Tag: Royal College of Emergency Medicine

RCEM launches public appeal to support A&E staff facing stress and burnout

The Royal College of Emergency Medicine is launching a public appeal  to support the mental health and wellbeing of A&E staff after data show that many have struggled with burnout, distress, and other psychological conditions resulting from the stress of the pandemic, further to the continued pressures of their day-to-day work in Emergency Departments.

The NHS entered the pandemic underfunded, under-resourced and understaffed. This meant the severe demands of the ensuing pandemic were faced by the existing but understaffed workforce.

The shortage of health care workers has meant these existing staff have been continually pushed to their limits and beyond. And throughout the pandemic these health care workers have been physically, mentally, and emotionally challenged. Staff have been working with little or no respite in challenging conditions while facing ever increasing pressures.

The Health and Social Care Committee report “Workforce burnout and resilience in the NHS and social care” cites data from NHS Providers that show 92% of trusts raised “concerns about staff wellbeing, stress and burnout following the pandemic”.

A study published in January 2021 found that nearly half of frontline doctors, including those working in Emergency Medicine, suffered psychological distress during the first wave of the pandemic with others suffering from trauma, PTSD and other psychological conditions.

A study from 2019 found that working as an emergency physician is one of the most fatiguing and stress-inducing professions, a result of regularly working shifts longer than 12-hours, struggling to find work-life balance, and burnout. This was recorded prior to the pandemic, during which the pressures on Emergency Medicine staff significantly increased.

Dr John Heyworth, Consultant in Emergency Medicine in Southampton and Chair of RCEM Fundraising, said: “We know that many Emergency Medicine staff are exhausted and facing burnout.

“After 15 months of this pandemic, with waves of Covid causing intense pressures on our overstretched emergency departments, and now a return to high pre-pandemic levels of hospital activity, added to the stress of the threat of a further wave of covid – this is not surprising. But it is deeply worrying.

“We must do all we can to protect and support our frontline Emergency Department staff. Their hard work and dedication throughout this extremely challenging time has been incredible. As ever, they have been on the frontline throughout the pandemic risking their personal health and dedicating themselves to the care of others.

“The public have shown their remarkable support and respect for the health service. And now, we want to appeal to them to support our A&E staff who work 24/7 in Emergency Departments, ready to treat anyone who seeks care.

“When we know that our Emergency Medicine workforce is struggling with exhaustion, burnout, stress and other psychological conditions then we must take action, and they deserve our support.

“RCEM’s Public Mental Health and Wellbeing Appeal aims to raise money to develop and expand the support services offered to A&E staff who may be struggling with mental health conditions including PTSD, stress, burnout and exhaustion.

“The support offered will be guided and dictated by what A&E staff need most so that we can help them in the best way possible.

“RCEM’s goal is to ensure the services and support provided have a positive and lasting impact on the mental health and wellbeing of our frontline A&E workers.”

RCEM Appeal:

 https://www.rcem.ac.uk/RCEM/Get_Involved/Wellbeing_Appeal.aspx

Donate here:

http://www.rcem.ac.uk/RCEM/Get_Involved/Sign_in_for_donations.aspx?f=SPRW

Prepare Emergency Departments now for the next phase of challenges, says RCEM Scotland

The latest data released today by the Scottish Government for March 2021 show that attendances at Emergency Departments are beginning to return to pre-pandemic levels.

In March 2021 there were 90,833 attendances to major Emergency Departments across Scotland. This is a 30% increase compared to February 2021 and a 7% increase when compared to March 2020.

Despite this increase, 87.5% of attendances to major Emergency Departments in Scotland were seen within 4 hours, meaning one in eight patients are waiting for four hours or more before being seen. Although, this represents an increase of 1.6 percentage points compared to February 2021.

In March 2021, 315 patients spent 12 hours or more in an Emergency Department, this is down by one third compared to February 2021 and down by over one quarter compared to March 2020.

Data also show that 1,358 patients spent eight hours or more in a major Emergency Department, this is down by over 22% compared to the previous month and down six percentage points on the previous year.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said: “We are beginning to reach pre-pandemic levels of hospital activity and demand for urgent and emergency care services. We fear a return of the pre-pandemic crowding that put patient safety at risk.

“The health service is in recovery, elective care waiting lists are growing, attendances at Emergency Departments are increasing, and the already depleted workforce is exhausted.

“As a result, some hospitals are beginning to face pressures with patients delayed for hours. We must rapidly assess and address our resources, capacity, and the way we deliver care.

“The College launched its campaign Summer to Recover: Winter Proofing the Urgent and Emergency Care system for 2021 which presents a series of actions the Scottish Government, NHS Boards and ED Leadership Teams can take to prepare their departments for the challenges ahead.

“There are threats of a further wave of covid in the late summer and a potentially gruelling winter with seasonal flu in the community. We saw how the NHS in Scotland was underprepared and under-resourced for the pandemic and the brutal winter which followed, now we have a chance to learn and do what we can to ready ourselves for the next phase.

“Staff are exhausted after a difficult year and are facing new challenges on every front, by preparing now and ensuring that departments are ready for this next phase, we may be able to manage demand and cope with system pressures.”

RCEM: To prevent another crippling winter, we must use the summer to prepare our hospitals and Emergency Departments

The Royal College of Emergency Medicine has launched a new campaign Summer to Recover: Winter-Proofing Urgent and Emergency Care for 2021.

The campaign outlines a series of important actions, recommendations, and guidance that four-nation Governments, NHS bodies, NHS Trusts and Boards, and Emergency Department Leadership Teams can take to ‘winter-proof’ the Urgent and Emergency Care system.

The campaign comes following the intense pressures faced by hospitals and Emergency Departments across the UK as a result of the pandemic and the gruelling winter the health service has just experienced.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “This year has been like no other for health care workers and Emergency Medicine staff. We have all had to adapt quickly to face the intense pressures of the pandemic and in many ways, we have changed the way we deliver care.

“Every winter our hospitals near capacity, our Emergency Departments become crowded, and staff are stretched thinly, sometimes having to administer care in corridors.

“This winter, with the severely high-risk of covid, patient safety was at the forefront of our minds. We could not have crowded Emergency Departments and we could not allow for corridor care. Prevention of hospital acquired infection, enforcing strict infection prevention control measures and social distancing were vital tools to keeping our patients and staff safe.

“Winter saw intense pressures in our Emergency Departments: the ambulances waiting to admit patients into hospital were pictured and widely reported; there were long-delays for some patients in Emergency Departments; staff severely struggled to move patients through the system; and there were huge issues with capacity. It was incredibly tough for staff and patients alike and for many, it will be unforgettable.

“Now, we are seeing a return of our community patients and demand for urgent and emergency care services is beginning to increase, as we return to ‘normal’ we cannot allow our old practices to make a comeback. Crowding and corridor care presented a huge challenge to staff and put patient safety at risk.

“We currently have an opportunity to transform the urgent and emergency care pathway. So, we are launching a new campaign, Summer to Recover: Winter-proofing Urgent and Emergency Care for 2021 outlines a series of recommendations the College is making to the four-nation Governments and NHS bodies, to NHS Trusts and Boards, and to ED Leadership Teams.

“We know there is a challenge ahead with tackling the backlog of elective care, but we must use the time we have and use the Summer to Recover and prepare our hospitals and staff for Winter 2021.

“NHS England 2021/22 priorities and operational planning guidance for the year ahead, together with the recommendations outlined in the consultation on the clinical review of standards are welcome and are aligned with the College’s own recommendations in our new campaign.

“The implementation of the metrics proposed in the consultation on the Clinical Review of Standards, particularly measuring 12-hours from arrival, are welcome and will help identify areas of improvement quicker, but without the ability to resolve these issues with adequate capacity, resources, staff or alternative care there will be little we can do in the Emergency Department.

“Expanding capacity, ensuring there is adequate alternative care that patients have access to, and working with local health systems, are all tools that will be crucial to ensuring our Emergency Departments are not crowded again.

“We have said it before; we must not let Emergency Departments become the safety-net of the system. What happens in the Emergency Department ripples throughout the hospital and the health and social care network. We must work together to prevent crowding, to maximise the safety of our patients and to reduce long and high-risk delays.

“Next Winter may seem like a long way off but to prevent another crippling winter, like the one we have just experienced, we must learn, and recognise the shortages and lack of preparation we faced and absolutely guarantee that this winter, we are ready, and we are prepared.”

As patient demand increases we must be ready for a new phase of challenges, says RCEM

The latest data from RCEM’s Winter Flow Project show that increasing numbers of patients are beginning to return to EDs, with 71,722 attendances recorded in the third week of March – exceeding the previous highest total set in week one of the Project in October 2020.

Throughout the pandemic demand at Emergency Departments (EDs) has been significantly lower than previous years. Lockdowns have also meant that the public were at less risk of accidents that might require attendance at an ED, while the use of masks and increased hygiene practices minimised the spread of other seasonal illnesses, such as flu.

Now as attendances have risen 12-hour stays have also increased once again. However, as a proportion, 12-hour stays remain low suggesting that the rise in attendances has not led to an increase in very long waits as yet.

Even as patients begin to attend EDs in larger numbers, the level of available beds continues to be largely static, partly due to the practical difficulties of opening additional beds while maintaining infection prevention protocols.

Commenting on RCEM’s latest Winter Flow Project report Vice President of the Royal College of Emergency Medicine, Dr Adrian Boyle, said: “While the NHS is manifestly in need of a recovery period, there are already indications that there may be little respite. We expect hospital activity to increase in the coming weeks and months as NHS services return to normal.

“Despite the ongoing success of the vaccine rollout, we know that we are not out of this yet. One trust has forecasted that June could see a surge in Covid patients on a par with the April 2020 peak.

“We are worried about this prospect and we are worried about potential variants coming into the country and spreading through the community. We would like everyone to continue to follow the rules and not become complacent. Unfortunately, without any time to recover and rest, NHS staff must once again be ready to face this if it comes.

“The College has consistently outlined the need for more staff, more beds and more resourcing for EDs, all of which may be needed as never before as Emergency Departments potentially attempt to juggle another wave of covid in addition to returning NHS services and activity to normal, all while maintaining proper infection prevention control measures.

“EDs have proved astoundingly resilient but that resilience will be stretched incredibly thin unless they receive the support they will undoubtedly need in the next few months.

“That being said NHS England’s operational planning guidance is most welcome. This outlines the top priorities for the year ahead and includes sufficient focus on the urgent and emergency care pathway. We particularly welcome the plans to expand capacity, introduce the collection of new data and ensure expansion of alternative care including SDEC and NHS 111.

“We have no doubt that we are once again facing an incredibly challenging phase, but NHS England’s latest guidance will be a welcome relief to many healthcare workers.”

England’s A&E doctors urge public to stay safe ahead of ‘Super Saturday’

Ahead of what is being dubbed ‘Super Saturday’ – when bars, pubs and restaurants reopen in England – The Royal College of Emergency Medicine is urging the public to act sensibly to not risk overwhelming A&Es.

Scots, of course, must wait a wee while longer for the hospitality industry to fully open but there are widespread concerns that tomorrow could see irresponsible behaviour put the UK’s gradual recovery from the coronavirus crisis in jeopardy.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “To many Saturday will come as a welcome release from an unprecedented nationwide lockdown and it is understandable that people want to let off steam.

“But we urge the public to be careful and use common sense. The NHS has coped admirably during this period, but staff are exhausted, and the system is very fragile. After seeing all of the goodwill, all of the clapping for the NHS, it would be heartbreaking to see A&Es overwhelmed on the first post-lockdown evening by people who have gotten too drunk or been in a fight.

“If you go to A&E because you’re plastered, you end up stretching the health service further and potentially put others at risk. Not only do you risk accidentally infecting someone with coronavirus because you don’t know you have it, but you are taking up the time of doctors who could be treating patients whose lives are in danger.

“It has never been more important that our Emergency Departments are for absolute emergencies only, and it has never been more important that people drink responsibly.

“While social distancing measures may have been relaxed, the threat of coronavirus has not gone away; it is still very real, it is still very dangerous.

“We need the public to help; act responsibly, drink responsibly and do maintain social distancing. It is also really important that people choose the care service that is most appropriate for their needs. If it is not an emergency, call 111, see a pharmacist, book a GP appointment. If you are seriously injured or sick, go to your A&E – you will be treated.

“We cannot go back to a pre-covid world where everyone turns up at a crowded A&E for treatment. We need patients to choose wisely and we need proper provision of alternative care services. Without both, A&Es risk becoming hubs of infection and we will end up back at square one.”

Prime Minister Boris Johnson will make an appeal to the public to stick to guidelines at a press conference later today. Whether the public will listen or not we’ll find out tomorrow.

WHAT COULD POSSIBLY GO WRONG? Private Eye’s view …