Consultants by 2025.
2. An increase of 120 Emergency Medicine training places per year above current numbers to address the deficits in WTE trainees caused by increased flexibility in training in the short term and Consultant shortages in the longer term.
3. Delivery of the 50,000 nurses as outlined by the Conservative Party manifesto by 2024/25; Emergency Medicine requires 4,000 WTE Emergency Nurses by this time to reach adequate staffing numbers to deliver safe care.
4. The 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.

A strong Urgent and Emergency Care system underpins a resilient National Health Service. There is no NHS without staff: the future of the NHS relies on doctors, nurses, and clinicians being there to deliver the service and to provide effective care to all.

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

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 10,000 A&E clinicians across the UK.

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