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RCEM calls on MPs to support the redesign and rebuilding of A&Es in fight against COVID-19

26 May 2020

The Royal College of Emergency Medicine today calls on MPs help reset the delivery of Emergency Care by supporting the redesign and rebuilding of many Emergency Departments to prevent the further spread of COVID-19.
As part of its campaign, COVID-19: Resetting Emergency Department Care, RCEM recommends that the MPs and the UK government should:
  • support the structural rebuilding of Emergency Departments to promote good infection control and provide isolation facilities for patients
  • support the redesign and rebuilding of selected parts of acute hospitals to promote good flow and safe infection control
  • introduce a multi-year capital plan to redesign and rebuild Emergency Departments to promote good patient flow and safe infection control.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “Before this pandemic the lives of patients were put at risk due to overcrowding in Emergency Departments.

“If we go back to how things used to be it will never be more evident that crowding kills. Emergency Departments could become hotbeds of coronavirus transmission without proper measures to enforce social distancing; to do that we will need to physically redesign and rebuild many departments.”

COVID-19: Resetting Emergency Care also calls for MPs to ensure that the right service is available at the right time for the needs of all patients.

“We have been worried that many patients may have unwittingly put themselves in danger by staying away from Emergency Departments for fear of contracting the virus. Our departments are safe and open for business; seriously ill or injured patients should come to get help.

“Those with minor problems or ongoing health issues should be – and have been – seeking help from primary care or NHS 111 and national equivalents. These services still need further expansion and the government must look to how it enables that.

“But we are gradually seeing attendances rise again at A&Es, and most of these patients will need to be there. These means we urgently need more space in which to treat them and keep them apart from each other.

“Considering at the height of winter last year many departments had run out of chairs for patients, space is at a premium and expanding departments will be no easy task.

“As MPs begin to consider the steps to return us to normality and prevent further spread, we ask them to consider finding ways to fund the expansion of A&Es to prevent further loss of life to COVID-19.”

In a briefing issued to all MPs and Lords today as part of its campaign to Reset Emergency Care, RCEM also recommends the continued expansion of the Emergency Medicine workforce, extra bed capacity, expansion of Same Day Emergency Care, and an adequate long-term supply of PPE and testing.

Dr Henderson said: “We are at the beginning of a long period of transformation for the NHS. Policymakers must act quickly and follow our recommendations to ensure that COVID-19 – and similar diseases – can be managed safely alongside regular Emergency Care.  The failure to do so will risk the lives of more patients and staff.”


Notes to Editors
RCEM’s briefing to MPs can be found here.

The five fundamental aims outlined in ‘COVID-19: Resetting Emergency Department Care’ are:

  1. Emergency Departments must not become reservoirs of nosocomial infection for patients
  2. Emergency Departments must not become crowded ever again
  3. Hospitals must not become crowded again
  4. Emergency care must be designed to look after vulnerable patients safely
  5. Emergency Departments must be safe workplaces for staff.

There are six key areas to ensure safety:

  1. Improved infection control
  2. Reducing crowding and improving safety
  3. Patients already under the care of specialist teams
  4. Physical Emergency Department redesign
  5. Using COVID-19 testing for best care
  6. Metrics to support reduced crowding.

Each key area has several recommendations which can be read in full in the position statement

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