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There must be a meaningful recovery plan for Urgent and Emergency Care, RCEM says

21 February 2022

Commenting on the latest Winter Flow Project data, Dr Adrian Boyle, Vice President of the Royal College of Emergency Medicine, said:

“For the second week in a row the Royal College’s Winter Flow Project has recorded 1 in 11 patients delayed by 12 hours or more in an Emergency Department from time of arrival. The extent of harm coming to patients is alarming and distressing. The situation in Emergency Departments continues to be a step change worse than previous years and is set to derail any plans to recover elective care. Patients admitted as emergencies will displace planned elective admissions.

In a recent interview the Secretary of State for Health and Social Care was asked about plans for an Urgent and Emergency Care (UEC) recovery plan to which he indicated the NHS England 10-point action plan, published in September 2021, is the plan to tackle the current UEC crisis.

“This is disappointing to hear when patients are coming to real harm with those waiting the longest facing a risk of death. Not recognising the impact the crisis is having on patients or staff or seeing the threat the UEC crisis poses to elective care recovery falls short of expectations. Elective care is not isolated from Urgent and Emergency Care, this is a critical distinction that must be carefully incorporated into any recovery plan. Any credible recovery plan must detail the workforce required.

“Once again it is up to staff, who are burned out, overwhelmed and facing moral injury, to tackle the crisis and do their best to keep patients safe and minimise harm. It is crucial that system leaders work together and take a whole-system approach, as suggested by NHSE in a letter on ambulance pressures, and work interdepartmentally and cross-specialty to do their best to promote flow, minimise patient harm and ensure timely discharge of patients.

“However, existing staff who are already struggling can only do so much. Without an updated, meaningful recovery plan, Urgent and Emergency Care recovery is not viable and ambulance handover delays and long waiting times in Emergency Departments will only increase. It is patients in the community and patients attending Emergency Departments that will suffer.”

Notes to editor

Winter Flow February Week 2 data show:

  • There were 71,589 attendances, down from 71,794 the previous week
  • 6,502 patients were delayed by 12 hours or more from time of arrival in the Emergency Departments, down from 6,679 the previous week
  • Four-hour performance was 60%, up from 59.47% the previous week
  • 11,100 patients spent seven days or more in hospital, down from 11,547 the previous week
  • There were 1,587 elective care cancellations, down from 1,621 the previous week
  • 1,288 hours were lost during ambulance handovers, up from 1,262 the previous week
  • There were 22,938 active beds in service, up from the 22,888 the previous week
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