Emergency departments risk “grinding to a halt” this winter, say medical leaders. They warn that the number of patients facing long waits for treatment is likely to hit record levels.
Dr Taj Hassan, president of the Royal College of Emergency Medicine, said staff were dangerously overstretched, as NHS figures showed the number of people waiting more than 12 hours for treatment during the coldest months of the year has soared.
From January to March 2012, 15 patients waited for more than 12 hours – in 2017 this figure was 100 times greater, at 1,597.
Last winter was the worst on record for delays, with nearly 200,000 patients waiting for longer than the four-hour target. Hassan said emergency services will be under even greater strain this year, with patients forced to wait longer for basic treatments such as pain relief.
“Winter last year was relatively mild and without a major outbreak of flu. There are indications that the flu vaccine will not be as successful this year and as such we anticipate that conditions will be even more difficult,” said Hassan. Simon Stevens, chief executive of NHS England, has already put hospitals on high alert following major flu outbreaks in Australia and New Zealand, which it is feared may be repeated in the UK.
An extra 5,000 beds are needed to “to get us through what will be a pretty awful winter”, said Hassan. “Over the last five years there has been a continued reduction in bed numbers yet an increase in patients needing to be admitted. As a result, bed occupancy is now at 92% – significantly higher than the safe level of 85% – which is having a knock-on effect on waiting times.”
A lack of funding, especially in social care, and staff shortages are preventing patients from being admitted swiftly and undermining safety, he said. “There is not enough money in the system to get social care packages, patients are delayed in hospital who should be at home, there are not enough acute hospital beds.”
The number of patients waiting for more than 12 hours also increased during the spring months, a time when pressures usually start to ease. From April to June 2017, 311 people waited more than 12 hours for treatment. For the same period in 2012, this was the case for only two patients.
Such figures are likely to underestimate the length of time spent in A&E because they only capture waiting times starting from when a decision to admit is made, not when the patient arrives.
“There can be little doubt that patients are suffering the consequences of this reduction,” said Hassan. “Along with more doctors, we desperately need more beds to stop the system from grinding to a halt.”
A Department of Health spokesperson said A&E departments had received an extra £100m to prepare for winter, in addition to £2bn of social care funding.
The spokesperson added :“This analysis completely overlooks the continued rise in demand on A&Es and the fact that since 2010 hardworking NHS staff are treating 1,800 more patients within four hours each day and are seeing 2.8 million more people each year.”