Emergency doctors sound the alarm over patient care

A new snapshot survey from the Royal College of Emergency Medicine (RCEM) found that many medics feel patients are already coming to harm because of the current conditions in A&E departments around the UK.

Emergency doctors have painted a picture of patients being cared for in corridors and patients being forced to wait outside emergency departments in ambulances.

The vast majority are not confident their departments will cope well over the winter months.

Health leaders have conceded that this winter is “likely to be another challenging one”.

Performance against key targets in England fell short in emergency departments and ambulance response times, according to figures published on Thursday.

The new snapshot survey from the RCEM, conducted with 83 medics from emergency departments around the UK earlier this month, found:

– 83% have patients being cared for in corridors.

– 51% have patients being cared for in ambulances outside the department.

– 94% say they feel patients are coming to harm because of conditions.

– 87% of respondents said they aren’t confident that their department will cope well this winter.

– 41% feel less prepared for winter compared with last year. Only 11% said they felt better prepared this winter than they did last year.

President of the Royal College of Emergency Medicine, Dr Adrian Boyle, said: “This is a stark warning from those on the front line. Clinicians are worried and patients are unsafe.

“Winter is coming, and it looks like we are facing a massive crisis is every part of the UK.

“We cannot just ignore winter and our patients.

“Our patients, each one vulnerable and sick, in need of care and comfort, each one someone’s mum, dad, gran or grandad, condemned to degrading and dehumanising so called ‘corridor care’.

“This euphemism, in reality, means people being stranded for hours on trolleys or chairs.

“And as every hour ticks by, the associated risk of those people dying as a result increases.”

He added: “Let’s remember we are talking about people, and a workforce running on fumes trying to do their best.

“All this with the backdrop of a Government telling them they need to work harder and more effectively, but which has not invested any more resources for these winter months.

“In the Budget there was nothing to address or ease the pressures in A&Es this winter, no increase in bed numbers, no added support for social care, which could keep people out of hospital in the first place or allow them to leave when they are well enough.

“The Government may have written off winter, but we haven’t. We will keep highlighting the harm, and what should be done to eradicate it, and holding them to account for the unavoidable and unacceptable risk our patients are being exposed to.”

Commentators previously warned that a “corridor care disaster” is unfolding, as figures showed the number of people waiting more than 12 hours in A&E departments in England, from a decision to admit to actually being admitted, stood at 49,592 in October, up from 38,880 in September.

This is the third highest monthly figure since comparable records began in 2010.

And ambulance crews also failed to attend the most urgent emergency calls within the target time of seven minutes – with average response times for life-threatening illnesses or injuries eight minutes and 38 seconds in October.

Ambulances took an average of 42 minutes and 15 seconds last month to respond to emergency calls such as heart attacks, strokes and sepsis. The target is 18 minutes.

Health service officials highlighted the significant pressure on the health service, including high numbers of A&E attendances and ambulance call-outs.

The monthly performance figures also showed that an average of 12,340 hospital beds per day last month were occupied by people ready to be discharged.

Dr Nick Murch, president of the Society for Acute Medicine, said there had been no obvious sustained lull in activity so far in 2024 and staff had “trepidation and concern” about the coming months, sharing the concerns of RCEM colleagues.

“Reduced numbers of beds within hospitals, stretched community services and chronically low social care capacity means that emergency departments and acute medical units often become bottlenecks, with patients unable to ‘flow’ through hospitals,” he said.

“Regrettably, corridor care has become a normal occurrence but is dangerous, undignified and a real source of upset for staff forced to treat patients in these circumstances daily.

“It impacts the ability to care for patients as staff working in corridors cannot examine or care for patients while maintaining their dignity – and, in some cases, safety – and it leads to lower morale and poorer mental health outcomes among the workforce.”

He added: “We will continue to try to deliver high-quality care to those who need it most but fear that ongoing inactivity by those in power – particularly around social care provision and delayed discharges – will lead to considerable avoidable harm.”

An NHS England spokesperson said: “NHS teams have been putting in the hard work to put the system in the best possible position for this winter, including rolling out a new RSV vaccine programme alongside flu and Covid, setting up round-the-clock system control centres, putting more clinical decision-makers at the front door via same-day emergency care, and providing more care in the community such as falls services and virtual wards.

“But while these efforts mean that four-hour A&E performance is currently up on last year, this winter is likely to be another challenging one, which is why we have asked all parts of the NHS to work together to ensure that the safety and dignity of all patients, whether they are in hospital or at home, is the number one priority.

“As always, the public have an important part to play in helping NHS staff over winter, by getting all the vaccines you are eligible for as soon as possible, and using the NHS 111 service – through the NHS App, online or phone – for advice on how to access the right support for non-emergency health needs.”

A Department of Health and Social Care spokesperson said: “This government inherited a broken NHS where an annual winter crisis had become the norm. It will take time to turn things around but our action to quickly end the junior doctors strike means for the first time in three years NHS leaders are planning for winter rather than preparing for strikes.

“We understand the significant concerns held by hardworking staff about the pressures they face this winter. We are already working with the trusts who tend to face the hardest pressures during winter to ensure they are better prepared this year.

“The Chancellor recently announced a near £26 billion boost for the NHS over this year and next. Longer-term, through our 10-year health plan, we will build an NHS that is fit for the future and delivers for patients all year round.”

– The RCEM poll was conducted between November 7 and 13. Responses were received from 83 emergency doctors representing 83 hospitals out of 225 emergency departments around the UK – a 37% response rate.