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Wales facing intense pressures as 12-hour waits increase by one third

21 January 2021

Emergency care statistics released today by the Welsh Government show that hospitals in Wales are facing intense pressures as waiting times increase significantly across the board despite a major reduction in attendances.

In December 2020 the number of patients waiting 12 hours or more in a major emergency care facility increased by one third since November 2020 to 6,354, equal to 1,587 more patients. This means three in 25 patients spent 12 hours or more waiting to be admitted. It is the highest number of 12-hour waits in the pandemic and the highest figure since January 2020.

Four-hour target performance in major departments dropped to its lowest ever figure, 65.1% in December 2020. This marks a decrease of 5 percentage points on the previous month, November 2020. It is equal to seven in 20 patients waiting more than 4-hours to be admitted.

The number of patients waiting over eight hours increased by 20%. 10,227 patients waited eight hours or more in a major department, compared to 8,467 the previous month, November 2020.

New NHS Wales Experimental Emergency Department measures launched in October 2020. This experimental data from NHS Wales shows that the average time a patient waited to be seen by a senior clinician increased by 20% from 60 minutes in November 2020 to 72 minutes in December 2020, and marks a one third increase since October 2020, when the average waiting time was 54 minutes.

Despite all the considerable increases in waiting times, attendance at major Emergency Departments has decreased 6% from November 2020, or by 3,274 patients. It also marks a 40% decrease in attendances on the same month last year, December 2019, equal to nearly 20,000 patients.

The data signify the intense pressures facing Emergency Departments in Wales and the severity of patient’s conditions. The mixture of winter and covid present a formidable challenge. Social distancing rules mean there may be fewer beds available and self-isolation safety measures mean fewer staff may be able to work. These may be contributing factors to the increase in waiting times.

Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said:

“The data show the scale of the pressures we are facing. Ambulances are facing long waiting times, unable to admit patients into hospital. These ambulances are then unable to return to the community and respond to urgent and emergency calls.

“But this issue is not limited to A&Es. We are facing intense pressures across the system. Exit block is reducing flow through departments and patients are unable to move through the system. As the data show 12-hour and 8-hour waits have increased significantly and 4-hour performance has dropped considerably.

“Exit block leads to crowded departments and to a situation where doctors are having to administer care in corridors. These long waits are undignified for patients and significantly increase the risk of complications or death.

“While the recent marginal reduction in covid cases is a minor alleviation, we are beginning to see a surge in demand from patients in the community needing care. The reduced attendances are a serious concern to us, it is vital that anyone who needs urgent or emergency care seeks it out.

“We are also concerned that patients attending our Emergency Departments may contract or spread covid in the hospital. We must not let that happen and we are doing all we can to prevent this through strict infection prevention control measures. It is imperative that our hospitals are safe for patients.

“We are in a serious crisis facing an enormous challenge. There are no quick solutions. All we can do is work together to make sure our hospitals and patients are as safe as possible. We can work inter-departmentally and system wide to maintain flow and reduce waiting times. We can look out for and support our colleagues. The coming weeks will present further challenges, but the vaccine rollout is a light at the end of the tunnel.”

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