‘Patients and staff are desperate for meaningful action to tackle worst ever Emergency Care crisis’, RCEM NI says

 26 January 2023

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

“These data show the scale of this health crisis in Northern Ireland. The majority of patients in December 2022, three-in-five, faced waits of four-hours or more, and nearly one-in-five patients faced waits of 12-hours or more. It is devastating. Staff are pushed to their very limit delivering care for their patients in these extremely challenging conditions, while patients are anxious and worried.

“Staff cannot continue to work through adrenaline and goodwill to prop up a broken and failing system. This is the worst crisis we’ve ever had, and you can see that in the figures published today. The figures represent real people who are sick, injured, or unwell and need urgent and emergency care, but the system is providing it to them neither quickly nor effectively. More patients’ week-on-week face long and dangerous waits in crowded departments, corridors, on trolleys, it is undignified for patients and distressing for staff. We know long waits are associated with increased patient harm and mortality, but we are powerless as there are no beds on wards to which we can admit patients, so they stay in the Emergency Department for far longer than they should.

“We know that staff are burned out, exhausted, overwhelmed, some have left, and others will leave because the conditions are so bad right now and many staff face moral injury daily. The situation is very upsetting – patients aren’t getting the care they need, and staff aren’t able to provide the care they are trained to provide.

“Attendances have remained at a relatively steady level over the year. Demand is not the driver of these long-waiting times. The inability to discharge patients from hospital in a timely way is driving high bed occupancy, meaning there are no available beds for us to move patients into. This is known as exit block. The system is totally blocked, in gridlock, we can neither discharge patients nor admit patients, so the Emergency Department fills up more and more until it is dangerously crowded with patients facing extremely long and uncomfortable waits, while the backdoor is jammed. The shortages of social carers and social care beds in the community mean patients cannot be discharged in a timely way.

“We need cross-party political leaders to recognise the severity of this crisis, the damage to patients, staff and the damage to the health system. We need urgent and meaningful action to tackle this. This must begin with increasing the social care workforce and social care capacity and focusing on discharging patients in timely and safe way. While capacity across Trusts must be expanded where safely possible. Staff and patients are desperate for and deserve meaningful action to tackle this dire situation.”

Notes to editor

The latest Emergency Care Waiting Times Statistics for Q3 2022/23 (October – December 2022) published by the Department of Health Northern Ireland show:

• There were 158,492 attendances at Type 1 (Major EDs) A&E services in Northern Ireland. This is marginally lower than the pre-pandemic average for this time of year
• In December 2022 only 40.5% 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, December 2022 saw 9,816 patients spending 12-hours or more in an A&E department, equal to more than one in every six patients attending a major department.
• Patients awaiting admission 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 14 hours 9 minutes in December 2022, 3 hours 14 minutes more than the same month the previous year (10 hours 55 minutes).