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“There is simply nowhere to put patients” – reaction to A&E performance data

The alarming A&E performance figures released this week come as little surprise to those working within the health sector or indeed anyone who has been to an emergency department over the last few years; patients have suffered due to a lack of staff and lack of beds.

Three million patients having to wait over four hours is unacceptable and should be seen as a reflection of the under-resourcing that has been the status quo for so long.

For too long we have tried to cope with a growing level of demand that while predictable is disproportionate to the amount of staff we have. The staff we do have work incredibly hard to keep patients safe and the system afloat with the bare minimum of resources, but we are clearly near a tipping point.

The recent budget thankfully sought to address this, but the funding announced is a long way short of what the government was told would be needed, does nothing to help social care, and is likely to be too late to help this winter.

The new settlement is undoubtedly welcome and will go towards rescuing the parts of the healthcare system that are in dire need, but, as NHS England has warned, this will only be enough to patch up one part of the system at the expense of another. Ultimately patients are left to suffer.

Our own winter flow project highlights this problem. Our data shows that average performance across roughly a third of emergency departments is currently just 82%. This is despite a much higher number of cancelled elective operations in comparison to previous years, as Trusts divert resources from other areas towards the emergency department in attempt to rescue performance.

The BBC’s analysis suggests that we need an extra 20 emergency departments to cope with current levels of demand and get performance back to 95%. However, this can be achieved by boosting staff and bed numbers at existing sites.

In England, we are very pleased to have agreed a workforce plan for emergency medicine with NHS England, NHS Improvement and Health Education England, with an implementation and funding plan currently being developed.

This will boost staff numbers longer term but to get waiting times down and our departments moving again, in the short term we must work to reverse the downward trend in bed numbers.

At present, there is simply nowhere to put patients. We’ve previously estimated that we are short of around 5,000 beds, and with bed occupancy at some trusts now running at 99%, it’s imperative that this is addressed urgently. Until we have enough beds to ensure that occupancy does not go beyond 85% we will continue to see long waits in the emergency department and patient care will suffer.

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