Efforts to ensure the UK healthcare system is resilient against future pandemics will be undermined if the capacity issues in emergency care systems that are already ‘struggling to cope year-round’ are not addressed, according to the Royal College of Emergency Medicine.
The warning comes following the publication of the UK Covid Inquiry’s third report on the pandemic, titled the ‘Impact of Covid-19 pandemic on healthcare systems in the 4 nations of the UK (Module 3)’.
The Chair of the inquiry, Baroness Heather Hallett, investigated the impact of Covid-19 on healthcare systems across the four nations, including government response, how society responded, capacity of health care systems, and the impact on patients and healthcare workers.
The report concludes that healthcare systems “came close to collapse” and that ultimately, they “coped, but only just.”
The inquiry has made 10 recommendations, including the need to increase capacity in urgent and emergency care and ensure hospitals have the ability to implement surge capacity.
Dr Ian Higginson, President of the Royal College of Emergency Medicine, said:
“We welcome this thorough investigation by Baroness Heather Hallett and her team which has made a damning but honest assessment of how health systems around the UK coped with Covid-19.
“For our members and their colleagues, this report will make for sobering reading – it reflects the reality they lived through during the pandemic. They showed up when they were needed, and in many cases worked beyond their limits. They remain exhausted and burnt out because of a system that continues to run red hot.
“Covid-19 landed on an already fragile system. Our EDs were already experiencing overcrowding and long waits, which have only got worse since. It’s really frustrating that the obvious lessons around investing in emergency care haven’t been learned, and that it is necessary for a public enquiry into COVID to point out what everyone who works in emergency care already knew, still knows, and have been loudly saying.
“Our EDs are struggling to cope year-round. There are doubts as to how well many would cope with a local major incident. How can they be regarded as prepared for the next pandemic or other potential crises?
“Last year, 1,688,555 people waited 12 hours or more to be admitted, discharged, or transferred from a major ED in England. Compare that to 2019, when 487,729 people endured this wait.
“We have patients receiving care on trolleys in corridors, on chairs in other non-clinical areas, waiting for an inpatient bed to become available for them to move into.
“As the report recommended, there need to be plans for surge capacity in urgent and emergency care during a pandemic. This is true and we whole heartedly agree. But we need capacity all year round.
“While we do have institutional knowledge of what a pandemic could bring, and the ability to isolate some patients with infectious illnesses due to infrastructural improvements, I haven’t seen anything to suggest that our emergency care systems are better prepared now than we were then.
“The failure to prepare, which is an ongoing theme of the enquiry modules, put front line workers at risk due to inadequate PPE and outdated facilities compared to other countries that have chosen to invest in their emergency care systems and their ability to manage infectious disease outbreaks. Our patients and colleagues paid the price of this failure.
“This report is more evidence of the need to tackle systemic issues in urgent and emergency care. RCEM is pleased to have contributed to this important inquiry, and we will work with governments, across all four nations, to restore Emergency Departments to a state where they are fit for purpose and prepared for anything.”
The Royal College of Emergency Medicine provided evidence to the inquiry. A witness statement was submitted by former President, Dr Katherine Henderson MBE, who held the post between October 2019 and October 2022.
Former RCEM President, Dr Katherine Henderson MBE said:
“The Covid-19 pandemic was unprecedented.
“For our members and their colleagues working in Emergency Medicine, it was a time few of us have faced before and our health care system was not adequately prepared for a pandemic to hit, and to hit with such force.
“Emergency care is a core service for the public that they should be able to trust can deliver the care they need. It must be adequately resourced to be able to respond.
“In the pandemic staff lacked appropriate personnel protective equipment (PPE). And we struggled to isolate people who had COVID-19 to minimise the risk and prevent transmission of the virus. And there were concerns over ventilators and oxygen supplies.
“Emergency medicine staff are incredibly pragmatic and resilient, but the toll this has taken on the workforce cannot be understated. And the goodwill of those who are working in Emergency Departments can’t be the sole reason to prop up the system that isn’t working as it should.
“The lessons contained in this report must bring about the urgent changes we need to futureproof our service – for both staff, and our patients.”
