New figures have revealed that almost 400,000 spent 24 hours or more in an emergency department in England last year.
According to The Royal College of Emergency Medicine (RCEM) the very long waits are a ‘matter of national shame.’
Data uncovered by the college shows that 399,908 people waited 24 hours or more in an emergency department in England in 2022/23. It also warned that there could be a similar situation this year.
It comes just a few weeks after the number of people in England waiting to start routine hospital treatment rose to a new record high.
An estimated 7.68 million people were waiting to start treatment at the end of July, up from 7.57 million in June, NHS England said two weeks ago.
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Dr Adrian Boyle, president of the College, has warned that patients are coming to avoidable harm as a result of long waits.
He said: ‘We know that long stays in emergency departments are harmful.
‘There is good scientific data that shows that once people spend more than about six hours, and they need to be admitted into hospital, actually their mortality starts to get worse.
‘I think it should be a matter of national shame that we have the these very long waits for admitted patients.’
He added: ‘We must not normalise very abnormal situation. 24 hours in A&E is not just a documentary, it’s a way of life for lots of people, and it’s a way of life for far too many people.
‘This is a fixable problem but requires political will and commitment to sort this out.’
Dr Boyle said that the College wants ‘an emergency care system that people feel they can be looked after safely’.
He said that ‘end to end’ the whole process of receiving emergency care should take no more than six hours, including a person being collected by an ambulance, taken to A&E, handed over to emergency department staff who organise tests and either discharge or admit the patient to the hospital.
‘That is not what is happening at the moment,’ he said.
‘The figures we’ve got from the freedom of information request shows show us that nearly 400,000 people in England waited over 24 hours in an emergency department.
‘And this is because we just don’t have enough beds in hospitals.’
He said that people caught up in the long waits are ‘often elderly and vulnerable’.
Dr Boyle also raised concerns about ‘trolleys stacked up in corridors’, saying that this is seen in emergency departments ‘all the time’.
He added: ‘It feels actually sometimes a little bit embarrassing the level of care that we’re able to offer people when they really need us, and that’s very demoralising.’
Asked whether there could be a repeat of the 400,000 figure this year, Dr Boyle said: ‘Yes, we have seen 12-hour stays continue this year with little change, so it is perfectly possible that the 24-hour stays will continue.’
A record number of people attended A&Es in England in 2022/23.
Last year there were 25.3 million attendances in English A&Es, up 4% from the previous year, according to figures released last week.
The data also show that 71% of people spent four hours or less in A&E in 2022/23.
The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours, with further improvements expected the following year.
An NHS England spokesperson said: ‘This data relates to last year and winter, when services were facing record demand, industrial action and a twindemic of Covid and flu, but since we published our urgent and emergency care recovery plan in January we have seen significant improvements.
‘Thanks to the hard work of NHS staff Category 2 ambulance response times are now an hour faster than in December, A&E four-hour performance is up from 69% to 73%, and the proportion of patients waiting 12 hours in A&E is down a sixth.
‘We know there is more to do, which is why we set out our winter plans earlier than ever before this year, expanding care ‘traffic control’ centres, delivering additional ambulance hours and extra beds to boost capacity and reduce long waits for patients, and other initiatives like same day emergency care units and virtual wards which can mean patients are able to get the care they need without an unnecessary trip to an emergency department – this is better for them, and means A&E staff can continue to prioritise those with the most urgent clinical need.’
The health service in England published data on a number of different A&E outcomes including how many people are seen within four hours and data on the number of people waiting more than 12 hours in A&E departments in England from a decision to admit to actually being admitted.
But data is not routinely published on 24-hour waits.
As a result, The RCEM sent a freedom of information to NHS England asking for: ‘A count of attendances at Type 1 Emergency departments in England taking place between January 2022 and February 2023, showing those attendances that lasted 24 or more hours in the department’.
The data published from April 2022 onwards is counted as ‘provisional’.
Commenting on the figures, Liberal Democrat health spokesperson Daisy Cooper MP said: ‘These shocking figures reveal the scale of the damage this Conservative government has done to the NHS.
‘Long waits at A&E are leading to agonising waits for patients and unnecessary harm.
‘It’s vital that the Health Secretary comes up with a proper winter plan including ensuring hospitals have enough beds and staff, and finally coming up with a proper plan to tackle the social care crisis.’
A Department of Health and Social Care spokesperson said: ‘No patients should be waiting longer than necessary.
‘That’s we have set out the widely-endorsed urgent and emergency care recovery plan since this study was carried out, which aims to deliver one of the fastest and longest sustained improvements in waiting times in the NHS’s history, including creating 5,000 permanent staffed hospital beds, with recent improvements made in A&E performance compared to last year.’
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