'Immediate action' needed to avert A&E 'disaster' this winter

‘Immediate action is needed to avert disaster’ in Wales’ emergency departments this winter as pressure on the health system grows, the Royal College of Emergency Medicine (RCEM) has said.

According to a RCEM survey, top A&E doctors from almost every single Emergency Department in Wales have said they are very worried about the pressure departments will face this winter.

The survey asked over 150 clinical leads, doctors in charge of A&E departments, across the UK about how they are managing and their views ahead of winter.

RCEM said the findings were “stark” and “should serve as a stark reminder to government that immediate action is needed to avert disaster.”

Of the 11 respondents in Wales, representing almost every A&E in the devolved nation, 10 told RCEM they were either 'very' or 'extremely' concerned about the pressure their A&E will experience this winter.

Meanwhile, all 11 respondents said pressure was 'high' or 'very high' at the time of the survey.

Three quarters said pressure was much higher than the same time last year.

Dr Rob Perry, RCEM Wales Vice President, said: "Emergency Departments across Wales have been struggling throughout the year.

“We had one of the toughest summers on record, leaving us little room to breathe as it is.

"What this means is that, when winter hits, we will have no spare capacity to stretch.

“I am deeply concerned about how the next few months will go.

"For our patients, this will mean more long waits, more corridor care and, I fear, more people coming to harm as a result.

“My colleagues and I will be there, rain or shine, to look after our patients – but there is only so much we can do when we are up against it.

"The new Welsh Government has promised to make Emergency Care one of its key priorities.

“With winter fast approaching, the time to act is now.

"We need greater bed capacity for patients who need to be admitted, better resources to speed up discharges – and for A&E overcrowding to be treated as the serious threat to life that it is."

Dr Ian Higginson, RCEM President, said: "Overcrowding, corridor care and the impending surge of demand from winter are creating a perfect storm for EDs across the UK.

"Colleagues from across the four nations have been crystal clear: we simply are not ready for winter, and can barely manage as we are.

"We have patients lining our departments, many stuck in trolleys for hours upon hours.

“The sickest and most injured among them can't get into a hospital bed and end up stuck with us, sometimes for days.

"It's a disgraceful state of affairs and I cannot believe it has been allowed to get this bad."

Of the 163 clinical leads across the UK, 91 per cent said they were very or extremely concerned about winter A&E pressures while just three per cent said their A&E was well prepared for the cold months.

Two-thirds described their A&E as unsafe, the survey revealed.

Calls for action on the crisis in Welsh A&E departments have been long-standing, with years of increasing pressure, tighter budgets and missed targets.

Earlier this year, the new Plaid Cymru Welsh Government announced ‘early action’ to help the NHS prepare for winter after last year “saw too many people wait too long for care and support.”

Health and Care Minister, Mabon ap Gwynfor has asked NHS Wales and social care partners to “plan earlier and focus on practical steps that will help people get the right care sooner.”

The Welsh Government said the “aim is for safer and more resilient ambulance, emergency department and acute hospital services over the challenging winter period.”

“This includes targeting support for older people with complex needs, tackling corridor care and helping people to return home from hospital when they are ready,” the Welsh Government said.

Health and Care Minister, Mabon ap Gwynfor said: "Our fantastic NHS and social care staff worked incredibly hard last winter, and we are being clear with health boards and partners more needs to be done.

“Last winter was tough – too many people waited too long for the care they needed, and that's not good enough.

“Early planning and action are key, and I've also asked officials to begin planning now so we're better prepared for the winters ahead.”

The latest official performance figures for Welsh Emergency Departments showed that around one in six people who attended A&E in August waited more than 12 hours before being discharged, admitted or transferred.

The data for A&E departments in Wales for August showed a decrease in attendances compared to July, and 63.8 per cent of patients spent less than four hours in emergency departments from arrival.

While an improvement compared to the previous month the figure is far below the 95 per cent target set by the Welsh Government.

That target has never been reached.

In August, 10,977 patients waited 12 hours or more, latest figures show.

That represents a 6.3 per cent improvement from July, but targets say nobody should be waiting that long.

Mr ap Gwynfor faced cross-chamber criticism over NHS funding after setting out his strategy to tackle seasonal winter pressures in the Senedd on 13 October.

Mr ap Gwynfor outlined three immediate priorities for NHS Wales: protecting people through vaccination, speeding up patient discharge to improve hospital flow, and strengthening urgent care in the community.

To support the plans, an extra £2m is being made available through the national urgent and emergency care improvement programme.

Mr ap Gwnyfor said: “It will be targeted at practical action before, during, and after winter to improve acute hospital flow, accelerate safe discharge, reduce avoidable delay and strengthen patient safety at the points of greatest pressure.”

However, opposition politicians dismissed the extra money as insufficient to address the scale of the financial crisis facing Welsh health boards.

Benjamin Hodge McKenna, Reform's shadow health minister, labelled the cash boost a “drop in the ocean.”

Welsh Labour leader Ken Skates voiced similar concerns, describing the minister’s statement as "light on detail and even lighter on financial commitments".

Calling the announcement "more of a commentary than a detailed action plan", Mr Skates pressed the health minister to reveal the total figure being directed toward winter pressures, but received no figure in response.