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Tue, 7 April 2020

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RCEM: second worst ever quarterly performance a failure for patients

Royal College of Emergency Medicine

2 min read Member content

Responding to today’s monthly and quarterly emergency care performance figures, Vice President of the Royal College of Emergency Medicine, Dr Chris Moulton said: “It is commendable that there has been a mild recovery in terms of monthly performance and all credit should go to staff who have faced another gruelling winter.


However, the second worst quarterly performance on record is absolutely nothing to celebrate and a failure for patients. Overall four-hour performance moved up by just 0.1% percentage point on the same period last year and even this may be a data anomaly.

Quarter three had the highest ever number of attendances at major A&Es and the highest ever number of patients waiting for longer than four hours. We also saw the second highest number of emergency admissions with only the preceding quarter being worse, and the third lowest ever number of patients seen within four hours at major A&Es. The overall data is made to look better by including data from NHS walk-in centres (Type 3 A&Es).

NHS focus is currently on redirection schemes and data changes. In light of these figures we would warn against failing to address the root causes of the problems we are experiencing as a matter of urgency – a lack of beds, staffing and whole hospital ownership of targets. The government should also commit to finally publishing its green paper on social care.

It is abundantly clear that resources should follow demand rather than fund attempts to move problems elsewhere. Airports do not respond to increased demand by telling travellers to go by bus or train instead; they expand accordingly.

The figures also highlight how crucial it is to have robust metrics that not only track system performance but also patient experience. We are pleased to be involved in the NHS review of standards. We are agreed on common themes with NHS England and NHS Improvement and look forward to contributing to discussions on the various testing phases in a way that is rigorous and transparent.

We must ensure the outcome of this process provides metrics that are better than the four-hour target. Any replacements must drive improvements in clinical care and patient experience and must not make the difficult situation of crowding and exit block worse.”

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