‘This is a call to action’, RCEM & College of Paramedics say as Lords Public Services Committee detail scale of crisis in Emergency Care

Responding to the House of Lords Public Services Committee’s report Emergency Healthcare: a national emergency published today, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said:

“We thank the Lords Public Services Committee for their time and for the publication of this important report. We welcome the gravity, openness, and honesty with which they have acknowledged and laid out the reality of the crisis in Emergency Care and its severe impact on both patients and staff.

“The report is exactly right: lack of hospital capacity; lack of adequate or sufficient social care; fundamentally dishonest 12-hour waiting time data; inability to admit patients; inability to discharge patients; these have all contributed to a crisis on a scale not seen before. A crisis which has led to a gridlock across health services, and in turn has led to dangerous crowding and extremely long waiting times that we know are associated with patient harm and patient deaths. Emergency Medicine staff and paramedic colleagues have been stretched to their limit trying to mitigate the harm to patients and continue delivering effective care, but it is extremely challenging in the current circumstances. Staff can no longer burn themselves out on adrenaline and goodwill alone.

“We welcomed the £250 million that the government pledged to social care and to tackle ambulance handover delays. We are yet to see the detail on when this funding will be made available for local systems and when the extra care home capacity will be opened. NHS England have pledged to open 7,000 beds in hospitals including virtual wards, again, we are yet to see the detail on how many of these beds have since been opened, how many are virtual, and where we can track these data.

“While both of these steps are welcome and rightly aim to tackle the immediate impact of the crisis, there remains an unwillingness to take the necessary, meaningful long-term, cross-party action to tackle the root. This crisis was foreseeable and has been culminating since long-before the pandemic. A decade of under-funding, under-resourcing, cuts to social care all matched with a failure for long-term workforce planning and a significant shortfall in beds have led us to a broken health and social care system.

“It is time for the government to face this dire crisis, to finally acknowledge its depth, and to take the necessary meaningful action to tackle it. We urgently need to see long-term workforce planning; this must begin with retention – this means valuing and supporting existing staff who have faced years of exceptionally challenging conditions. We must see significant, continued, and sustained investment in social care – including an immediate bolstering of the social care workforce, to ensure patients can be supported and discharged in a timely way. We must see acute capacity across England expanded where safely possible. Lastly, the Committee are absolutely right, NHS England must now publicly publish monthly 12-hour A&E waiting time data measured from the time of arrival at the Emergency Department, as a matter of transparency and honesty.”

Tracy Nicholls, Chief Executive of the College of Paramedics, said:

“The insightful Lords Public Services Committee report today lays bare the stark reality of the inability of paramedics, ambulance clinicians and our emergency colleagues to provide the care they want, and that patients deserve. What now needs to follow is meaningful action, not further rhetoric. Patients suffered harm yesterday, and today, and will suffer harm tomorrow, so time is imperative. Moral injury of paramedics and ambulance clinicians is a reality, so the College supports RCEM’s call for meaningful actions, including longer-term workforce planning.”