This winter is already far worse than last winter, says RCEM President
The latest data from The Royal College of Emergency Medicine’s Winter Flow Project 2021/22 show that since the beginning of October 2021 there have been 56,096 patients delayed by 12 hours or more from time of arrival in Emergency Departments.
In comparison, last year’s Winter Flow Project 2020/21 didn’t record over 50,000 12 hour stays from time of arrival in Emergency Departments until February Week 3.
Data also show that in December 2021 Week 2, four-hour performance fell to 56.3%, the lowest ever recorded.
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:“The data show a deepening crisis. We’ve now reached 50,000 12-hour delays, a figure we didn’t reach until February last winter.
“It is hard to communicate the enormous strain NHS staff are under and how deeply the pressures affect patient care. The latest Winter Flow Project report details some of the harrowing conditions patients find themselves in and conditions in which staff are delivering care. This winter is already far worse than last winter, with the coming weeks set to take us deeper into crisis.
“Trusts are already doing all they can, opening every last bed where safely possible. The government must ensure adequate support is given to social care, as difficulties in discharging patients following their treatment has knock-on effects throughout the system and causes exit block in Emergency Departments, ambulances handover delays, and prevents ambulance crews from returning to the community and responding to emergencies.
“The public must be cautious and sensible over the Christmas period and take care of themselves and those around them. Using facemasks, washing hands, avoiding spending long periods of time in very crowded places, getting tested if you develop Covid symptoms, and getting boosted – all these practices will make a real difference in the coming weeks.”
A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020.
The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day.
One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with seven per cent reporting the longest stay to be more than 48 hours.
Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK.
“Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options.
“We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now.
“The data is stark, and this is August. Our members are really worried about what may come in autumn and winter. We have a duty to our patients and staff. Currently there is extremely high demand – for a number of reasons – but demand is not the whole picture.
“Demand presents a challenge because of the limitations of hospital space, workforce shortages, difficulties arranging quick ambulance handovers, smooth care and safe discharge of patients from wards, and a lack of services and alternatives to admission, particularly in the evenings and at weekends.
“The health service entered the pandemic short of staff, with less beds, and underprepared. Throughout the pandemic these shortages have been felt, but with demand higher than ever before, and with a workforce that is burned out, these shortages are felt more acutely than ever.”
Commenting on the increase in ambulance handover delays, Tracy Nicholls, Chief Executive of the College of Paramedics, said: “The College of Paramedics’ members also speak passionately about the potential for harm to those patients who, as a consequence of these lengthy ambulance handover delays, can wait an unacceptably long time for help. It is deeply concerning.
“Like the Royal College of Emergency Medicine, we recognise that all partners are working exceptionally hard to manage this situation and current demand. The reality is, however, that unless effective actions are taken now to ease the system pressures, more and more patients will face these delays as we head into another difficult winter, and both paramedics and ambulance clinicians across the UK will face the brunt of any further increase in demand.
“We urge NHS leadership to take action now to mitigate this risk wherever possible and protect both patients and our collective workforce from the inevitable pressure that we face if nothing is done.”
The survey also found that over 80% of respondents had little or no confidence in their organisation’s ability to safely and effectively manage the current or predicted combination of pressures as we head into winter.
Dr Higginson continued: “The final response that found an overwhelming lack of confidence signals something deeply troubling.
“The College has consistently warned of the upcoming winter and ongoing pressures. It is time we saw leadership and an equivalent response. There must be a comprehensive plan for the current demand and upcoming winter that include short- and long-term solutions to tackle these serious challenges.
“If ambulance services and Emergency Departments cannot cope with ongoing pressures, then it is patients and the workforce looking after them who will suffer. The winter could lead the health service into a serious crisis. Patients and staff must have assurance that they, their Emergency Department and their hospital will get what they need to manage.”
Traffic Scotland has reported that the M8, Scotland’s busiest motorway, currently remains closed in both directions at Harthill (J4A westbound, J5 eastbound) after a serious accident in the early hours of this morning.
There are long delays – motorists are advised to use an alternate route at this time and should allow extra time for their journey.
A mistake in a spreadsheet calculation set in motion a series of events that led to the delayed opening of the new £150m Sick Kids hospital, a new report has revealed.
The go-ahead for a new hospital at Little France, a replacement for the ageing Sick Childrens Hospital in Sciennes, was first agreed by NHS Lothian in 2005 but the project has seen a catalogue of delays and spiralling costs.
Scottish Conservative health spokesman, Lothian MSP Miles Briggs, said: ““It is absolutely staggering that this mistake has had such huge repercussions and was not picked up until after the new hospital had been built.
“This review is highlighting how ill equipped health boards are for undertaking projects the magnitude of a new hospital.
“SNP Ministers are ultimately responsible for what has been described as a ‘collective failure’ in the specifications of ventilators at the hospital.
“This fiasco has cost the tax payer enormous amounts of money, money which should have gone towards properly resourcing hospitals and improving treatment times.”
The saga of Edinburgh’s new Sick Kids hospital is set to be extended again – after health secretary Jeane Freeman admitted the latest timescale was “under review”.
The facility, which is now eight years late, was supposed to finally open in the autumn.
However, Ms Freeman admitted in a parliamentary answer on Friday that the handing over looked set to be held up again because of coronavirus pressures.
Ms Freeman said: “NHS Lothian is working closely with IHSL to ensure delivery of the programme as close to the timeframe of a full handover in Autumn 2020, but this timeframe is now under review. A refreshed programme is likely to be available during the second half of May and I will of course keep Parliament updated.”
Shadow health secretary Miles Briggs said while this particular delay may be understandable given the Covid-19 crisis, it could have all been avoided had the SNP hit any of the previous targets for opening.
The much-needed facility has been plagued by problems, meaning staff and patients have been forced to continue to use the ancient building in the Sciennes area of the city, which the health board itself has acknowledged is no longer fit for purpose.
Scottish Conservative shadow health secretary Miles Briggs said: “Obviously with the current situation it’s inevitable there will be delays with almost all projects of this nature.
“What wasn’t inevitable was the SNP’s failure to get this hospital open in anything like the timeframe initially set out. This vital hospital – which was commissioned, planned and built by the SNP – was meant to open in 2012.
“It should currently be open, thriving and assisting our dedicated NHS staff with the coronavirus battle. Instead, it lies empty while the rest of the hospital estate is placed under immense pressure.
“Families across the east of Scotland will not forget the SNP’s spectacular mismanagement of the Sick Kids project.”
The second and final part of a review into compliance of all building systems at the Royal Hospital for Children and Young People (RHCYP) and Department of Clinical Neurosciences (DCN) has been published.
Concluding work ordered by Health Secretary Jeane Freeman in July, the latest NHS National Services Scotland (NSS) report focuses on fire systems, electrical systems and medical gases. This has identified remedial work required within fire and electrical systems prior to occupation and the need for other improvements. Continue reading New Sick Kids: still on course for Spring move
A programme of improvement measures has been put in place to ensure patient safety at the new Royal Hospital for Children and Young People (RHCYP) – but Conservative politicians are calling for a parliamentary inquiry to get to the bottom of what has gone wrong with the beleaguered project.
Update on Royal Hospital for Children and Young People
To protect patient safety the Health Secretary has delayed the move of patients, staff and services from the existing Royal Hospital for Sick Children to the new site at the Royal Infirmary of Edinburgh, which was due to take place next week. Continue reading New Sick Kids Hospital: MOVE HALTED
The Royal Hospital for Children and Young People has yet again been delayed till Autumn 2018. The project, which was originally meant to open in the winter 2012, was delayed until Autumn 2017, further delayed to Spring 2018 and is now to expected to open in Autumn 2018. Continue reading Another New Sick Kids opening delay “unacceptable” says Tory MSP
