RCEM response: Improvement in monthly 4 hour performance welcome but rate of quarterly admissions a cause for concern.
Responding to A&E performance figures for December 2018 and Quarter 3 of 2018-19 President of the Royal College of Emergency Medicine, Dr Taj Hassan said:
“It is commendable that four-hour performance is better than in December 2017 and a testament to both our staff and the measures put in place to mitigate the impact of winter.
“While it isn’t a huge improvement, and 63% of our Emergency Departments remain in the Red Zone, it is certainly welcome for patients; particularly in the context of the highest ever attendances and admissions for a December.
“However, it should also be remembered that the last few months have been particularly benign in terms of the weather and instances of flu have so far been lower than in previous years.
“When considering this it makes it especially concerning that figures for Quarter 3 of 2018-19 show the second worst ever four-hour performance at major EDs, record attendances and the highest ever number of emergency admissions, with nearly a third of patients attending A&E requiring a bed.
“With average bed occupancy in December around 91% – an unsafe level – patient flow is still clearly a problem, and we worry that January will be much worse.
“The new Long-Term Plan, while highly admirable in many of its aims, offers little tangible commitment to tackling Emergency Department waiting times. It instead hints at scrapping one of the NHS’s mandated goals – seeing 95% of people attending A&E within four hours. This would be very undesirable for patients and would only serve to make things worse.
“However, the plan sensibly does not assume that a move towards community and primary care will necessarily reduce the need for hospital beds. The College welcomes the focus on ambulatory emergency care and this is a vital component to better gatekeep the in-hospital bed base. We welcome funding to roll out ambulatory care within every emergency department. But these figures clearly show that in addition to this we will need more beds, as an ever-increasing number of people require admission.”