Ministers warned of ‘crisis in urgent and emergency care’

The Royal College of Emergency Medicine’s president said ‘this is only the beginning of winter and of what may come’.

Ambulances parked at an accident and emergency department
Ambulances parked at an accident and emergency department

Accident and emergency doctors have warned of a “crisis of patient safety” as figures indicated nearly two-thirds of casualty departments had ambulances queuing to transfer patients every day.

The Royal College of Emergency Medicine (RCEM) survey also showed almost half of A&E departments were forced to treat patients in “non-designated areas” such as corridors.

RCEM president Katherine Henderson said the figures showed the “serious state that our urgent and emergency care system is in”.

The warning was echoed by other leading health bodies representing ambulance trusts, paramedics and nurses.

Dr Henderson said: “None of us want to have patients held in ambulances, treated in corridors, or waiting very long times to go up to a ward bed.”

The survey covers the period November 8-14. It was sent to clinical leads in emergency departments across the UK and received 70 responses.

The NHS mandates that ambulance handovers ought to be reliably completed within 15 minutes of arrival, but 61% of emergency departments in the survey were struggling to meet this standard every day.

Dr Henderson said: “This is only the beginning of winter and of what may come. We are facing a crisis in urgent and emergency care and a crisis of patient safety.”

Ten of the responses to the survey said there was “no effective same-day emergency care” in their departments.

Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said: “These alarming new figures from RCEM underline once again the unprecedented pressures facing the entire urgent and emergency care system.

“We now know that excessive handover delays and crowding in A&E departments are routinely harming patients, some very severely.

Labour Party Conference 2021
Shadow health secretary Jonathan Ashworth said the NHS had been left exposed by funding issues and staff shortages (Gareth Fuller/PA)

“To resolve this, we need system leaders to further toughen their resolve to deal with this problem once and for all and as a matter of priority and we await details of progress being made in this area, while underlining our commitment to work as part of the solution to this complex issue.”

Tracy Nicholls, of the College of Paramedics, said: “Reform must happen to alleviate the intolerable pressure and reduce the guilt many paramedics and emergency department staff feel about dealing with patients who are waiting outside emergency departments or, more worryingly, in the community.”

Royal College of Nursing director for England Patricia Marquis said: “Ministers are systematically failing to invest in the staff needed to deliver the care patients need.

“The situation is becoming increasingly unsafe for patients.”

Labour accused the Government of having “no idea or any plan to fix the deep-rooted problems the NHS is grappling with”.

Shadow health secretary Jonathan Ashworth said: “A decade of flat funding, bed closures, swingeing social care cuts and chronic understaffing left the NHS exposed without capacity when the pandemic hit.

“Today, that means overwhelmed A&Es, slower ambulance response times and rocketing waits for treatment.”

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