26 May 2021
Responding to the findings of the consultation on the Clinically-led Review of Urgent & Emergency Care Standards, President of the Royal College of Emergency Medicine, Dr Katherine Henderson said:
“The consultation results make it crystal clear that there is significant support for improving a pressured urgent and emergency care system and tackling the wider problems it faces.
“We support an implementation of a bundle of metrics, that will provide better information than the four-hour target.
“As the report makes clear ‘a single measure is no longer suited to the different models and pathways that deliver urgent or emergency care to people.’ Now is the time for change, and we are pleased to see the warm reception the proposals have had.
“It is vital that there is a clear programme of implementation ahead of winter. We are particularly keen to prevent ambulance offload delays and long waits in EDs for a bed. The metrics in the planning guidance should be defined and implemented.
“Doing this ahead of winter is vital to help us highlight and tackle ‘corridor care’. Overcrowded EDs with patients being treated in corridors risks the spread of infection and could derail any hope of elective recovery. Measuring and reporting 12-hour from time or arrival may help prevent this.
“There is no justifiable reason for a patient to spend half a day in an ED. This data is already collected, but only reported annually. This must be reported alongside the monthly performance statistics.
“We also welcome the wider recognition that there is a potential need for a six- or eight-hour metric. Long stays are wholly unacceptable and detrimental to patient care. But one metric is not more important than any of the others.
“The holistic approach of the measures will help better identify pressure points in the system, and it is good to see that some Integrated Care Systems are already thinking about how this will help at a local level. These measures should be a vital component of thinking around local transformation in line with the government’s white paper.
“The enthusiasm for the proposals should accelerate the process of implementation – we are currently in a performance vacuum. We understand the urgent need to address the elective backlog, but unscheduled care patients deserve a safe, timely service, and failure to plan risks derailing the elective recovery.
“More work is needed around thresholds and frequency of reporting, but the consultation report is a significant step in the right direction of transforming care for the better.”