A research study that has found less than one in 10 emergency doctors feel confident they could evacuate their A&Es in an emergency because they are too full, has been described by the Royal College of Emergency Medicine (RCEM) as: “sobering proof that that the Urgent and Emergency Care system in this country falls short of what the public deserve.”
‘A Survey of Major Incident Preparedness in English, Type 1 Emergency Departments’ was published in the Emergency Medicine Journal (EMJ) earlier this month. Researchers surveyed doctors working in Emergency Departments (EDs) across the country – including major trauma centres and trauma units – on the level of crowding currently experienced and how they felt their department would be able to respond to a major incident.
With a 47% response rate (71 EDs in total), the survey found:
• 88.7% (63 total) reported that their hospital’s major incident plan required them to clear the ED but only six (9.5%) of the 63 thought this was achievable
• 100% of respondents said their ED experienced crowding, with 53.5% (38) saying their ED was crowded more than 75% of the time
• 5% (11 total) were confident that their ED could adequately respond to a major incident.
Dr Adrian Boyle, President of the RCEM says: “Just this week we have seen how sorely unprepared the health system is to deal with events as predictable as a surge in flu and cold weather.”
During the recent cold spell, up to 20 hospitals declared critical incidents due to the exceptionally high workloads within A&E departments amid a surge in flu cases.
A&E data released by NHS England on January 9 shows more than 1.4m attendances to major EDs in December 2024 – that’s the second highest number of attendances on record for the month of December. It further shows that 166,989 patients waited for 12 hours or more in major EDs. RCEM points out that is more than a 10% increase compared to November, as well as December 2023.
“If hospitals currently don’t have capacity to deliver safe emergency care on a normal day – how can we expect them to respond to a major incident?” Dr Boyle continues.
“While the results of this survey are sobering reading, they sadly come as no surprise to anyone that has worked in or attended an Emergency Department in the last few years. Overcrowded A&Es, burnt-out doctors and nurses forced to deliver care to people in corridors – this is now the norm.”
RCEM has campaigned extensively about the dangers of long A&E waits, particularly for the elderly and vulnerable, and the increased risk of avoidable they bring. “This survey shows another danger of the fragility of the current system,” Dr Boyle continues. “That in the event of a major incident it is reasonable to believe that hospitals would struggle to cope because they are too full.”
