31 January 2023
Commenting on the publication of the Delivery plan for recovering urgent and emergency care services by NHS England and the Department of Health and Social Care, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said:
“This plan is a step towards tackling the crisis in Emergency Care. We welcome the ambition from NHS England, having a plan to build up from towards long-term transformation is a crucial step at this time. However, some things remain unclear, acquiring 800 new ambulances, opening 5,000 more beds, opening more same day emergency care units, using virtual wards, and discharging patients are all highly sensible and effective ideas. However, you cannot ask existing staff – who are already reaching burnout – to do more. Without significant recruitment into the ambulance services, Emergency Medicine, community and social care – these initiatives will do little to alleviate the current pressures. Opening a bed without sufficient staff will leave that bed void, just as acquiring an ambulance without more paramedics will leave it parked.
“‘Growing the workforce’ remains an ambiguous and unfulfilled promise – we hope that the long-term fully funded NHS workforce plan is imminent, and the Chancellor of the Exchequer, Jeremy Hunt, delivers on his pledge to publish workforce projections.
“We welcome the focus on making more clinicians available for NHS 111 services, we are optimistic that with more clinical input, the 111 service will improve and become more effective for patients.
“We are also wary of virtual wards, NHS England claim that they have ‘successfully rolled out 7,000 virtual ward beds’ since the summer – but where are the data, where can these be tracked? It is vital that we understand what beds are available where and how we can utilise them effectively.
“While we recognise the significant fall in four-hour performance and the need for NHS England to set an achievable target, we are uncomfortable with the target of 76%. We think it is unambitious and worry it may do little for high acuity patients who need to be admitted to a bed. It’s possible that it won’t address the root of the issue, which is poor flow through our hospitals and exit block – where patients cannot be admitted to wards because other patients cannot be discharged. We raised our concerns with NHS England and suggested a higher target for four-hour performance.
“Nonetheless, we are significantly encouraged to hear the Secretary of State for Health and Social Care, Steve Barclay, reaffirm NHS England’s pledge to publish 12-hour data measured from time of arrival from April 2023 as detailed in the delivery plan. This is a vital step towards transparent metrics that are not only honest about patient waits but are comparable with the rest of the UK. This is a huge win for both patients and staff and something the College has long been campaigning for. We look forward to seeing the data in April and agree that it will ‘enable urgent system action’ during periods of high demand and ‘allow a more granular understanding of patient flow to support improvement’.”
Notes to editor
RCEM: Five Priorities for UK Governments to #ResuscitateEmergencyCare