Responding to the latest Emergency Department performance figures published by NHS England for May 2022, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “A marginal improvement in performance data is positive but should not be cause for celebration. The data remain grim reading and there is no real sign of this crisis easing.
“While the improvement is once again a testament to the hard work of staff, the number of patients staying for over 12 hours is the third highest ever. As our report Tip of the Iceberg details, these 12-hour DTA waits are only a fraction of the true number of long waits.
“We know that the number of 12-hour waits measured from when patients arrive in the Emergency Department is far higher. But until NHS England are transparent about the scale of the crisis and publish the 12-hour data measured from time of arrival monthly, there is little to no hope of improving the situation on the ground for both patients and staff.
“NHS England must publish this data as a matter of urgency, so we can begin to tackle the crisis in its true breadth and depth. In May 2022 we wrote to Amanda Pritchard, Chief Executive of NHS England, about this and have still not received a response, leaving us in limbo and waiting for clarification on a timeline as to when these data will be published.
“Things are now worse than any previous winter, and next winter is already looming. Staff morale remains incredibly low; they are depleted and continue to face moral injury day-to-day. Patient safety remains at constant risk with excessively long waiting times, and patients are distressed at these shockingly long waits.
“It is naïve at best and disingenuous at worst to say that this is a consequence of the pandemic. Over the past 10 years the bed base has shrunk significantly, workforce planning has faltered, and resourcing has not met demand.
“This is to say nothing of the decline of social care. Unsurprisingly all of this has added up to a substantial deterioration in performance over these 10 years; the pandemic just made a terrible situation worse. It is entirely correct though that there are no quick fixes to mend a mess that’s been over a decade in the making.
“Telling staff there is no funding coming to help fix the situation and exhorting them to just work a bit harder will do nothing to improve morale. However, we greatly welcome talk of a 15-year staffing plan, but this will of course need funding to help fill the 100,000 current vacancies and ensure we do not have such shortages again.
“We also welcome NHS England’s recognition of the need for an Urgent and Emergency Care Strategy. We urge that any UEC strategy must contain meaningful action that begins to tackle this crisis and drive improvement.
“One meaningful action must be to publish the 12-hour data measured from time of arrival. Beyond that we must see emergency resourcing of social care, and the health system must do all it can to expand capacity.”
Responding to the publication of Healthcare Safety Investigation Branch’s Interim Bulletin Harm caused by delays in transferring patients to the right place of care, Dr Henderson said: “It is well-known among health care professionals, especially the Paramedicine and Emergency Medicine workforce, that ambulance handover delays cause serious harm to patients.
“Instances of ambulance handover delays became a frequent and serious threat in late 2020 and early 2021 and in response to this rising threat The College published Ambulance Handover Delays: Options Appraisal. In November 2021, The Association of Ambulance Chief Executives published their report Delayed hospital handovers: Impact assessment of patient harm which found that these delays were leading to an unacceptable level of patient harm and presented a serious risk.
“We welcome the HSIB interim bulletin and its safety recommendations, we urge the Department of Health and Social Care to prioritise and urgently act on these recommendations. The situation continues to worsen, and it is highly detrimental to patient safety, to paramedic and EM staff, and public confidence in the emergency care services. Critically, the Urgent and Emergency Care system is failing to function as it should, we must do all we can to change that.”