Since 2011 there has been a 43% increase in the number of people waiting more than 4 hours in emergency departments and an 89% rise in the number of so-called “trolley waits”. With A&E waiting times and the number of people waiting on trolleys for beds up significantly, Cliff Mann who is president of the body that represents emergency medics, has warned that the NHS faces the worst winter yet for its emergency wards. Andy Burnham, the Shadow Health Secretary, has also spoken of his concern relating to the pressure A&E departments are under, with too many worryingly close to the maximum capacity they can cope with before the winter is even upon us. While not yet in chaos, emergency departments are certainly in crisis.
Early indications of problem waits
Last year was considered the worst on record for emergency departments, but current figures indicate that this winter the problems will only deepen. There is particular concern as recent summer waiting times surpassed those seen during the winter months, when waits are usually at their highest; for example in one week in August more than 550 extra people waited longer than 4 hours to be seen in A&E compared to a week in January 2011. Later in November the Medical Director of the NHS is expected to compile a report detailing measures emergency departments need to take in order to cope this winter.
Explaining the rise in waiting times
A number of reasons have been suggested for rising waiting times in A&E. The UK has an ageing population and with a greater proportion of elderly people, more are likely to become unwell or fall, requiring emergency medical attention. The current Health Secretary, Jeremy Hunt, has also suggested that poor provision of out of hours care by GP practices has contributed to the problem, as in some instances patients are left with no option other than go to their local A&E department. However, another problem is the shortage of emergency medicine doctors; the stress of the job and unsociable hours mean that it is not a popular choice among medics, though calls have been made for better pay for work at nights and weekends to entice more doctors into this challenging field.
Relieving the pressure
The Department of Health has acknowledged the pressure A&E services are under and has praised the work of their staff, which has ensured that 95% of people are still seen in less than 4 hours of arrival. A spokesman for the Department of Health has advised of a £500million investment planned for emergency departments during the next two years and that longer-term commitment to integrated services will allow more people to be treated closer to home and will help to ease these pressures.
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