Lack Of Social Care Provision Causing “Chaos” In Emergency Care System, Says RCEM

The government, and health service leaders, must pay attention to the chaos inside Emergency Departments this winter, which are buckling under the pressure because of a failure to prepare for predictable surges in seasonal illnesses, and a lack of social care provision.

That’s the key takeaway from NHS England’s latest stats on the pressures the Urgent and Emergency Care system is under in England, published today, according to the Royal College of Medicine (RCEM).

The data showed that inpatient bed occupancy remains dangerously high, at 94.4%, far above the ‘safe’ level of 85%. A lack of inpatient beds is one of the key drivers of waiting times in Emergency Departments (EDs) themselves.

Concerningly, an average of 13,251 patients occupying these beds each day should not have been in them, as they were deemed medically fit to leave, but could not be discharged due to a lack of community, wrap-around and social care provision, or could not go back home.

If all of these patients were discharged, there would be enough beds to bring down occupancy to a safe level of 85%.

Pressure on EDs from this ‘exit block’ at the back door was made worse by a continued increase in the prevalence of Norovirus, also known as Diarrhoea and Vomiting (D&V) compared to the previous week.

Further, 51,094 staff were absent each day, an increase of 682 compared to the same week last year.

Dr Jason Long, RCEM Vice President, said:
“The chaos continues and the consequences of the government’s failure to prepare for winter are borne out once more in this week’s data.

“Sustained pressure from a predictable winter illness like norovirus would not be a catastrophe in a working hospital system.

“The fact that this appears to have tipped things over the edge is evidence of a need to urgently change the way we prepare for winter.

“Last year, the NHS England unveiled its winter plans a matter of weeks before the cold weather hit. It was too little, too late and the impact of this is more of the sickest patients stuck waiting in EDs on trolleys because there is nowhere else for them to go.

“What we need is a credible, long-term plan to reduce bed occupancy and for patient flow to be a key performance priority for the government and NHS leaders.

“Until this happens, patients will continue to suffer and my Emergency Medicine colleagues will continue to drop like flies.”