Hear from frontline clinicians on how to tackle the crisis facing emergency care
Royal College of Emergency Medicine
The Royal College of Emergency Medicine (RCEM) is holding an Emergency Care Crisis Summit on Tuesday 28th March, 15.30-17.00 in the Attlee Room, House of Lords. The event will aim to build political support to tackle the crisis facing our emergency care system.
Being treated quickly by a responsive emergency care service is a matter of life or death. The proportion of patients arriving in EDs admitted, transferred or discharged within four-hours is a useful indicator for overall NHS performance as ED waiting times are affected by pressures in other parts of the health and social care system. In England, this target was set to 95% in 2010 but performance has deteriorated since 2014. Between 2011 and 2021, four-hour performance fell between consecutive Januarys by an average of 2.4 percentage points. Between January 2021 and January 2022, the decline was 7.8 percentage points.
The origins of the crisis facing the emergency care system can be traced back to public policy decisions made over a decade ago. In England, since 2010, 14,000 hospital beds have been removed from the hospital system. Consequently, long before the pandemic, the NHS has been running at unsafe occupancy levels. Our hospitals continue to be gridlocked due to a lack of social care provision. These issues are playing out in the face of the increasing complexity of population emergency healthcare needs: NHS England recently reported that over the last five to seven years the percentage of patients attending an ED with more than three long-term conditions has risen from 10% to 30%1. Combined with a workforce crisis, pandemic, and years of running the system ‘hot’ these cumulative pressures came to a head in 2022
A never event for the NHS
2022 will be remembered as the year when stroke and heart attack patients struggled to access lifesaving emergency services. It was the year every single ambulance trust declared a critical incident.2 During the summer, patients faced long and horrific waits for hospital beds, and mortuaries neared capacity as there was an increase in the number of people dying because of the delays in emergency care. As a result of these failures, coroners took the unusual step of demanding action from the Government to address the systemic issues which led to the deaths in question. Unsurprisingly, it was also the year when public satisfaction with emergency care services hit record lows.3
In response to the dire circumstances the NHS found itself in, the Government, in early 2023, announced a package of immediate measures for immediate pressures and a Delivery Plan for the Recovery of Urgent and Emergency Care Services, with the aim of partially recovering services by 2025. The pandemic has shown us why Governments must invest in making the NHS more resilient to future shocks and spikes in demand. We must look beyond the electoral cycle and take action in the short term to help us ensure the emergency care system is adequately resourced to meet population needs.
Help us end the perennial crisis
Although no one likes to think about needing to use emergency care services; the reality is that any single one of us could be an emergency patient one day. We’re calling on parliamentarians to take action to close the gap between demand and capacity in the NHS and wider social care system in the long run. We know the challenges facing the emergency care system may be vast, but they are not insurmountable.
Join us at our Emergency Care Crisis Summit to discuss how we can work together to #ResuscitateEmergencyCare so it is there for us when we need it the most
1. House of Lords, Public Service Committee, Access to Emergency Services
2. https://nursingnotes.co.uk/news/clinical/every-singleambulance-service-in-england-declares-critical-incidentstatus/
3. https://www.kingsfund.org.uk/publications/publicsatisfaction-nhs-social-care-2021
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