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1 in 11 patients in A&E spending 12-hours or more in A&Es in Northern Ireland

13 January 2021

Data published today by the Department of Health in Northern Ireland showed in September 2020 in Type 1 Emergency Departments, a total of 4,212 patients spent 12 hours or more before being admitted, this is nearly 9% of all Type 1 ED attendances, or equal to 1 in 11 patients.

Data also show a total of 4,214 patients spent 12 hours or more in Emergency Departments, this is an increase of 67% since July 2020 and an increase of 21% in the same month last year (September 2020).

During the second quarter of this year (July – September 2020) there was a 23% increase in attendances compared to the previous quarter. However, attendances in September 2020 are down by 18% on the previous year, September 2019, and also down 4% on the previous month, August 2020.

In Quarter 2, on average 60.8% of patients attending Type 1 (major) Emergency Departments were seen, treated, and discharged or admitted to hospital within four hours of their arrival. This represents a decrease of 7.53 percentage points when compared to Quarter 1.

Despite this, Quarter 2 has seen a 263% increase in the number of 12-hour waits. Between April and June, 2,892 patients were waiting 12 hours or more while data for July to September data show 10,495 patients were waiting 12 hours or more before being admitted, transferred, or discharged. These long waits are likely a result of the severity of patients’ conditions, and it is highly likely linked to COVID-19 and a lack of resources to cope with the pandemic.

Dr Paul Kerr, Vice President of the Royal College of Emergency Medicine Northern Ireland said:

“These data show the gravity of the situation in Northern Ireland. We have had less attendances and yet the number of 12-hour waits has increased significantly. It is simply shocking. It is like nothing I have ever seen.

“Our Emergency Departments are under an extreme amount of pressure and staff and hospitals are doing all they can to expand capacity, stretch resources and get patients through the system to the right care. But many are working beyond full capacity.

“This leads to the most vulnerable patients waiting in corridors, for an unacceptable amount of time, to access a hospital bed. But there simply are not enough beds to admit patients to. Meaning ambulances cannot offload patients and are stuck waiting outside departments, unable to return to the community to urgent calls.

“These practices are unsafe, undignified and unacceptable. They present a huge risk to patient health – particularly corridor care which inevitably increases the risk of hospital acquired infection and spread of covid – and puts a huge amount of pressure on staff who are already stretched thinly.

“On the other side of this, the reduction in attendances is also a concern. We fear that there are people in the community who are not receiving the urgent care they need. While we are experiencing a highly challenging period, we want to make sure those who need urgent and emergency care most are not deterred from seeking it.

“We knew the that our Health and Social Care service in Northern Ireland did not have enough beds, resources or staff prior to the pandemic, but now the pandemic has cruelly shone a light on the true extent of these shortages.

“RCEM Northern Ireland has long campaigned for increased investment and additional resources for the Urgent and Emergency care system. Now staff and hospitals are doing all they can to boost capacity, beds and resources.

“A population needs assessment some years ago identified the need for 520 beds by 2026 and we will have difficulty achieving even this unless we begin to make some progress towards that goal. To allow both Emergency and Elective activity to be restored after this very difficult period it is essential priority is given as soon as possible to expanding capacity and workforce to make this possible.

“Right now, all we can do is work together to minimise the risks. We need support from across Health and Social Care Northern Ireland to maintain flow and prevent corridor care.

“But looking to the future it is essential that there is an action plan for the health system in Northern Ireland, post-covid. It must address the shortages we are currently facing and provide funding and investment, and increase capacity, beds and resources and adequately staff the workforce. These measures will ensure that everyone can access quality care and begin the work to reduce long waiting times.”

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