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Welsh Government’s Winter plan welcome as NHS in Wales could face crisis this Winter

21 October 2021

Emergency Department performance figures published today by the Welsh Government for September 2021 show four-hour performance has deteriorated for the sixth consecutive month, while 12-hour performance has deteriorated for the fifth consecutive month and eight-hour performance has reached the lowest on record.

The data show that there were 66,443 attendances at Major Emergency Departments in September 2021, 558 fewer than in August 2021.

Despite this four-hour performance fell for the sixth consecutive month once again reaching a new record low at 57.9%. This is a fall of 1.6 percentage points compared to the previous month, August 2021. 27,960 patients stayed in a major Emergency Department for more than four-hours before being admitted, transferred, or discharged. This is equal to two in five patients.

The data also show that 12-hour performance was 87.3%, a decrease of nearly one percentage point on the previous month, August 2021. Nearly 8,500 patients stayed in a major Emergency Department for more than 12 hours before being admitted, transferred, or discharged – equal to one in eight patients. 12-hour stays rose by 6%, or 500 patients, compared to the previous month, August 2021.

Eight-hour performance was the worst on record at 77.5%. This is 1.2 percentage points lower than the previous month, August 2021. Nearly 14,500 patients stayed in a major Emergency Department for eight hours or more before being admitted, transferred, or discharged. This is equal to almost a quarter of all major Emergency Department attendances.

In September 2021 bed occupancy for general and acute beds stood at 88.3%, the highest bed occupancy since the start of the pandemic.

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

“As the figures show we have had consistent deterioration in performance over the past five or six months. The situation is unsustainable. Emergency Departments continue to be under severe strain, and we know these pressures are not limited to Emergency Departments but are increasing across the whole system.

“The figures are extremely concerning. Bed occupancy for general and acute beds has reached its highest since the start of the pandemic. This comes despite a drop in attendances which indicates that the patients attending Emergency Departments are the very sickest.

“Long-stays have also risen once again with one in eight patients staying in a major Emergency Department for 12-hours or more while nearly a quarter of all attendances are staying for eight hours or more. Long-stays are linked to patient harm and threaten patient safety. Staff are doing all they can to minimise this risk and deliver care as quickly and effectively as possible.

“The NHS in Wales continues to tackle the pandemic with covid rates once again on the rise, while managing the elective care backlog, and seasonal illnesses returning. It is an incredibly challenging time, and we know that as we head into winter the scale of the challenges will grow. There is a potential crisis ahead and the actions taken now will determine the health service’s ability to cope.

“We welcome the publication of the Welsh Government’s winter plan which rightly focusses on: protecting people from covid; acknowledging the threat of seasonal viruses; prioritising patient safety; and the importance of social care services.

“The plan also sets out the priorities for urgent and emergency care over the winter period. Patients should always attend the Emergency Department when they need emergency care. But we welcome the Government’s plan to invest in and maximise the use of alternative health pathways that could alleviate the pressures facing Emergency Departments.”

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