Almost nine in ten UK A&E clinicians who responded to a survey by The Royal College of Emergency Medicine said they aren’t confident that their departments will cope well this winter.
And shockingly 94% think that patients are being put at risk due to the pressures currently being experienced.
RCEM conducted the poll between November 7-13, asking department Clinical Leads a series of questions aimed at capturing a snapshot of the current state of overcrowding and the standard of care patients are receiving in their hospitals.
In total, representatives from 83 hospitals across England, Northern Ireland, Scotland and Wales, responded. The results revealed:
• 87% of respondents said they aren’t confident that their department will cope well this winter
• 83% of respondents had patients being cared for in corridors
• 51% of respondents had patients being cared for in ambulances outside their Emergency Department
• 94% said they feel patients are coming to harm because of conditions
• Only one in ten respondents (11%) said they felt better prepared this winter than they did last year.
A&E pressures already high
The latest figures released by NHS England for October show the extent of the pressure under which A&E services are operating, with a record number of A&E attendances in the past year, a record number of the most urgent ambulance call outs (37% more than pre-pandemic) and a record number of 999 calls of any month this year. In addition, on average, 12,340 beds each day are taken up by people who are ready to be discharged.
The State of the Provider Sector survey from NHS Providers reinforces the RCEM fears, showing that 96% of Trust leaders are worried about the effect of winter pressures on an already stretched NHS.
Also released this month, the CQC’s survey of people attending type 1 and type 3 urgent and emergency care departments, conducted in February 2024, reported poor experiences of care, with long waits compounded by a lack of information, support, and communication.
The CQC survey found that more than a quarter (28%) of people attending type 1 (A&E) departments waited for more than one hour for an initial assessment by a doctor or nurse; only 29% had an initial assessment. Most patients were not told how long they would wait to be examined or treated. The majority of patients who spent more than four hours in an A&E department said that they were not able to get help with their condition or symptoms whilst they waited (54%). Almost two in five patients attending type 1 (A&E) departments said that they did not, or only “to some extent,” have enough time to discuss their condition with a doctor or nurse (39%). Only 70% of patients attending type 1 departments and 81% attending type 3 departments said that they were treated with respect and dignity “all of the time.”
Chris Graham, Group CEO of Picker, which co-ordinated the CQC survey, says: “As it is likely that long waits will persist throughout the winter months, services should prioritise improving people’s experiences of waits – by communicating clearly about how long people can expect to wait; updating people as often as is practicable; and ensuring that support is available for people who are suffering with their conditions or symptoms as they wait.”
He adds: “The findings are particularly worrying as the NHS heads towards what is expected to be a challenging winter.”
Making a difference
There are some simple steps that E&F teams could take to make a difference. As an example, at Barts Health NHS Trust, catering team members are now based within each of the Trust’s three Emergency Departments to provide food and beverage services to patients and any family members, friends or carers who might be with them, whilst they are waiting to be seen by a member of the clinical team. Sometimes this might mean supplying hot drinks, at other times it might be more substantial. It also provides a vital point of contact and communication, reassuring patients who are waiting that they haven’t been forgotten which can help to remove anxiety.
Stark warning
Dr Adrian Boyle, President of the Royal College of Emergency Medicine, described its survey results as a “stark warning” from those on the frontline. “Winter is coming, and it looks like we are facing a massive crisis in every part of the UK. We cannot just ignore winter and our patients,” he says.
“The Government may have written off winter, but we haven’t. We will keep highlighting the harm, and what should be done to eradicate it, and holding them to account for the unavoidable and unacceptable risk our patients are being exposed to.”
