The recently aired Channel 4 Dispatches programme, Undercover A&E: NHS in crisis has received widespread coverage due to its exposure of the “suffering and indignity faced by patients on a daily basis” in the the Royal Shrewsbury Hospital’s emergency department, where an undercover reporter worked as a trainee healthcare assistant for two months.
The footage was shocking, but for those who work in NHS emergency care it was nothing new.
On X/Twitter, Professor Rob Galloway, A&E Consultant at the Royal Sussex, noted:
“last night there was a shocking tv expose on NHS A&E care. But what’s truly shocking is that for those of us who work in A&E, we’re not shocked. We have become normalised to the unacceptable. The unacceptable is now the accepted norm. Society cannot continue to accept this. Our patients deserve better.”
The Royal College of Emergency Medicine (RCEM) described the footage filmed in A&E at Shrewsbury and Telford Hospital NHS Trust as ‘shocking but not isolated’.
Dr Adrian Boyle, president of the RCEM, said: “I don’t think this is unique to this hospital by any stretch of the imagination.”
Siva Anandaciva, chief analyst at the King’s Fund, said: “That could be any one of a number of hospitals up and down the country, which is absolutely staggering. I think the standard of A&E care in England is in about as deep a hole as I’ve seen in the last 20 years. So, whatever government comes in, they have a huge task to recover performance.”
Incredibly, NHS England chose to deny the situation, with Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, saying:
“What has been observed in Shrewsbury and Telford Hospital NHS Trust in recent weeks is not commonplace in A&Es across the country, and is not acceptable, and we are continuing to offer the trust the highest level of national support to improve care for patients.”
An interesting statement given that all the evidence points to this situation being commonplace across the country and it is resulting in unnecessary deaths.
The RCEM carried out a snap poll last week, in which 87% of Emergency Departments which responded said they had patients being cared for in non-designated areas such as corridors. Of these departments, one out of every five people who visited the A&E ended up being treated in a corridor on a chair or on a trolley. Furthermore, 68.3% of departments had patients being cared for in the back of an ambulance outside of the ED.
And 90.5% of A&E leaders who responded said that they believed that, at present, patients were coming to harm due to the care they are able to deliver within the constraints of an overcrowded department.
For 2023, the RCEM’s figures show that more than 1.5 million patients waited 12 hours or more, 65% of those were patients awaiting admission. Furthermore, almost a quarter of people waiting 12 hours (24.2%) went on to wait 24 hours or more, equating to almost 400,000 patients waiting for over a day in A&E.
There is very good evidence that longer waits in A&E are related to avoidable deaths. An analysis of 2023 data by the RCEM found that over 250 needless and preventable deaths are occurring each week due to delays in A&E.
Despite the situation the main political parties have paid little attention to emergency care in their manifesto, which led the RCEM on 20th June to write to the leaders of the Labour, Conservative and Liberal Democrats expressing its dismay that the situation was being given so little attention in the election campaign:
“The serious omission of any meaningful priority to address overcrowded A&Es and resulting in so called ‘corridor care’ is unconscionable. If these associated deaths were taking place in any other setting, they would not be tolerated, yet within any manifesto and surrounding talks regarding the NHS there appears to be a blatant disregard for patients seeking Emergency Care, and the clinicians caring for them. Any mention of the matter has been light touch and hugely disproportionate to the scale of the issue.”
Dr Boyle noted that:
“But as the political parties detail their plans and commitments ahead of the General Election, we have yet to see one specific policy in any manifesto aimed at tackling this scandalous and shameful situation. Seriously?
“The risk to patients’ lives is very real, it is very serious and is happening right now. People are dying, and all we have from those hoping to form the next government is a deafening silence on this issue, which really is a matter of life and death.”
However, Dr Boyle has since welcomed the Liberal Democrats highlighting of A&E waits in its campaign; on Monday Leader Ed Davey declared that there are just “ten days to save the NHS” before polling day, and highlighted the number of people waiting 12 hours or more to be admitted to A&E has risen over 100-fold since 2019.
“We very much welcome the Liberal Democrats’ focus on this extremely important issue, and for responding to our request for more focus to be given by all political parties to the crisis happening right now in our A&E departments.
The Lowdown recently covered the rise in corridor-care and the dangers it poses for patients. Noting that NHS England’s new plan to speed up the response of A&E services and reducing waiting times, published in May has set a new target of 78% of A&E patients to be seen within four hours – way short of the 95% target that was being regularly achieved prior to 2010. However, any plan will be hampered by lack of beds and problems with discharging patients.
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