RCEM: improvement in performance welcome, but budget does little to prepare for challenge ahead

Responding to the latest performance figures published by NHS England Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“It’s pleasing to see the performance dials moving in a useful direction. We are particularly relieved to see the number of 12-hour delays is going down as covid recedes. We still need to see the true picture though, as this only measures from the point a decision to admit has been made, and we look forward to seeing the full 12-hour from arrival data being published in winter sitrep as soon as possible.

“It is also interesting to see an increase in the utilisation of booked appointments. This has the potential to help the system, and patients, but there must be properly resourced alternatives services for patients to go to for this to be of true value. We need to close the loop on the outcome of referrals – did the patient get care in the right place through this initiative?

“There are still considerable challenges within the UEC pathway despite attendances at major Emergency Departments (EDs) being the second lowest ever. While rates of covid are going down, we know that attendances to A&E may begin to increase quickly as we exit from the pandemic and we have to maintain all the Infection Prevention and Control measures. We must plan and prepare for the return to the usual levels of unscheduled care activity within the context of covid still around as failing to do so could derail a recovery in terms of elective care and the backlog of operations.”

The data show:

• 12-hour delays decreased – with 1,038 in February 2021 compared to 3,809 in January 2021.
• Four-hour performance in major EDs was 77.4%, a significant improvement on January’s figure of 70.1%. However, this is still one of the lowest percentages since the start of the pandemic.
• There were 903,644 Type 1 ED Attendances, a decrease on the previous month (941,151) and the second lowest ever figure.

Dr Henderson continued:

“Last week’s budget was an opportunity to plan ahead for a return of regular hospital activity and prepare the workforce, but it fell far short of what the NHS desperately needs.

“NHS recovery from the pandemic will be long and difficult. Existing staff are exhausted, and the recommencing of routine services will see a significant rise in hospital activity.

“Without additional funding the NHS will struggle to recover, staff will continue to be spread thinly and we will see a return of dangerous crowding, corridor care and extensive delays.

“The recent announcements of a freeze on pension tax thresholds may push senior clinicians to retire early. Now is the time when their expertise and skill is needed most. And the 1% pay rise for NHS staff has been a significant blow to morale, especially to our nursing colleagues.

“The government’s recent announcements will do little to retain existing or entice prospective staff into a career, and some may feel their work has been devalued – particularly students and trainees who have gone above and beyond.

“We cannot rise to the problems facing the health service with a workforce that feels undervalued – or barely even exists – and an NHS that is not adequately funded or resourced.”