Record number of 12-hour stays for patients

Record number of 12-hour stays for patients in A&E as the Government publishes reforms for Health and Social Care: Responding to English A&E performance figures for January 2021,Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“January was an extremely challenging month and placed unrelenting pressure on the health service. The data show huge numbers of 12-hour stays and difficulties offloading patients from ambulances into departments – we do not have enough beds to meet the demand.

“12-hour stays have reached the highest ever figure and four-hour performance dropped to its lowest ever. This rise and fall come despite the number of attendances being the lowest ever for the month of January and the lowest since May 2020.

“We know that the 12-hour stay reported by NHS England measure only from decision to admit to admission and do not present the full scale of 12-hour stays from arrival to discharge. The College has called for this to be resolved in the new metrics proposed in the Clinical Review of Standards. We hope this will present the full picture of the issues facing urgent and emergency care and lead to transformation and changes for the better.”

The latest performance data shows that in January 2021 there were:

• The highest ever number of 12 hour stays (3,809)
• The third highest ever number of ‘trolley waits’ (94,989)
• The lowest ever January attendances
• The worst ever four-hour performance at major Emergency Departments (70.1%) and second worst ever performance at all types (78.5%)
• Queues of ambulances, with 13.4% of ambulances waiting longer than 30 minutes to transfer patients into Emergency Departments.

Dr Henderson said: “The figures are terrible for patients and paint a picture of a truly battered and beleaguered health service. We were in an incredibly tough place going into the pandemic, but staff have worked magnificently throughout it.

“They have risen to the added pressures facing our hospitals for nearly a year now. However, these pressures and the hard work has taken a huge mental and physical toll on staff.

“Our work does stop as the peak passes and as covid admissions begin to fall, the NHS will begin a new phase of recommencing services. We hope that the lessons learned about the smooth running of the Emergency Care pathway are maintained.

“In the short term it is absolutely essential that mental health and psychological support is provided to all health care workers. There is a significant training backlog that must be addressed – time and resources must be allocated to ensure professional progression and deliver a qualified workforce.

“In the long term, the College cautiously welcomes the white paper published by the Department of Health and Social Care. However, gaps remain in the operationalisation of the reforms and there is little detail on the impact this will have on Emergency Care.

“It is vital that any reforms whatsoever are accompanied by an appropriate recognition of the shortfall in funding and investment that the NHS has faced along with the huge workforce crisis and staff shortages. The paper does not detail plans to fix social care which underpins a well-functioning health service.

“While we recognise the positives of centralising responsibility, we must see in detail a plan for more investment and funding, more training places and medical places at universities and a detailed plan on social care reforms.

“Without resolving the workforce crisis and the funding shortages any reforms will remain hollow and fail to have an impact in improving the services and care we provide to patients.”