Long-term Welsh A&E decline must be the focus

Thursday 22 February 2024

The long-term deterioration of A&E standards rather than small monthly improvements must be the focus for the Welsh Government

That’s the view of RCEM Wales as new monthly data shows one in seven people waited in A&E for 12 hours or longer in January.

The Emergency Department performance statistics for January 2024, published today (22 February) by the Welsh government showed a slight improvement in four and eight-hour wait times but remained well below pre-2017 figures.

These data also show:

• 63,586 people attended major emergency care facilities in January.

• Overall, 58% of patients in major A&Es were admitted, transferred, or discharged within four hours from arrival.
  • This is a 1.5 percentage-point increase from last month, and a 2.5 percentage-point decrease since January 2023.
  • 42% of patients in major A&Es waited longer than four hours (26,684 patients). The number of patients waiting more than four hours has decreased by 2.6% compared with last month (27,388).
  • The number of people waiting more than four hours has increased by 63.5% compared with January 2017 (16,318).

• 24% of major A&E attendances waited more than eight hours (15,228 patients).
  • This means that nearly one in four patients were delayed eight hours or more at a major emergency department. It is a 0.7 percentage-point decrease on last month.
  • The number of people waiting more than eight hours has increased by 100% compared with January 2017 (7,465).

• 15.5% of major A&E attendances waited more than 12 hours (9,838 patients).
  • This means more than one in seven patients were delayed by 12 hours or more. It is a 0.3 percentage-point increase on last month.
  • The number of people waiting more than 12 hours has increased by 143% compared with January 2017 (4,048).

Between 2007 and 2016, performance levels were moderately consistent, four-hour performance rarely dropped below 80%. However, since January 2017, the numbers waiting four hours or more increased by 64%, the numbers waiting more than eight hours by 100%, and the numbers waiting more than 12 hours by 143%. This is despite attendance increasing by only 0.9% in the same period.

Dr Rob Perry, The Royal College of Emergency Medicine’s Vice President Wales said: “Obviously we are pleased that the crisis hasn’t deepened but when one in seven patients is now waiting 12 hours or more to be seen, and when you consider how much worse the situation is compared to just seven years ago, you comprehend the true scale of the problem.

“To praise small improvements month on month when the overall situation remains so dire, and while our Emergency Medicine clinicians are still experiencing such immense pressure, is not right.

“Our Emergency Departments are full to bursting; patients are being treated in corridors and the backs of ambulances.

“Our hospitals are reaching capacity, and we have the tragically ironic situation where patients who need to be admitted can’t get a bed, and patients who have a bed but no longer need it can’t be discharged.

“All our patients and our members want is a safe, functioning system where people can access the timely care they need and deserve.

“The Welsh Government must look at these numbers and those for the past seven years and take action to address this shameful situation.”

The full data set and graphs can be found on the RCEM website.