The President of the Royal College of Emergency Medicine, Dr Katherine Henderson, has urged hospital boards to take immediate action to reduce crowding in Emergency Departments this winter.

Dr Henderson said: “As the declaration of a critical incident at Nottingham University Hospitals Trust shows, winter has clearly arrived after minimal let up over the summer.

“Most departments are struggling to admit patients into hospital beds, and offload ambulances. The result is that sick and elderly and frail people are spending hours waiting on trolleys in a noisy, undignified environment.

“We are calling on hospital Boards take to take action. There must be a focus on creating capacity within the hospital to get sick patients out of the Emergency Department once they are ready to be admitted; long waits in emergency departments are associated with increased mortality.”

4,000 more beds

Less than two weeks earlier the RCEM warned that the NHS needed at least 4,000 extra acute beds in England to avoid “corridor care”, keep bed occupancy at a safe level, and keep emergency departments moving, between 4,000 and 6,000 staffed beds will be needed.

Dr Henderson said: “Since Quarter 1 of 2010/11 we have lost over 15,000 beds from the system.

“Cuts to the bed base must be reversed otherwise we will end up seeing more patients stranded for hours on trolleys in crowded corridors.

“Bed occupancy during winter last year was an average of 93.5% – far higher than the recommended safe level of 85%. This was despite a mild winter, with the lowest number of bed closures due to norovirus in years.

“Performance against the four-hour standard at large A&Es was just 77% last month and declining performance is linked to declining bed numbers.

“This is bad for patients and demoralising for hardworking staff.”

The calculation of 4,000 beds is based on the number of beds required to move to 85% bed occupancy.

However the RCEM has not calculated the numbers of consultant, junior doctor and nursing staff that would be required to allow these extra beds to be used.

With the vast majority of major NHS trusts already deep in deficit, seeking to cut spending and reliant on borrowing the funds to prop up flagging balance sheets, the cost is also a factor.

ν The RCEM has announced that its 2019/20 Winter Flow will publish weekly aggregated performance figures from 50 trusts and boards across the UK, including the number of patients waiting 12 hours, or experiencing ‘corridor care’.

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