RCEM survey finds majority of EM clinicians do not believe their ED has enough isolation facilities to cope with coronavirus

30 June 2020

Emergency Medicine clinicians do not believe that their Emergency Departments have enough appropriate physical spaces to treat coronavirus patients in.

A survey of members of the Royal College of Emergency Medicine about the pandemic so far found that that 69% reported that they do not have negative pressure rooms in Emergency Departments and 72% reported they do not have enough side rooms.

Nearly half of respondents thought that the layout of their department is not safe enough for adequate infection control.

The survey of 1,167 Emergency Care clinicians carried out between 22 May and 7 June 2020 also found that:

Seven out of 10 disagreed with the statement ‘the UK government is doing enough to protect and test healthcare workers’
A third of respondents reported having had episodes where they lacked access to PPE items when having clinical contact with suspected or confirmed COVID-19 patients
A third reported having had incidents where they had to reuse disposable PPE
One in 10 have not had training in the use of PPE
Over half reported that their mental health had worsened because of the pandemic.

Survey feedback also suggests that:

Staff have risen to the challenge, but some have felt overwhelmed at times by the rapid change and uncertainty
Staff perceived that PPE guidance seems to have been based on availability rather than science
Staff are very unhappy about the processes around provision of FFP3 masks; the masks change regularly and there is no consistency about the supply of these
Many staff felt that they were being asked to take unacceptable risks in assessing patients with inadequate PPE.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine said: “These results show there is still much work to be done particularly in terms of Emergency Department design and configuration. Negative pressure rooms are vital to help prevent the further spread of coronavirus and it is concerning that hospitals do not appear to have enough.

“We knew before the pandemic that many Emergency Departments needed to be rebuilt or completely redesigned to be able to provide 21st century care, but now it is crucial. Without measures to enforce social distancing EDs risk becoming sponges for the infection; crowded departments could turbo-charge its spread so physical capacity must be expanded to help prevent this.

“It is important that the NHS and government take stock of where we are now and how we got here. Covid-19 is now endemic, and we are finding new ways of working but we must reflect, learn lessons and plan before any second wave.

“Understandably Personal Protective Equipment has been a major concern for our staff as these results show. We are pleased that many of the early supply issues seem to have been resolved but staff should never have been put in a situation where they were forced to reuse disposable PPE.

“The worry over PPE may well have been a contributing factor in the 50.47% reporting a negative impact on their mental health and may also be reflected in the high numbers reporting concerns for the health of their colleagues.

“It is good to see that most staff have felt supported by their Trusts or Boards, but it is clear that staff have been concerned with how the government acted in terms of protecting staff and healthcare workers.

“The findings of this survey should act as a reminder that it’s not yet mission accomplished; let’s learn from what has happened to ensure we do not face another scenario where we cannot adequately protect our staff and patients.”

-ENDS-

Notes to Editors
RCEM surveyed 1,167 Emergency Care clinicians between 22 May and 7 June 2020. All responses were anonymous.

The survey data can be found here.