Deepening crisis for Urgent and Emergency care

Record number of patients delayed by 12 hours or more as Urgent and Emergency Care faces deepening crisis: The latest Emergency Department performance figures published by NHS England for January 2022 show:

• There were 1,246,817 attendances at major Emergency Departments
• 16,558 patients were delayed for 12 hours or more from decision to admit to admission
  • This is the highest figure since records began and it is nearly a one-third increase on the previous month, which was the previous highest
  • Nearly one in 30 of all emergency admissions were delayed by 12 hours or more
• Four-hour performance was 62.3%
• 122,427 patients were delayed by four-hours or more from decision to admit, the highest figure on record
• Over one-quarter of all emergency admissions experienced waits of four hours or more (often referred to as ‘trolley waits’), representing the highest proportion on record
• Nearly one in five booked appointments were not seen within four hours at major Emergency Departments
  • The 95% target has only been met once in August 2020 (97.2%) which was the first month reporting and publishing booked appointment data

Mrs Lisa Munro-Davies, Vice President of the Royal College of Emergency Medicine, said:

“These data show the scale of the crisis in Urgent and Emergency Care and the sharp, continued and consistent decline in performance and compromise of patient care. For the fifth consecutive month we have a record number of 12-hour waits since reporting began. 16,558 patients delayed by 12 hours in an Emergency Department. In November 2021, we reported that one in 67 patients staying in an Emergency Department come to avoidable harm or even death, one could estimate that at least 247 patients have faced such harm or potential death in January 2022 alone.

“However, NHS England’s published 12-hour data is not measured from time of arrival but from when a decision to admit has been made, meaning that the actual number of patients waiting for more than 12 hours is significantly higher. We have previously estimated the figure to be 21 times higher. For system transformation and improvement in Urgent and Emergency Care, 12-hour data from time of arrival – that is already being collected by all Trusts – must be published by NHS England.

“This week the Secretary of State announced his recovery plan for elective care with some ambitious targets and revamped initiatives such as diagnostic and community surgical hubs. What has not been recognised though, is the inextricable link between Urgent and Emergency Care and elective care or the workforce expansion required to deliver these plans.

“A workforce crisis, shortages of beds, a social care crisis; these cannot be circumvented by targeting elective care alone. While it is right that elective care is provided with the resources it needs to tackle the extremely high backlog, patient care is the priority and too many patients have waited for too long to receive their operations or surgery.

“But the Secretary of State and the government need only glance at January’s performance figures to see the severe crisis facing Urgent and Emergency Care that, if not met with a recovery plan, will most likely scupper any elective care delivery plan.

“The government made workforce promises such as the recruitment of 50,000 more nurses as well as a promise to fix social care. We have yet to see any long-term workforce plan or meaningful plan for social care. What we now have is an isolationist plan for elective care that fails to include detail on how it’s initiatives will be staffed, given the current workforce crisis.

“An Urgent and Emergency Care recovery plan must be published for this elective care recovery plan to stand any chance of hitting its targets, and the publication of a fully funded workforce plan encompassing all aspects of health and social care service delivery must be the immediate priority.”