RCEM: ‘This is the start of another extremely difficult winter, and we don’t have the beds that we desperately need’

9 November 2023

Latest data show almost one in nine patients faced 12 hour waits in A&Es in England in October, as the Royal College of Emergency Medicine warns “this is the start of another extremely difficult winter, and we don’t have the beds that we desperately need.”

Published today (9 November 2023) by NHS England, the A&E performance figures for October 2023 show:

• There were 1,413,560 attendances to major A&Es (Type 1 EDs) in October 2023, this is the highest level of attendance for major A&Es so far in 2023.
• In October 2023, 152,115 patients waited 12-hours or more from their time of arrival at A&E – this is equal to nearly one in nine (10.7%) patient attendances to major A&Es.
  • This the greatest number of patients waiting 12-hours or more so far in 2023.
• The four-hour target at major A&Es stood at 55.9%, this is the fourth worst four-hour performance on record and the lowest so far in 2023.
• 44,655 patients waited 12 hours or more from decision to admit (DTA) to admission.
  • This is the second highest number of 12-hour DTA waits on record.
• Beds data for October 2023 show bed occupancy stood at 94.1%.
• Data show there were 97,371 Type 1 General & Acute beds available.
  • This is an increase of 39 beds from September 2023 (97,332). And an increase of 84 beds from October 2022 (97,287).
• Since it was announced in January 2023 that 5000 new beds would be made available by winter, there has been a decrease of 2,675 beds (down from 100,046 in January).
• There were 401,523 emergency admissions at major A&Es, this is the highest number of admissions in 2023 and the third highest number of admissions since 2021.

Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said:

“The data are clear; we are heading into another extremely difficult winter and we don’t have the beds that we desperately need.

“Our worst fears are becoming manifest, increases in attendances, increases in admissions, increases in dangerous and harmful delays – all not being matched with the necessary increases in beds.

“The pledge to deliver 5,000 beds continues to go unmet, and it is affecting patients, their care and the whole system.

“Bed occupancy has reached dangerous levels and one in nine patients faced 12 hour waits in A&Es in October – we know that for some of these patients 24 hours in A&E will be their reality.

“It is appalling and unacceptable. Without the necessary action, ambulance queues outside A&Es will become more frequent, along with the heart-breaking patient stories of traumatic delays for emergency care.

“Patients deserve dignified, effective and efficient care, but in current circumstances and with the severe bed shortages, what many of our patients receive are distressing waits in overcrowded A&Es. It is not right, and no clinician wants to see this.

“The Government must look on these data as a stark warning of what is to come and take the necessary meaningful action to mitigate patient harm.

“We have the solutions to #ResuscitateEmergencyCare, it is time these priorities were adopted – beginning with actually increasing bed numbers in hospitals.”

Today’s data come following the King’s Speech on Tuesday (7 November), in which His Majesty King Charles III announced the State Opening of Parliament and set out the Government’s agenda for health care. Responding, RCEM said “without increasing capacity, it will be extremely difficult for the system to deliver the Government’s agenda for health care” and reiterated the need to deliver and implement the long-term workforce plan.