RCEM calls for political leadership to ensure functioning health and social care service amid ‘catastrophic’ Emergency Care crisis

27 April 2023

Responding to the latest Emergency Care Waiting Time Statistics for Quarter 4 (January – March 2023) published by the Department of Health Northern Ireland, Dr Russell McLaughlin, Vice President of the Royal College of Emergency Medicine Northern Ireland, said:

“The crisis in Emergency Care in Northern Ireland is catastrophic for patients and staff. Despite the efforts of hardworking Emergency Medicine professionals to ensure a functioning Emergency Care system and to both reduce delays and mitigate against the harm to patients, performance continues to deteriorate. Patients face appalling delays to care in busy, overcrowded, uncomfortable Emergency Departments with limited privacy. It is incredibly challenging.

“We know that these delays are associated with patient harm and patient deaths – and the longer the delay the higher the chance of a worse outcome. The delays are a consequence of our inability to admit patients to a bed from the Emergency Department. In turn, poor flow through the hospital and exit block are caused by our inability to discharge patients in a timely way. The system is in a ‘traffic jam’ with more patients waiting longer and longer throughout the system. The low bed base is leading to high bed occupancy and patients remaining in beds in hospital for longer than necessary, as unresponsive social care means they cannot be discharged home.

“It is a desperate situation. The lack of functioning government means there is a lack of meaningful action to tackle it. Patient safety is at high-risk and patients across Northern Ireland are actively coming to harm. At the same time, staff are exhausting and burning themselves out in ever-more-challenging conditions – as the risk of them leaving the profession increases. We urgently need to see cross-party political leadership to engage with the crisis and to ensure we have a functioning Emergency Care system and wider health and social care service.”

Notes to editor

The latest Emergency Care Waiting Times Statistics for Quarter 4 (January – March 2023) published by the Department of Health Northern Ireland show:

• There were 159,232 attendances at Type 1 (Major EDs) A&E services in Northern Ireland, only 0.8% more than Quarter 4 2022.
• On average 42.5% of attendances at A&E services were seen and resulted in a subsequent admission, transfer, or discharge within four-hours; this is the worst quarterly performance on record.
• Similarly, in January 2023, 18.1% of attendances at major A&E services spent 12-hours or more in an A&E department, equal to more than one in every six patients. This is the second worst 12-hour performance on record.
• The median time patients who were admitted to hospital spent in a Type 1 ED was 14 hours 16 minutes in March 2023, 1 hour and 21 minutes more than the same month the previous year. In March 2023 admitted patients also spent more than 3 times longer in an A&E department than those who were discharged home.