There was a total of 562,062 instances of staff absences
249,173 instances of staff absences were covid related, an increase of 41% on the previous week
Nearly half of instances of staff absences were covid related
Since the start of December there has been an increase of 198% in covid-related instances of absence
On average 16,906 patients resided in hospital who no longer fit the criteria and were ready to be discharged, of these, on average, 9,858 remained in hospital
This is equal to almost six in 10 patients who were ready to be discharged remaining in hospital
Nearly one quarter of ambulance arrivals were delayed by 30 minutes or more
Almost one in 10 ambulance arrivals were delayed by at least an hour
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:“The scale of the pressures facing the health service is highlighted in these figures. Instances of covid-related absence have tripled since the beginning of December. Now the army has been deployed to assist the health service in London.
“Ambulances continue to be delayed in handing over patients on arrival putting patient safety at risk, while high numbers of patients ready to be discharged remain in hospital due to the ongoing social care crisis.
“Promoting flow through the hospital is vital but rests upon timely discharge of patients back home once their treatment is complete. To ensure this social care must be resourced and supported, this will help reduce admissions and free up beds in hospital.
“It is a perilous situation, and an enormous strain is put upon staff working in hospitals, who continue, as ever, to go above and beyond to ensure care continues to be delivered and patients are kept safe.”
A new film from the UK government Better Health Smoke Free campaign has been released to discuss how adult smoker can influence younger people
Experts warn that teenagers whose parents smoke are likely to copy them in adulthood
New film features health experts discussing how adult smokers can act as role models
NHS support offered to smokers – in particular parents, carers and other adults – to encourage them to quit in the new year
Top medical experts have warned that teens whose parents or caregivers smoked are FOUR TIMES as likely to have taken up smoking.
Analysis has also shown that early teens whose main caregiver smoked were more than twice as likely to have tried cigarettes (26% vs 11% ) and four times as likely to be a regular smoker (4.9% vs 1.2%).
A new government Better Health Smoke Free campaign has launched as leading family doctors warn of the issues facing the children of smokers – and calls on people to help prevent this by quitting in January.
In a new film released today, NHS and behavioural health experts discuss the link between adult smoking and the likelihood of children in their household becoming smokers. This includes family GP Dr Nighat Arif, child psychologist Dr Bettina Hohnen, and smoking cessation experts Professor Nick Hopkinson and Dr Anthony Laverty of Imperial College London, who have called on parents in particular to give up smoking in the new year in order to set a good example to their children.
Maggie Throup MP, Parliamentary Under Secretary of State and Minister for Vaccines and Public Health, explained why the campaign is launching now: “We know that many people make a quit attempt in January, and while there are so many good reasons to stop smoking for yourself, we hope that this new campaign – by highlighting the inter-generational smoking link with parents influencing their children – will be the added motivation many need to ditch the cigarettes for good this year.
“With so much help and support available for parents, carers and anyone looking to quit – including the NHS Quit Smoking app, support on Facebook, daily emails and texts, and an online Personal Quit Plan – you won’t be alone in your New Year’s resolution.”
Recent research from NatCen Social Research has also shown children aged 10-15 were more likely to smoke if either their mother or father currently smoked. Children were also more likely to smoke if either parent had smoked in the past, even if they were not a current smoker.
Deputy Chief Medical Officer and joint lead for the Office for Health Improvement and Disparity, Dr Jeanelle de Gruchy said: “Smoking is terrible for your health but it also has a negative impact on people around you.
“Most people know the dangers of second smoke but we should not overlook the impact that parents have as role models. Every parent wants what is best for their child and will not want them to become smokers.
“By stopping smoking now, parents can help break the pattern of smoking in their family across the generations, protect their children and improve their own health.”
The film forms part of the Better Health Smoke Free campaign from the new Office for Health Improvement and Disparities (OHID) in the Department of Health and Social Care, and aims to give smokers a strong motivation to quit in January, offering free and proven NHS resources and advice.
The campaign comes as the most recent data from the Office for National Statistics shows that one in eight adults in England still smokes. There has been a complex picture of smoking patterns since the pandemic, with high rates of quitting but also high levels of relapse and signs of a rise in smoking rates among younger adults.
Professor Nick Hopkinson of Imperial College London said: “Our research findings are clear – adult smoking has a tangible impact on children. Children whose caregivers smoke are four times as likely to take up smoking themselves.
“The most effective way to help prevent this would be for adults to quit smoking – clearly not only does this have enormous benefits for them but it will also benefit their children both now and in later life.”
Dr Bettina Hohnen explains how parents’ behaviours can have a huge impact on their children’s’: “Even if we don’t directly expose children to second-hand smoke, or believe we are hiding our smoking by not smoking directly in front of them, it can still have a major impact and children can pick up the behaviour without you even being aware you’d had an influence.
“Children copy their parents’ and carers’ behaviours, so it’s important to model the behaviour you want from your child – or we can pass on behaviours without even realising. Actions really do speak louder than words, so if you don’t smoke, you will significantly reduce the chances of them taking up smoking in the future.
Family GP Dr Nighat Arif has first-hand experience of helping smokers in her general practice: “One in eight adults in England still smokes, and it remains the leading preventable cause of premature death.
“Stopping smoking is one of the best things you will ever do for your health, and it’s never too late to quit. If you want to quit smoking for your family or for your own health this January, you’re not alone. The Better Health campaign provides tons of proven support and resources from the NHS which can help you quit for good.”
Georgina from Harrogate, North Yorkshire, is 35 and stopped smoking in January 2021 after being a smoker since she was only 16. Her nephews inspired her to quit: “After 15 years of smoking I took the decision to quit because I really didn’t want to pass the habit on to the children in my life.
“I was totally unaware at first, but over time I noticed that my 7- and 4-year-old nephews were watching me smoke. I am a big influence in their lives so obviously I was worried they’d one day pick up smoking too.
“In the end I quit smoking – both for my own health but for my nephews as well. When I felt ready to start my stop smoking journey, I turned to the Better Health website, and looked at the different resources they had available to help me build confidence and give myself the best possible chance of quitting.”
The Better Health campaign gives access to a range of free quitting support and tools including free expert help from local Stop Smoking Services, the NHS Quit Smoking app, Facebook messenger bot, Stoptober Facebook online communities, daily emails and SMS, and an online Personal Quit Plan.
Search “Smoke Free” for free and proven quit smoking tools and advice on different types of support, nicotine replacement therapies (NRT) and e-cigarettes, to help you quit smoking.
A record-breaking week for daily vaccinations with a rolling average of nearly 1 million top-up jabs in arms a day
New vaccine sites have opened across the country making it easier than ever to get vital protection from Omicron
More than 30 million people, over 56% of adults in the UK, have now had their COVID-19 booster during a record-breaking week for top-up jabs.
Yesterday saw a record number of daily vaccines administered, with a total of 1.06 million first, second and third jabs in arms. Of those, 968,665 were boosters as another daily record has been broken for UK top up jabs.
The expansion of the booster programme continues at rapid pace, with all eligible adults aged over 18 able to get their lifesaving jab by booking online through the National Booking Service, or by visiting their nearest walk-in vaccination centre. This week more vaccination sites have popped-up across the country making it as easy as possible to Get Boosted Now, including football stadiums and shopping centres.
Health and Social Care Secretary Sajid Javid said: We’re continuing to smash booster and vaccine records – with 30 million total boosters in the UK and more than 1 million total vaccines on one day being an absolutely fantastic achievement.
“I am so grateful to people up and down the country for rolling up their sleeves to secure vital protection for themselves and their loved ones against Omicron this winter.
“Every top-up jab in someone’s arm means that as a country we are strengthening our wall of defence against the Omicron variant. Let me be absolutely clear – this festive season, the single most important thing you can do is come forward for your lifesaving booster jab.
“I am urging you – please, keep coming forward to Get Boosted Now.
Yesterday also saw new guidance issued in England which will enable the 10-day self-isolation period for people who have tested positive for COVID-19 to be reduced to 7 days in most cases.
Studies also demonstrate that LFD tests are just as sensitive at detecting the Omicron variant, as they are for Delta.
Vaccines Minister Maggie Throup said: “I am absolutely overwhelmed by the public’s response to our national mission for everyone to Get Boosted Now. Today’s milestone of 30 million boosters is a phenomenal achievement and a true representation of the community spirit we share here in the UK.
“In the race between vaccine and virus, it is thanks to the work of our wonderful NHS that we are able to stay ahead and protect ourselves and our loved ones.
“Everyone can play their part. Please – keep coming forward for your lifesaving booster jab. It has never been easier, as you can book an appointment via the National Booking Service or choose to queue up at one of our vaccination centres around the country.
Dr Emily Lawson, head of the NHS vaccination programme, said: “Our NHS staff have pulled out all the stops, aided by our fantastic volunteers, to accelerate the NHS COVID-19 Vaccination Programme ahead of Christmas and we have now administered more than 30 million doses across the UK, including 26 million in England alone.
“Being asked to accelerate the booster programme, the NHS has delivered lifesaving covid vaccines at an unprecedented rate, breaking daily and weekly records, and I would urge anyone yet to book in for their vital top-up dose to do so at the earliest opportunity – there are plenty of appointments available and it is the best way to guarantee protection for you and your loved ones this winter.”
There is further positive news as more cutting-edge antiviral treatments for COVID-19 have been secured for NHS patients as the UK Government signs two new contracts to help tackle Omicron.
The significant new deals have been accelerated following the emergence of the Omicron variant, to protect vulnerable people over the coming months. The move will help reduce hospitalisations and therefore ease pressures on the NHS.
While the government was quick to herald reaching the latest milestone, yesterday saw another siginificant milestone – and a distinctly unwelcome one.Daily Covid-19 cases in the UK exceeded 100,000 for first time.
As Scotland faces one of its most challenging winters, Health Secretary Humza Yousaf has praised the continued courage, commitment and professionalism of Scotland’s health, social care and social work staff.
In his Christmas message, Mr Yousaf said: “This year has been an incredible race to get ahead of COVID-19 with a vaccination programme which has been the largest logistical peacetime operation Scotland has ever seen.
“As we set our sights on recovery, we have had to adapt and respond to new variants, following guidelines which are constantly updated to take on board the course of this pandemic.
“Every single person working in health, social care and social work has continued to provide exemplary care in the most trying of circumstances, saving lives and protecting our NHS at a high cost both personally and professionally.
“You continue to be extraordinary in your response to unprecedented demands, delivering services in what can often be new and often unfamiliar ways. I have heard directly from some of you about the impact that working in pandemic conditions has had. And I want to sincerely thank you for everything you have done, and continue to do, during this difficult time.
“We will only overcome the challenges ahead if we look after our most valuable asset – the people who provide care through this pandemic. Your wellbeing, wherever you work in the sector, is a key priority.
“Now more than ever, it is critical to look after your wellbeing, and that of your colleagues, and provide support so you can take the time you need to access local and national wellbeing resources available.
“To complement the help that is available to you at a local level, we also have a range of services on hand through the National Wellbeing Hub, including a 24/7 National Wellbeing Helpline, confidential mental health treatment through the Workforce Specialist Service and Coaching for Wellbeing resources.
“I implore you to speak up if you or a colleague need support. You are doing an amazing job, and deserve our help in return.
“The pandemic has been the most significant challenge the NHS has faced in its 73-year history. We know that it is not over, and that the new Omicron variant and other pressures will continue to impact us for some time.
“We hope this Christmas will not be as restrictive as last year, but we’re asking everyone to play their part in helping to suppress the virus by limiting their socialising as much as possible. This is to save lives, and to support all of you in the work that you do. Because we will overcome this virus if we work together and think carefully about how our actions might impact others.
“I want to share my heartfelt gratitude for everything you continue to do in order to support and care for the people of Scotland, and take this opportunity to wish you a happy Christmas and a peaceful and prosperous New Year.”
UK Government and NHS announce ambition to recruit tens of thousands of volunteers to help get jabs into arms
All eligible adults will be offered the chance to get their jab before the New Year
PM: “We need you to come forward again, to work alongside our brilliant GPs, doctors, nurses and pharmacists, to deliver jabs and save lives.”
Prime Minister Boris Johnson and NHS Chief Executive Amanda Pritchard have joined forces to issue a rallying cry for thousands of volunteers to come forward and support the NHS booster campaign.
The public will be urged to play a crucial role in the UK’s fight against Omicron by helping the NHS to get as many jabs into arms as quickly as possible. No task will be too small to contribute towards this national effort.
Yesterday the Prime Minister announced a new ambition for every eligible adult to have the chance to get their jab by the end of the year.
This follows new evidence that suggest the Omicron variant is extremely transmissible and two jabs are not enough to protect against infection.
The new target means the NHS will be massively ramping up its vaccine operations in the next few days, and it needs as many people as possible to play their part by volunteering their time to help.
Urging volunteers to sign up to the booster drive, Prime Minister Boris Johnson said: “As part of our Get Boosted Now vaccination drive we need to increase our jabbing capacity to unprecedented levels.
“But to achieve something on this scale, we need your help. So today I’m issuing a call for volunteers to join our national mission to get jabs in arms.
“We need tens of thousands of people to help out – everyone from trained vaccinators to stewards.
“Many thousands have already given their time – but we need you to come forward again, to work alongside our brilliant GPs, doctors, nurses and pharmacists, to deliver jabs and save lives.
“So please come forward if you can.”
There are now almost 3,000 vaccine sites across the country, staffed by over 90,000 volunteers who have given up 1.1 million hours of time so far.
In the next week hundreds more sites, mobile units and pop ups will be springing up across the country. These will be in a range of locations that will make it as easy as possible for people to get boosted – such as at football stadia, shopping centres and racecourses.
This means volunteers are needed to perform tasks such as registering patients, managing queues and giving jabs.
Last week the NHS announced a recruitment drive for 10,000 paid vaccinators and support staff and that it will also work with the Royal Voluntary Service and St. John Ambulance to recruit a further 40,000 volunteers for roles such as admin and stewarding queues.
In the last week, 13,000 people have come forward as steward volunteers, and a further 4,500 people have registered their interest to take up one of the 10,000 paid vaccinator roles. The government and NHS now want to go even further.
NHS England Chief Executive Amanda Pritchard said: “In the face of the grave threat posed by the new Omicron strain of Covid, the NHS is seeking to offer vaccine booster protection to all eligible adults by the end of the month, a new national mission in which everyone can play their part.
“There is no doubt that our incredible NHS staff will rise to the challenge but we cannot do this alone – we need the support of the public and volunteers to once again support the Covid vaccination programme.
“Since we first issued a call to arms we have had an outstanding response but Omicron has shifted the goalposts and we are now renewing our plea to the nation – I would urge anyone who has volunteered in the past, or considered it but not taken up the opportunity, to come forward now – search ‘NHS vaccine team’ today and find out more about how you can help us save lives.”
Health and Social Care Secretary Sajid Javid said: “To help us turbocharge our COVID-19 booster programme we need people across the country to join our national mission to get boosted now.
“We are so grateful to the volunteer vaccinators from organisations such as St John Ambulance and Royal Voluntary Service who have made an enormous contribution by administering millions of vaccinations since the start of this year.”
People interested in either a voluntary or paid role are urged to visit the Join Vaccine Team page or search ‘NHS vaccine team’. People who volunteered or were trained for paid roles previously are also being contacted to help out again.
Scotland’s First Minister will make a statement on the situation in Scotland this afternoon. It’s expected that restrictions will be strengthened here as Omicron variant cases continue to rise sharply across the UK.
Armed forces step up to support vaccination drive across UK
Over 100 personnel are currently supporting the vaccine rollout in Scotland. 600 Armed Forces personnel have been made available to NHS England to administer vaccines, working in small teams across the country.
In addition, around 50 personnel will provide planning support to NHS England. 41 planners will deploy to NHS trusts across England and 10 logistics experts will be based at NHS England’s headquarters in London.
Defence Secretary Ben Wallace said: “We have rapidly mobilised Service personnel to work alongside our dedicated health services to accelerate the vaccine booster programme.
“Our Armed Forces will help to get vaccines into arms as quickly as possible as we continue our efforts to support the UK’s response to the pandemic.”
Health and Social Care Secretary Sajid Javid said: “We are turbocharging our COVID-19 booster programme to offer every adult in England a vaccine by the end of the year to protect people from the Omicron variant.
“Building our defences through boosters is a hugely important national mission and it’s brilliant to see the military supporting our NHS staff in our race against the virus.
“Please get boosted now to top-up your immunity and keep yourself and your loved ones safe this winter.”
Chief of the Defence Staff Admiral Sir Tony Radakin said: “I’m proud of our Armed Forces who are once again stepping up to help protect people and communities.
“We have a long history of working hand in hand with the NHS as two organisations with a common goal – to help keep our people safe.”
Planners based at NHS England headquarters will be led by Brigadier Phil Prosser who was previously deployed to support the delivery of the vaccine programme which began in December 2020. They will work alongside NHS England to maximise existing capacity and ensure the vaccine programme can be delivered at pace.
Since March 2020, Defence has supported over 430 tasks as part of Operation Rescript – Defence’s support to the UK’s response to the pandemic.
Defence is currently supporting ambulance services in Wales and Scotland and the vaccine rollout in Scotland among other tasks including testing.
Personnel supporting on Operation Rescript tasks have deployed from across the three services – Royal Navy, British Army and Royal Air Force – and are a mixture of regulars and reservists.
Prime Minister and NHS turbocharge booster programme against Omicron and launch an urgent national appeal calling for people to get jabbed
Latest data shows booster is needed to protect ourselves and the NHS against the variant
Prime Minister: “A tidal wave of Omicron is coming. Get Boosted Now.”
UK Chief Medical Officers raise UK Covid Alert Level from Level 3 to Level 4
All adults in England to be offered a booster jab by the end of the year. Devolved administrations also agree to accelerate vaccinations.
The Prime Minister, together with the NHS, last night launched an urgent national appeal calling for people to get jabbed, as he outlined plans to significantly increase NHS vaccination capacity.
It comes as the UK Chief Medical Officers increased the UK Covid Alert Level from Level 3 to Level 4 due to a rapid increase in cases of the Omicron variant.
The latest data suggests Omicron is extremely transmissible and will become the dominant variant by mid-December. Cases are now doubling every 2 to 3 days.
Data published on Friday suggests that vaccine efficacy against symptomatic infection is substantially reduced against Omicron with just two doses, but a third dose boosts protection back up to over 70%.
It is too early to draw firm conclusions about whether the Omicron variant is as virulent as Delta but even if it is more mild, a slight fall in vaccine efficacy can lead to a substantial increase in hospitalisations. Hospitalisations in South Africa have doubled in a week and are expected to rise in the UK over the next 2 weeks.
The extent of transmissibility, coupled with reduced protection after two doses and the raising of the alert level by the UK CMOs, means the Prime Minister and NHS England are today launching an urgent national Omicron appeal for the public to Get Boosted Now.
The government and NHS will rise to the challenge, working flat out to deliver jabs, save lives and ensure the NHS is not overwhelmed this winter with an influx of Omicron cases.
The vaccination programme is already delivering hundreds of thousands of boosters every day, with over 530,000 jabs in arms on Saturday alone, while catching up on elective surgeries and appointments and delivering all urgent care.
All adults will now be offered a booster jab by the New Year, bringing the target forward by one month.
Bookings through the National Booking System will be prioritised at most sites unless it is a pop up or walk-in only site. The National Booking System will now be stood up for over 18s and will take a short time to operationalise. From tomorrow adults over 30 will be able to book online, and all over 18s from Wednesday.
Some walk-in appointments will be available from tomorrow for over 18s, dependent on location. If there are long queues or all slots have been booked, people are encouraged to be patient and keep trying, or book online.
To deliver the ramped-up vaccination programme, NHS staff will need to be redeployed away from non-urgent services. This means that all primary care services will now focus on urgent clinical need and vaccines, and some non-urgent appointments and elective surgeries may be postponed until the New Year while every adult in the country is jabbed.
Without the added protection from this third dose, NHS beds will quickly fill up and the long term damage to the economy and the NHS efforts to bring down the backlog will be even greater.
The NHS will be given everything it needs to get jabs in arms as the UK responds to the Omicron variant.
The Prime Minister yesterday set out that the NHS will be given everything it needs to boost jabbing capacity, which will include:
New vaccination sites set up across the country, including mobile pop up sites
Increasing opening times for vaccination sites, to 7 days a week with more appointments early in the morning, in the evening and at weekends
50 military planning experts will help coordinate the national effort by supporting the NHS with logistics of the rollout
Reprioritising the NHS workforce to deliver as many jabs as possible
A national call for thousands more NHS volunteers
If Omicron is left unchecked the NHS is at risk of being quickly overwhelmed. Last week the Prime Minister confirmed the move to Plan B for England following its rapid spread.
Face coverings are now compulsory in most public indoor venues in England – this is already in place in Scotland – people are asked to work from home if they can from today, and from Wednesday 15 December negative lateral flow tests will be needed to enter nightclubs and large events, except for those who are double vaccinated and subject to approval from Parliament.
Every adult in the country is now being urged to book their jab as soon as possible. The vaccination programme is open to everyone, and first and second doses remain available.
The government will continue to work closely with the devolved administrations on the booster rollout, and there will be Barnett consequentials for any new funding.
Nearly two thirds of A&Es across the UK had ambulances waiting to transfer patients every day in the past week, according to a new survey from the Royal College of Emergency Medicine.
The latest RCEM survey covers the period 8 November to 14 November 2021 and was sent to Clinical Leads in Emergency Departments across the UK and received 70 responses.
The NHS mandates that ambulance handovers ought to be reliably completed within 15 minutes of arrival, but 61% of Emergency Departments in the survey were struggling to meet this standard every day.
The survey also found that over half of Emergency Departments had provided care to patients in non-designated areas such as corridors every day in the past week.
These findings come following a report by the Association of Ambulance Chief Executives (AACE) which found that 160,000 patients may be coming to harm annually as a result of ambulance handover delays.
While a separate report by the Royal College of Emergency Medicine, ‘Crowding and its Consequences’, found that at least 4,519 patients have died as a result of dangerous crowding in Emergency Departments in England in 2020-2021.
14% of respondents stated that the longest stay they had had in their Emergency Department was between 48 and 72 hours
36% of respondents stated the longest stay in their Emergency Department was 24 to 48 hours
39% of respondents stated the longest stay in their Emergency Department was 12 to 24 hours
14% of respondents stated that there was no effective Same Day Emergency Care available in their Emergency Department
50% of respondents stated that Same Day Emergency Care had limited availability, less than 12 hours a day or weekdays only in their Emergency Department
71% of respondents stated that they were unable to maintain social distancing for patients in their Emergency Department in the past week
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:“These results show the serious state that our urgent and emergency care system is in.
“None of us want to have patients held in ambulances, treated in corridors, or waiting very long times to go up to a ward bed. Sadly, these findings support our stark report on crowding and the AACE’s shocking report on ambulance handovers.
“We all need to work together to solve this acute patient safety problem. We believe enacting many of the suggestions we have made in RCEM CARES: The Next Phase will help. We want patients to feel confident that their Emergency Care system is there for them, but this winter is going to be a huge challenge unless we can get flow back into the system.
“RCEM CARES: The Next Phase details our system-wide plan to tackle the current crisis and improve patient care as well as staff wellbeing. In the short-term, to promote flow and to reduce handover delays, capacity must be expanded in a safe way. Same Day Emergency Care must be made available at all Trusts and they must expand its provision, so it is available 12 hours a day, seven days a week. While maximising the service Discharge to Assess will allow patients to be discharged in a timely and supported way.
“In the long-term, we urge the government to publish a long-term workforce plan, this must include actions to retain existing staff as well as recruit new staff. Across the UK there is a shortfall of 2,000-2,500 WTE Emergency Medicine consultants, and crucially, there are also widespread shortages of Emergency Medicine nurses and both junior and supporting staff. At the same time capacity is severely depleted across the UK. The government must restore bed capacity to pre-pandemic levels, this requires an additional 7,170 beds across the UK.
“This is only the beginning of winter and of what may come. We are facing a crisis in urgent and emergency care and a crisis of patient safety. The Secretary of State in the House of Commons spoke of ‘a duty to avoid preventable harm of everyone working in health and social care’, we urge him to act on his own words and prevent avoidable harm and ensure the safety of patients.”
Managing Director of AACE Martin Flaherty OBE QAM said:“These alarming new figures from RCEM underline once again the unprecedented pressures facing the entire urgent and emergency care system.
“We now know that excessive handover delays and crowding in A&E departments are routinely harming patients, some very severely. To resolve this, we need system leaders to further toughen their resolve to deal with this problem once and for all and as a matter of priority and we await details of progress being made in this area, while underlining our commitment to work as part of the solution to this complex issue.”
Tracy Nicholls, Chief Executive of the College of Paramedics, said:“We must not forget that behind all these mounting figures are real people, both staff and patients, who are bearing the brunt of this continuing strain on services.
“Reform must happen to alleviate the intolerable pressure and reduce the guilt many paramedics and Emergency Department staff feel about dealing with patients who are waiting outside Emergency Departments or, more worryingly, in the community.
“We support any efforts to deal with the here and now, but we commit to working with stakeholders and partners to make real change happen.”
A new report by the Royal College of Emergency Medicine ‘Crowding and its Consequences’ has found that at least 4,519 patients have died as a result of crowding and 12 hour stays in Emergency Departments in England in 2020-2021.
The new report investigates the extent of harm that crowding causes and applies NHSE’s own findings from the Getting It Right First Time (GIRFT) program which found that one in 67 patients staying in the Emergency Department for 12 hours come to excess harm.
The report also provides comprehensive analysis on a variety of data points:
Four-hour target
12-hour waits
Decision-to-admit (DTA) waits and admissions
12-hour DTA waits vs. 12-hour time-of-arrival waits
Time to initial assessment for ambulance arrivals
Time to treatment
Median total time patients spend in Emergency Departments
Ambulance handover delays
Bed availability
Length of hospital stays
Dr Adrian Boyle, Vice President (Policy) of the Royal College of Emergency Medicine, said:“To say this figure (4,519 excess deaths) is shocking is an understatement. Quite simply, crowding kills.
“For many years we have issued warnings about the harm that dangerous crowding causes, but now we can see the number of excess deaths that have occurred as a result. This will not surprise any member or fellow of the Royal College.
“October 2021 saw an unimaginable 7,059 12-hour stays from decision to admit, the highest number ever recorded, 40% higher than September 2021 which was the previous highest on record. The number of 12-hour stays has risen drastically for six months and is very likely to rise again in coming months.
“The picture is more bleak as Hospital Episodic Statistics show that 12-hour stays from time of arrival are 21 times higher than 12-hour DTA stays. We now know that at least one in 67 of these patients are coming to avoidable harm. It is appalling.
“The situation is unacceptable, unsustainable and unsafe for patients and staff. Political and health leaders must realise that if performance continues to fall this winter: more and more patients will come to avoidable harm in the Emergency Department; staff will face moral injury; and the urgent and emergency care system will be deep into the worst crisis it has faced.
“This potential trajectory is supported by the recent report by the Association of Ambulance Chief Executives that found that as many as 160,000 patients annually, may be coming to harm as a result of delayed ambulance handovers. We continue to urge the Secretary of State to meet with us to discuss patient safety and the unprecedented pressures facing the urgent and emergency care system.
“RCEM CARES: The Next Phase outlines our system-wide plan to improve patient care. In the short-term Trusts must safely expand capacity where possible. They must maximise the use of services such as Same Day Emergency Care and Discharge to Assess. Trusts must focus on promoting flow through the hospital, ensuring patients are discharged in a timely way once their treatment is complete.
“In the long-term, the government must restore bed capacity to pre-pandemic levels, across the UK an additional 7,170 beds are required. The government must ensure that social care is resourced to support patients both when leaving hospital and once they are back in the community, this would help to reduce long hospital stays and prevent successive trips to the Emergency Department.
“Lastly, as a matter of urgency the government must publish a long-term workforce plan, this must include actions to retain existing staff who are reaching burnout as well as to recruit new staff. Across the UK there is currently a shortfall of 2,000 – 2,500 WTE Emergency Medicine consultants, as well as shortages of essential Emergency Medicine nurses and junior and supporting staff.
“This is the beginning of a long winter and an extremely challenging time for the current workforce as pressures will rise and patient safety will continue to be put at risk. These pressures may currently be facing urgent and emergency care and the ambulance services, but the solutions and actions must be system-wide and joined-up.
“It is up to the government, NHS leaders, and all of us to work together to put a stop to dangerous crowding; avoidable harm; preventable deaths; ambulance handover harm; and to ensure that we keep patients safe and deliver effective urgent and emergency care.”
More than 2 million consultations with NHS Pharmacy First
An innovative NHS community pharmacy service has helped see patients quickly and relieve pressure on A&E units and GP surgeries by sparing the NHS 200,000 avoidable appointments for the treatment of urinary tract and skin infections in the last year.
The NHS Pharmacy First network of more than 1,200 community pharmacies are the first port of call for minor ailments and common clinical conditions. The NHS Pharmacy First Scotland service has carried out over 2 million consultations since the launch of the service in July 2020.
The service provides free access to a consultation with an appropriately qualified member of the pharmacy team who provides advice on self-care, referral to another part of the NHS if they feel it is necessary and, if appropriate, will provide treatment.
The community pharmacist can also treat certain conditions such as urinary tract infections, shingles and impetigo without the need for a prescription or to see a doctor. This is part of a co-ordinated series of measures to improve patient care and help reduce demand on A&E.
Pharmacists in the network have taken more than 200,000 appointments in the last year which would otherwise have gone to GP surgeries or hospital A&E departments.
Since its launch at the height of the pandemic, only 4% of patients needed to be referred on to another healthcare professional, such as a GP or hospital unit. The majority were handled by the pharmacy team, advice on self-care or with treatment.
Health Secretary Humza Yousaf said: “Community pharmacists are playing a fantastic role in ensuring that millions of people have their minor ailment needs addressed quickly, without needing to go to a GP or hospital. They are a prime example of getting the right care in the right place at the right time.
“This is particularly helpful as our NHS faces one of the most difficult winters in its history, with the NHS Pharmacy First service helping to relieve some of the current pressures faced by emergency departments. As community pharmacy staff continue to give care and advice during the busy winter period, please continue to be kind and patient.
“The Scottish Government introduced the NHS Pharmacy First service, backed by £10 million of investment. As part of the NHS Recovery Plan we will look to expand the range of common clinical conditions that can be treated by community pharmacists, avoiding unnecessary GP and out of hours appointments.
“We have also committed to establishing a community pharmacy hospital discharge and medicines reconciliation service to help speed up the process for people being discharged from hospital. New digital solutions such as ePrescribing and eDispensing will make prescribing paperless and free up capacity for healthcare professionals to see more patients, while making it easier for the public to access their medicines quickly and safely.”
NHS Pharmacy First Scotland launched on 29 July 2020, and is designed to encourage everyone to visit their community pharmacy as the first port of call for all minor illnesses and specific common clinical conditions.
The latest Emergency Department performance figures for Scotland published by the Scottish Government yesterday for September 2021 show a deterioration in performance for the fifth consecutive month. The data show the worst four-hour performance on record and both the highest number of 12-hour and eight-hour stays since records began.
In September 2021 there were 113,998 attendances to major Emergency Departments across Scotland, the number of attendances dropped by 3,500 patients (3%) compared to the previous month, August 2021.
Despite the slight decrease in attendances data show that four-hour performance reached a new record low, with 73.8% of patients being seen within four-hours, this is 1.5 percentage points lower than the previous month, August 2021. It is the second time in 2021 that performance has fallen below 75%.
In September 2021 1,840 patients spent 12-hours or more in a major Emergency Department, this is an increase of 31.5% compared to the previous month, August 2021. This number increased for the fifth consecutive month and is once again the highest number of 12-hour stays since records began.
Data also show that 6,413 patients spent eight hours or more in a major Emergency Department. This is an increase of 20%, equal to over 1,000 patients. The number of patients delayed by eight-hours or more increased for the fifth consecutive month and once again this is the highest number of eight-hour stays since records began.
Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The consistent fall in performance is seriously worrying. What we are seeing: ambulance handover delays; dangerous crowding; long stays; put patient safety at risk and can lead to harm or avoidable deaths.
“The problem is poor flow throughout the hospital and exit block, this will not be resolved in the Emergency Department, it is a system-wide problem and requires system-wide solutions and collaboration.
“Boards must safely expand capacity where possible, provided doctors and nurses and other healthcare workers are available to staff the beds. Same-day emergency care can help to reduce unplanned hospital admissions, maximising the delivery of this service may alleviate some pressures.
“Discharge to assess, ensuring that patients can be discharged in a safe and timely way where they have the support they need to recover in the community, can help free up beds to increase flow throughout the hospital.
“Lastly, it is vital that adequate support and resources are given to social and community care so vulnerable patients do not face successive trips to the Emergency Department or hospital.
“Clear communication between Clinical Leads and senior Board management about the reality of ambulance handover delays; dangerous crowding; and long stays is also vital. Stating the threat these practices pose to patient safety and both reporting and escalating incidents as they occur should guide leadership to take swift action.
“It is a very difficult time, and we are preparing for a gruelling winter. The past five months of performance figures suggest that more deterioration is set to come. In Emergency Medicine we must continue to work towards collaborative solutions and work with other departments, specialties, and management.
“But we continue to call on the Scottish government to set out a long-term workforce plan. In Emergency Medicine (EM) in Scotland there is a vital need to both recruit new and retain existing staff, we need at least 113 EM consultants along with sufficient numbers of both junior and supporting staff and nurses.”
Today’s statistics revealed the worst weekly and monthly A&E statistics since records began.
The statistics show that only 65.6% of attendances at A&E services in NHS Lothian were seen and resulted in a subsequent admission, transfer or discharge within 4 hours for the week ending on the 24th of October.
This is lower than the previous record low of 66.3% recorded in week ending 12th September. Furthermore, 508 patients in NHS Lothian waited more than 8 hours, with 240 not being seen for 12 hours.
Scottish Labour MSP Foysol Choudhury said: “A&E services in the Lothians are in crisis, with the situation rapidly deteriorating with every passing week.’’
“Hard-pressed frontline staff have been sounding the alarm for months, but the Health Secretary has spectacularly failed to take action. Patients in the Lothians are being put in danger thanks to the SNP’s catastrophic failure to support A&E services.
‘’The Health Secretary is without a workable plan, so we have a health service in freefall. Action must be taken now. Our NHS deserves better’’
