Commenting on today’s publication of a study in Emergency Medicine Journal showing that patients who wait more than five hours in emergency care have a greater risk of death within 30 days, Dr Simon Walsh, BMA consultants committee deputy chair and emergency medicine consultant, said:
“Performance against the four-hour target over recent months has been the worst recorded since it was introduced and this paper shows that the longer patients wait, the greater their risk of death. The study used data from before the pandemic started and sadly, we know that more patients are now waiting much longer than the target of four hours, with a huge increase in the number who are waiting over 12 hours to be seen and admitted. This exit block from emergency departments, caused by a lack of any spare capacity in hospitals, also leads to delayed ambulance handovers, sometimes for several hours, with devastating effects on ambulance response times also resulting in harm to patients.
“The reason that patients are having to wait longer for emergency ambulances and emergency treatment in hospital is because of decades of underinvestment in the NHS, combined with a workforce crisis. Doctors are exhausted from working through the pandemic, often feeling hugely exposed due to inconsistent access to Personal Protective Equipment (PPE) and in many cases, are being redeployed to work in unfamiliar environments. This workforce crisis has been compounded by punitive taxation rules which penalise doctors for doing more work and, with no end in sight, many are leaving the NHS entirely, often taking early retirement.
“It’s clear that hospitals simply do not have the capacity to cope; patients who are medically fit for discharge remain stuck in hospital while awaiting social care which means that there is no capacity to admit emergency patients in a timely manner, which ultimately leads to unacceptable delays in emergency departments and ambulance services. We know this is a huge problem for our members, with three-quarters of doctors telling us that discharging patients, including to adult social care, has become more difficult in the last year, and more than eight in 10 saying they are experiencing more delays to admission compared to one year ago.
“The BMA has been clear where responsibility lies for the worsening pressure on urgent and emergency care for many years; the Government must invest across the NHS and, importantly, in social care provision. The BMA published a medical staffing report last summer which calls for the government to tackle this crisis and our recommendations include increased Treasury investment in the medical workforce including sufficient medical school places. The Government, as a priority, must change the punitive pension taxation rules that mean that doctors are forced to work fewer hours and even to retire early, in order to avoid huge tax bills on existing pensions. We’re also calling for better flexible working for all healthcare workers alongside more joined-up health and wellbeing initiatives to support the retention of doctors in the NHS.
“If the Government does not take urgent action to invest in the NHS and social care and to tackle the workforce crisis, then it’s difficult to see how further deaths that result from the delays in emergency care can be prevented.”
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.