Tag: performance figures

“We are seeing the sharp demise of the health service”

30,000 patients wait more than 12 hours in A&Es in England in July

Responding to the latest Emergency Department performance figures published by NHS England for July 2022, Vice President of the Royal College of Emergency Medicine, Dr Adrian Boyle said: “These performance figures are worse than we could have ever expected for a summer month.

“There were nearly 30,000 12-hour waits (measured from decision to admit to admission) in July 2022, that is more than 3.5 times the total number of 12-hour waits for the whole of 2019.

“This is only the Tip of the Iceberg as the true number of 12-hour waits, measured from time of arrival, is much higher. We urgently need transparency for the scale of the crisis, only then will everyone recognise the reality of the situation and begin to take critical action. We urge NHS England to commit to publishing this data (which is already collected by all Trusts) monthly with immediate effect.

“The crisis is escalating quickly, and health workers are seriously concerned about the quality of care being provided, especially as we exit summer and head into winter. The system is struggling to perform its central function: to deliver care safely and effectively.

“This is a whole-system problem and requires a whole-system approach. There must be total focus on promoting flow throughout the hospital and priority around our ability to provide an NHS that helps patients in an emergency.

“We must ensure patients are discharged in a timely way, so beds are freed and patients in A&Es are able to move through the system and be treated. Flow and discharge rely heavily on an effective social care service that has sufficient workforce – the government must get to grips with this.

“Across the UK we urgently need 13,000 beds to drive meaningful improvement: in Emergency Medicine in England there is a shortfall of 2,000-2,500 Consultants as well as widespread shortages of nurses, trainees, SAS doctors and junior and supporting staff.

“The social care workforce must also be bolstered, which can be achieved by giving these core workers a fair wage that respects and recognises the value of their role. Retention of all health and social care workers is vital, staff are burned out and exhausted, and some are considering their careers.

“We are seeing the sharp demise of the health service and we are seeing little to no political will to act on or acknowledge the crisis – neither of the leadership candidates seem to recognise the scale of the crisis at hand.

“Winter is looming, which will bring a wave of flu and covid and increased footfall in Emergency Departments, with the data as dire as it is today and the scale of patient harm already occurring, we dread to think how much worse things could get for patients.

In winter four-hour performance typically decreases while the number of 12-hour waits significantly increases. We may reach a point where only half of patients are seen or treated within four-hours and see an even higher number of 12-hour waits.”

The latest Emergency Department performance figures published by NHS England for June 2022 for show:

  • There were 1,385,080 attendances at major Emergency Departments
    • There were 2,163,779 total attendances at all Emergency Care facilities
  • 29,317 patients were delayed for 12 hours or more from decision to admit to admission, this is just over 3.5 times higher than the total number of 12-hour waits over the whole of 2019
    • This is the highest number of 12-hour waits on record
    • This is a one third increase compared to the previous month, June 2022, or an increase of over 7,000 12-hour waits
    • There have now been 150,014 12-hour waits (from decision to admit to admission) so far this year
  • Four-hour performance at major Emergency Departments was 57.0%, this is the worst four-hour performance on record
    • More than 2 in 5 patients were delayed by four-hours or more
  • Type 1 admissions stood at 358,284 (a daily average of 11,575
  • 136,221patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)

RCEM response to worst Scottish weekly performance figures ever

The latest weekly update of Emergency Department performance figures for Scotland show:

  • There were 21,163 attendances at A&E services in NHS Scotland.
  • 67.4% of attendances at A&E services were seen and resulted in a subsequent admission, transfer or discharge within 4 hours.
  • 2,079 patients spent more than 8 hours in an A&E department.
  • 690 patients spent more than 12 hours in an A&E department.

This data shows the worst weekly four-hour performance since records began. The highest number of (weekly) eight hour waits since records began, and the highest number of (weekly) 12-hour waits since records began.

More than one in eight patients were delayed in an Emergency Department by eight hours or more.

Responding to this data, Dr John Thomson, Vice President of the Royal College Emergency Medicine, Scotland, said: “This data is deeply concerning and distressing. More than one in eight patients have been delayed by eight hours or more; this is shocking.

The health service is in the middle of a serious crisis. Staff are working exceptionally hard but are burnt out and overwhelmed and face moral injury on every shift.

Patient safety is frequently compromised. We know long waiting times increase the risk of death and patient harm. The exit block that exists in our Emergency Departments which prevents patients moving in a safe, timely manner to an appropriate ward is worsening, causing even more harm to our patients.

“It is a critical time for the health service, and we must see a vision for the future. The government must acknowledge the shortfall in staff and beds as the root of this crisis, and this must lead to a commitment to publish a long-term workforce plan that includes measures to retain existing staff who may be thinking of leaving our NHS following this exceptionally challenging period.

“The government must also commit to opening 1,000 more acute beds across Boards in Scotland, which will promote timely patient flow through the hospital. Lastly, a key cause of exit block are the patients who remain in hospital when they no longer require ongoing Hospital care.

“The ongoing crisis in social care means patients are unable to be discharged home following the completion of their treatment. It is vital social care is resourced and adequately staffed to support the most vulnerable patients in their return to the community.”

RCEM Scotland: Performance deteriorates further as four-hour target falls to record low

The latest Emergency Department performance figures for Scotland published by the Scottish Government yesterday for July 2021 show that performance has deteriorated once again with four-hour performance reaching its lowest since records began, and the number of patients delayed in major Emergency Departments continues to rise steeply.

In July 2021 there were 114,392 attendances to major Emergency Departments across Scotland. This is a three per cent decrease compared to June 2021, an 18% increase when compared to July 2020.

Four-hour performance reached its lowest since records began, having deteriorated for the third consecutive month. 79.5% of attendances to major Emergency Departments in Scotland were seen within four hours. 23,493 patients were delayed by four-hours or more in a major Emergency Department, this is the highest figure since records began.

This is equal to more than one in five patients delayed by four hours or more in a major Emergency Department. The number of patients delayed by four-hours or more reached its highest ever figure having increased for the fifth consecutive month.

In July 2021, 755 patients spent 12-hours or more in a major Emergency Department, this is the highest figure since February 2020. This is nearly a 50% increase on the previous month, June 2021. It is a 3,000% increase compared to July 2020 and it is a 200% increase compared to July 2019. The number of patients delayed by 12-hours or more increased for its third consecutive month.

Data also show that 3,477 patients spent eight hours or more in a major Emergency Department. This is the second highest figure since records began. It is an increase of 50% compared to the previous month, June 2021.

It is an increase of over 1,000% compared to July 2020, and it is an increase of 200% compared to July 2019. The number of patients delayed by eight-hours or more increased for its third consecutive month.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said: “These figures show an ongoing deterioration in performance. Current pressures are equal to or worse than normal winter pressures – but these figures are for July.

“Among staff there is serious concern and low morale, winter is fast approaching and quite simply there is low confidence that our hospitals and staff are going to be able to cope.

“The number of patients delayed in Emergency Departments has risen steeply for three consecutive months, the pressures on this trajectory could lead the health service into a crisis.

“It is unacceptable that patients are delayed for so long, in one Emergency Department a patient was delayed by 48 hours – these are dangerously long waits that are likely to adversely affect patient outcomes.

“We have a duty to keep patients safe and treat them quickly and effectively. The current challenges are hindering our ability to achieve that, and for both patients and staff alike it is incredibly difficult.

“The entire health service is under severe strain. Our primary care colleagues are facing record demand, the elective care waiting lists continue to grow, all departments and specialties are facing these unprecedented challenges.

“Yet, while demand is high, the numbers of patients are not the challenge – the challenges stem from capacity issues, across-the-board workforce shortages, and the limitations and deterioration of hospitals and equipment – resourcing has not met demand for some time.

“It would be irresponsible to look on these consistently decreasing monthly performance figures and not recognise the potentially looming crisis fast approaching this winter. Now is the time for an appropriate response.

“We need the Scottish Government to take action, to develop and communicate a joined-up plan on how the health service is going to manage ongoing demand and prepare the workforce, hospitals and Emergency Departments for the upcoming winter.”