Responding to the A&E statistics for September 2018, Vice President of the Royal College of Emergency Medicine, Dr Chris Moulton, said:
“Patients and staff are unfortunately in for another tough winter if these figures are anything to go by. Whilst attendances aren’t the highest they’ve been for a September, this is undoubtedly the worst September performance we’ve seen, with the highest number of emergency admissions; patients are sicker and have more complex needs than they did a decade ago.
“As the CQC’s State of Care report highlights, access to care is variable across the health service, which is in part driving demand to emergency departments – nearly half of which require improvement. Without significant investment in social care, alongside the forthcoming 10-year settlement for the NHS, overcrowding is unlikely to diminish and performance against the four-hour target will remain low.
“The solution to this problem absolutely must not be to say the target is unachievable; it is. As we have said in ‘Making the case for the four-hour standard’, while the target may not be perfect it is by far the best measure of wider system performance we have and is invaluable in highlighting the problems around the system. With the correct resourcing to both the NHS and, crucially, social care, four-hour performance of 95% should very much be achievable.
“Part of the issue in meeting the target is that it is seen only as an ED problem, when all parts of the system need and must take ownership of it. We would encourage all Trust boards to view this as a hospital-wide issue in order to maintain safety over winter. A key part of this is early capacity planning, aiming for a safe bed occupancy of no more than 85%, which will help to improve flow throughout the hospital.
“We know that there were fewer beds last winter than the previous year, and this is unlikely to have improved over the summer; the CQC report shows that in April this year only 16 of the 152 local authority areas in England had bed occupancy rates below the safe level of 85%. The recent funding injection must go towards ensuring that we do not lose more capacity this winter; these performance figures show that we can ill afford to.”