One in six patients faced 12-hour wait in major Emergency Departments in Northern Ireland as ‘grim winter’ approaches

4 November 2022

Responding to the latest Emergency Care Waiting Time Statistics (July – September 2022) published by the Department of Health Northern Ireland, Vice President of the Royal College of Emergency Medicine Northern Ireland, Dr Paul Kerr said:

“The figures for Quarter 2 (July – September 2022) are dreadful. As winter approaches, the urgent and emergency care system is under continued pressure. More patients than ever before face extremely long waits – one in six patients at major Emergency Departments faced a 12-hour wait or more. We know these long waits are associated with serious patient harm and even death. Staff face moral injury daily, doing the best they can to deliver effective care, but they are extremely concerned about the months ahead and the threat of both Covid-19 and flu. It is going to be a grim winter.

“We are glad that the Health Minister, Robin Swann, recognises the serious challenges this winter presents. We welcome the Department of Health’s winter preparedness plan that he delivered last week. In particular, we welcome the focus on increasing capacity and bed availability at Trusts. Expanding capacity where safely possible will be essential to ensuring we maintain flow throughout our departments this winter.

“We agree with the Minister that any winter plan must take a whole-system approach and not solely focus on demand management at the front door of the hospital. The commitment to funding for community and acute hospital services as well as investment in domiciliary care with a focus on hospital discharge is vital. The difficulties in discharging patients in hospital is a key driver of these dangerously long waits for admission of patients in Emergency Departments and increasing ambulance handover delays. Ensuring we have a social care workforce who can support the timely discharge of patients is crucial.

“We also welcome the Consultation Findings Report on the Review of Urgent and Emergency Care. It is good to see the Department commission a ‘Getting It Right First Time’ (GIRFT) review of Emergency Medicine for Northern Ireland, we urge the Department to prioritise this and get this under way as soon as possible. The College would welcome the opportunity to provide input or partnership to this review and assist in any way.

“The Report details the ‘increasingly difficult environment’ for staff who ‘continue to work tirelessly’. We also agree that ‘staff morale and burn out is an issue within the existing workforce’. We are pleased that the Department has received this feedback and we welcome their commitment to deliver a subsequent implementation plan that focuses on ‘workforce, capacity and training issues within urgent and emergency care.”

Notes to editor

The latest Emergency Care Waiting Times Statistics for Q2 2022/23 (July 2022 – September 2022) published by the Department of Health Northern Ireland show:

In Quarter 2 (July – September) 2022:

• There were 165,294 attendances at Type 1 (Major EDs) A&E services in Northern Ireland. Attendances are back up and in line with pre-pandemic levels.
• In July 2022 only 43.3% of attendances at A&E services were seen and resulted in a subsequent admission, transfer, or discharge within four-hours; this is the worst performance on record.
• Similarly, Q2 saw 26,752 patients spending 12-hours or more in an A&E department, equal to one in every six patients attending a major department.
• Admitted patients are on average spending three hours longer in A&E than they were last year, while the non-admitted patient is spending only 30 mins more. This would indicate that the system is failing the sickest patients the most.
• The median time patients who were admitted to hospital spent in a Type 1 ED was 13 hours 36 minutes in September 2022, 2 hours 20 minutes more than the same month last year (11 hours 16 minutes).

Written statement to the Assembly by Health Minister Robin Swann – Winter Preparedness: https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-wms-261022-winter-prep.pdf

Review of Urgent and Emergency Care: Consultation Findings Report: https://www.health-ni.gov.uk/sites/default/files/consultations/health/doh-review-uec-departmental-response.pdf