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Emergency care already facing greater ‘winter pressures’ than last year

And winter has barely begun, warns Royal College of Emergency Medicine

Caroline White

Monday, 21 November 2016

Emergency care departments are already facing greater winter pressures than last year, despite the fact that winter has barely begun, the Royal College of Emergency Medicine has warned.

The warning comes as it publishes its Winter Flow Report, which analyses performance data collected from over 50 NHS Trusts across the UK, from October 2015 to March 2016, revealing the extent of the problems experienced by emergency departments in the winter season.

In a bid to provide a more rounded picture, trusts were asked to submit weekly figures on: the number of acute beds in service; the number of cancelled planned operations; the number of patients in their trust who no longer medically need to be in hospital; as well as four-hour performance figures.

Provisional data submitted so far suggest that average performance against the four-hour target is down by over 4% on the same period last year at just 85.83%—nearly 10% below the 95% target.

To cope with demand, hospitals had to find an extra 600 beds, in all, and there were 250 instances of delayed transfers of care every week, creating exit block for the system.

“Whilst the four-hour target data is invaluable in measuring how the system is performing, it should not be seen in isolation, but seen alongside other key statistics; in order to get a more complete picture. Simply looking at just one performance measure is not good enough,” said College President, Dr Taj Hassan.  

Last year, performance declined over the early winter period and failed to recover at the start of the New Year, despite rates of attendances easing after Christmas, he said. 

“The report shows that the greatest challenge to the four-hour standard is clearly with issues of bed availability, which is exacerbated by increased delays in transfers of care. Last year showed that these delays – predominately attributable to a lack of provision of community and social care – rose significantly over the winter months,” he pointed out.

“We are already seeing Emergency Departments struggling this winter, with performance already worse than the same period last year. Unless action is taken, patients will continue to suffer as a result of inadequate resources. Crowded departments compromise the ability of staff to do even some of the most basic tasks well,” he warned.

“We would once again echo the calls for additional funding for social care, as well as for emergency medicine staffing, made by the recent Health Select Committee report, and for the sake of patient safety call upon the Chancellor to address this in his Autumn Statement.” 

The College intends to repeat the Winter Flow project for 2016-17.

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