Emergency Departments face ‘bleak scenes’ as winter crisis continues amid severe bed shortage, says RCEM
The crisis in English Emergency Departments is fixable, if government and health service leaders are willing to act on bed capacity in our hospitals.
That’s the key takeaway from the latest Urgent and Emergency Care ‘situation report’ from NHS England, published today, covering the week ending 1 March.
The figures showed why Emergency Departments (ED) continue to be full to bursting, with virtually no capacity in wards to admit patients.
In that week, the average bed occupancy was at 94.2% – higher than the previous week, and around the same as the same week last winter. At such high occupancy, wards essentially have no beds left, as there are always some which are closed due to infectious diseases, or being turned over.
Driving this, the figures showed, was a daily average across England of 13,778 patients who occupied beds despite being medically fit to leave – known as delayed discharges.
Meanwhile, sustained pressure remains from seasonal illnesses like Norovirus and Flu. Patients with these diseases occupied an average of more than 1,500 beds per day.
A ‘safe’ bed occupancy level is thought to be 85%, and a total of 10,855 additional available beds would be needed to get there.
This lack of beds has a severe knock-on effect in A&E, where the sickest patients are waiting to be admitted.
When there are no beds available, these patients often end up stuck on trolleys for hours and hours. This is where corridor care occurs.
Commenting on today’s figures, Dr Ian Higginson, RCEM President, said: “The bleak scenes my colleagues and I are seeing in our Emergency Departments each day are borne out in today’s new figures.
“What is not represented in these numbers is the impact it is having on our patients, the sickest of whom are experiencing unjustifiable long waits on trolleys in corridors because there are no beds left in wards.
“And the ripple effect this has on staff is profound.
“It’s no surprise that we are losing more and more colleagues to illness, or to them leaving the job altogether.
“Each year, we tell the government that winter will be brutal unless there is a step change in the way we do things, and yet this situation is allowed to happen again and again.
“We need a credible, long-term plan to bring down bed occupancy. This is a problem all year round, but worse in the winter.
“If the bed situation is brought under control, real strides in fixing the crisis in EDs could be made and, ultimately, patients will benefit.
“But for this to happen, the political will to act must be there.”
NHS England’s data also showed:
There were 1,058 fewer beds available in type-1 NHS trusts than in the same week last year
Delayed discharges fell on the previous week, but only by 42, to a daily average of 13,778
28 ambulances were diverted away from major EDs in the week ending 1 March. This typically happens when departments are overwhelmed and there are concerns about the time it would take to hand off a patient
