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MPs lay out ‘the damning reality of emergency care’ in new report, RCEM says 

25 October 2023

The Royal College of Emergency Medicine has described a new report by MPs as laying out the ‘the damning reality of emergency care’. 

The Public Accounts Committee (PAC) Report Access to urgent and emergency care published today (25 October 2023) found staff ‘have been let down by a system which has seen performance fall far below the standard the NHS says patients should expect to receive’. While the quality of service that patients receive heavily depends on regional variation. 

It also highlighted that NHS England’s recently published workforce plan, which maps out NHS staffing requirements for the next 15 years, only has funding of £2.4 billion confirmed by government to cover the costs of training in the first five years.  

Adding the absence of clarity and assurance on sufficient longer-term funding creates a real risk that the workforce plan may put ‘unsustainable financial pressure’ on the NHS in the future.  

But despite the bleak assessment, RCEM says the problems described are ‘fixable’ if the government moves away from current plans – which the PAC described as containing ‘significant assumptions and uncertainties’ – and towards meaningful long-term strategies, combined with adequate investment and action.  

The report also highlighted:  

  • The NHS’s own target for A&E waits has not been met since 2015 and its target for ambulance handovers has never been met since it began reporting against this metric in 2017. 
  • Ambitious plans to recover services and improve patients’ access and improve patients’ access and experience set out by the Department for Health and Social Care and NHS England have ‘significant assumptions and uncertainties attached to these plans’. 
  • NHS England’s improvement plans rely on better staff recruitment and retention to address significant shortfalls in the NHS workforce, but we are not convinced that NHS England’s current approach will achieve its very optimistic assumptions. 
  • And concluded NHSE’s plans lack ‘haste’ 

It also said not enough was being done around delayed discharges and, that alongside the decline in performance, there was also a decline in productivity and rise in inefficiency. 

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

“This is another report that lays out the damning reality of emergency care. Our members and their patients are being let down. 

“But we know these problems are fixable. This government – and whoever forms the next – must adopt our five priorities to #ResuscitateEmergencyCare, in which we lay out the steps that can be taken to improve services for patients and staff. 

“We are on the cusp of what looks likely to be another devastating winter. Having adequate capacity for our patients is vital. This will reduce dangerous levels of bed occupancy and improve flow through our hospitals and go some way to easing the pressure on the system. 

“We know that since the pledge increase bed numbers by 5,000 was made in January, we have not made nearly enough progress on this fundamental solution. The priority must now be on significantly increasing bed numbers before the cold weather, and the inevitable winter pressures hit.” 

Dr Boyle also described as ‘disheartening but not surprising’ the Committee’s finding that performance varies from region to region, adding: “We must be able to better understand what is happening at a local level .  

“At the moment we do not know how well or how poorly individual hospitals are doing because the official data is published by each Trust, which may encompass several sites. 

“RCEM is campaigning for NHS England to publish transparent performance figures for individual A&Es, so increased resources and support can be provided to the sites that are struggling the most. Improving equality of care and resulting in significant benefit to patients and staff.” 

The report comes following the publication of the Care Quality Commission’s State of Care Report 2022/23 which found ongoing issues of ‘gridlocked care’, longer waits, poorer experiences of emergency care and poor system planning. 

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