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Record number of patients spending 12 hours or more in A&E

Royal College of Emergency Medicine

4 min read Partner content

The latest data published by NHS England shows that the number of patients waiting 12 hours or more before being admitted in December 2020 is the highest figure since records began. 3,745 patients were spending 12 hours or more in Emergency Departments. It marks an increase of 75% on last month, November 2020, and an increase of 60% on the same month last year, December 2019.

The contrast with May 2020 is stark where only 93 patients spent 12 hours or more waiting to be admitted, which is equal to a 4000% increase in December 2020.

Quarterly data published by NHS England present the same picture. Q3 of 2020 recorded 7,153 people waiting 12 hours or more to be admitted, marking a 70% increase on Q3 2019. Q1 2020 recorded only 505 patients waiting 12 hours or more to be admitted, equal to a 1300% increase in Q3 2020.

However, data from NHS England record 12-hour waits from decision to admit to admission, meaning there are many more patients waiting for 12 hours or longer than the data suggest, as reflected in the Royal College of Emergency Medicine’s Winter Flow Project.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“These data are truly alarming. While attendances are still down the number of patients spending over 12 hours in the ED has skyrocketed – and these are just the tip of the iceberg. We are no longer in a crisis; this is a national emergency.

“Patients should never have to wait for 12 hours or more to be admitted, but there are just not enough beds to admit patients to. It is incredibly challenging for staff who have to deliver care in corridors, which is unsafe and unacceptable at the best of times, but now is has the added risk of further spreading covid.

“I cannot emphasise the gravity of this emergency. Hospitals are under intense pressures. Ambulance services across the country are struggling to keep up with the number of calls they are receiving; hospitals cannot cope with the number of patients. Despite attendances being down, 12-hour waits are higher than ever, partly due to the severity of patients’ conditions.

“But these 12-hour waits are only measured from decision to admit to admission. Our annual Winter flow project shows, in part, the true extent of 12-hour waits; data from 32 trusts across the UK in December alone shows over 12,400 patients spent over 12 hours in an ED – measured from when they arrived.

"We cannot properly tackle this problem unless we confront it properly, so we welcome the new metric being introduced by NHS England with the consultation on the Clinical Review of standards, which will measure 12 hour waits from arrival to discharge. This will help us see where the problems in Emergency Departments lie and help us to resolve issues quicker, including putting a stop to unsafe crowding and corridor care.

“We entered the pandemic short of staff and short of beds and now we are truly feeling those shortages. It is devastating. Departments are already working beyond normal full capacity but are still trying to expand capacity further. We are finding beds and resources wherever we can.

“Healthcare staff have been doing this for eleven months, there’s no clap for carers or support anymore, there are only more patients, more deaths, more hours and more shifts, and this time they are being stretched more thinly.

“The lives of those in the community are at serious risk and excess deaths could soar quickly. It is incredibly distressing that surgeries and some other urgent care are being put on hold. We are also concerned that attendances are down; our fear is that there are people in the community who need urgent and emergency care who are not seeking it.

“We do not have the virus under control. The situation is far worse than April 2019 and what is happening is not sustainable. Our NHS is now at a tipping point and if it tips, we will not be able to stop it.

“Healthcare workers are doing an exceptional job in an emergency like no other, for many it may be traumatic. We must support each other and work together and get through the coming weeks. We can still mitigate the impact and minimise the risk of further damage.”

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