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Unrelenting strain on staff and departments despite reduced attendances

18 February 2021

Emergency care statistics released today by the Welsh Government show continued pressures on the system and a high-level of long stays despite a further reduction in attendances.

Data for January 2021 show that only 68.3% of patients were seen, treated or discharged within the four hours in major emergency departments (type 1). This is an increase of 3.2 percentage points compared to December 2020.

Attendances to major Emergency Departments have continued to decrease with 44,074 attendances in January 2021; this represents a 34% decrease when compared to January 2020.

Despite the decline in attendance, January 2021 saw 5,427 patients waiting 12 hours or more in major departments. While this is a decrease of 1,457 patients compared to January 2020, the proportion of attendances experiencing long waits has increased.

Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said:

“The data here are deceiving, while we have seen slight improvements in performance, we are still facing intense added pressures due to covid. The patients presenting at Emergency Departments are higher acuity and require an increased level of care – this is evident by the fact that the proportion of 12-hour stays remain significantly high.

“We have seen a drop in attendances for the fifth consecutive month and they have reached their lowest since April 2020. Despite this, the strain on staff and departments has been relentless and staff are mentally and physically fatigued.

“We are one year on; the intensity of this work is not sustainable. Despite the reduced attendances, departments are working beyond capacity caring for these higher acuity patients, staff are stretched thinly and nearing burnout levels, and we remain short of beds.

“As we await details of the road map out of the pandemic, we urge caution; we must avoid another wave. We already have capacity issues and another surge would put departments and hospitals under further severe pressures. We still have concerns around nosocomial infection and the risk of patients contracting covid in hospital, our infection prevention control measures remain strictly in place to ensure patient safety.

“And even as covid cases begin to fall, A&Es will continue their work, day in day out caring for those in the community without rest or respite. It is important to remember that in terms of Emergency Care, the ‘normality’ we had before the pandemic, was anything but normal – departments were crowded, patients were receiving care in corridors, and there were issues with long stays and capacity before this crisis.

“Today RCEM has published its Welsh Manifesto ahead of the Welsh elections in May, which details how to improve Emergency Care in Wales.

“The pandemic has highlighted where the problems in the NHS in Wales lie and looking to the future, we must build an action plan that focusses on fixing these issues and shortages and transforming the NHS in Wales into a successful public service that delivers for everyone.

“Any transformation will require a detailed plan to increase the workforce, bed capacity, and funding for both the NHS and social care in Wales.

“Without such a plan, the NHS in Wales will struggle with the approaching return to ‘normality’ and community demand and the challenge ahead of working through all the care that has been put on hold this past year.”

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