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RCEM Updates Guidance to Address Emergency Department Crowding Crisis

19 January 2024

The Royal College of Emergency Medicine (RCEM) has updated its guidance for Emergency Department (ED) crowding in response to the increasing threat to timely emergency care and the impact it is having on Emergency Medicine clinicians and their patients.

Initially issued in 2015, the 2024 update to the guidance supports further understanding of the causes and effects of crowding and provides more options for health systems.

Dr Ian Higginson, RCEM’s Vice President, has emphasised the urgency of addressing ED crowding and explained the the updated guidance in the video above and in a blog post: Emergency crowding in EDs – why our new guidance is so important.

Dr Higginson said: “The answers to crowding lie in health policy. Ultimately this sits with politicians in our four nations, and with national health service leaders.

“Their collective failure to acknowledge what they must surely know, and to offer both the vision and prioritisation of investment that is needed, is disappointing and at times difficult to understand.

“This problem is in right in front of us and affects tens of thousands of staff and patients, every day.”

The College has made repeated calls to UK Government to take urgent action to combat winter pressures as part of its ongoing #ResuscitateEmergencyCare campaign, but the lack of action has been clear from RCEM’s analysis of A&E data.

Emergency Department performance statistics for December 2023 show that patients coming to England’s A&Es faced waits for one in nine of 12 hours, with hospital bed occupancy at unsafe levels of 93%. The Welsh Government’s performance was worse. After failing to publish a winter plan, one in seven patients faced a 12-hour delay in A&Es during December.

December’s data for A&Es in Scotland is not yet available, and Northern Ireland’s is reported quarterly, with the next update for both nations due in February. The latest figures in November show dangerous waits on the rise for Scotland with more than one in three patients facing four-hour waits and one in six patients waited 12 hours in Northern Ireland between July and September last year.

Dr Higginson concluded: “Although it is not a policy document and is primarily designed to support those who are trying to manage the problem closer to the coal face, we hope that this guidance adds to the influencing picture.”

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