The next Welsh Government must commit to ending the “life and death” situation of emergency department (ED) overcrowding, says the Royal College of Emergency Medicine (RCEM).
It found that around one in three of the sickest A&E patients in Wales are being treated in corridors or cupboards on a “quieter” day.
New survey data gathered from clinical leads at all 12 EDs in Wales, published by the RCEM, found that almost half (304 out of 704) of patients in ED were stuck waiting for an inpatient bed.
Of these patients waiting for a bed, who are typically the sickest or most injured, nearly a third (32%) were being treated in non-designated spaces.
These spots include, but are not limited to, corridors, cupboards, and waiting room chairs if the patient was waiting for a cubicle. They are not appropriate areas for treating sick patients, the RCEM said.
The survey data, gathered on Monday, 16 February, provides a detailed snapshot of the situation on the front line of Wales’ EDs on that particular day.
Several of the clinical leads told the survey that the situation on that particular Monday was quieter than usual. Several others said it was as bad as usual.
According to the results of the survey, there were only 277 designated treatment spaces, or cubicles, for patients. This was not enough for the 304 people who were waiting for admission to an inpatient bed, let alone the overall 704 patients in the EDs.
In these conditions, corridor care is inevitable, the RCEM said.
It added:
“Such overcrowding in EDs is unfair, dangerous and undignified for patients. It does not promote privacy for people in our departments, some of whom are experiencing the worst day of their lives.”
92% of clinical leads responding to the survey blamed a lack of available inpatient beds on the conditions inside their EDs, compared to fewer than half who blamed a large number of patients with less serious conditions arriving.
Dr Rob Perry, RCEM Vice President for Wales, said:
“All across Wales, Emergency Departments are doing their best to provide care against impossible odds.
“This survey data paints an accurate picture of the state of EDs as overcrowded and providing sub-standard care because of a complete breakdown in hospital flow.
“As we have previously shown, there is a link between long waits in ED and mortality, particularly among patients who require admission to a hospital bed.
“Right now, something is profoundly wrong with our hospital system. Patients are stuck awaiting discharge at the ‘back door’.
“Yet, time and time again, the Government has not been able to move the needle on what has become a perma-crisis. All year around, not just in winter, our EDs are overloaded with patients who need beds, and they end up being cared for on floors, plastic chairs, corridors or even cupboards.
“This hurts patients, and the stress of working in such conditions is driving Emergency Medicine staff to despair.
“In May, the people of Wales will vote for who they want to lead the country, and by extension who will run our health service.
“Whoever wins that election must commit to ending Emergency Department overcrowding. It is literally a matter of life and death.”
The survey data also found that:
- Two patients had been waiting in an ED for around five days.
- Waits of more than two days were not uncommon.
- Fewer than half of clinical leads responding to the survey (42%) said that large numbers of low-acuity patients was a leading cause of overcrowding, compared to 92% who blamed a lack of inpatient beds, and 83% who listed difficulties discharging patients as a key reason.
- Many said that this particular Monday was better than normal, indicating that the situation is typically even worse.
