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  1. ITV Report

Wales sees highest number of patients at A&E for 'any December on record'

  • Video report by ITV News Political Correspondent Emily Morgan

Last month saw the highest number of people visiting A&E for any December on record, figures released by the Welsh Government have revealed.

The performance for 95% of patients to be seen within the target of four hours was the lowest since March 2016.

Statistics published today also show those aged 85 or over attending A&E was the highest it has ever been.

The figures come as a number of Consultants in Wales wrote to the First Minister warning him they "are severely and chronically under-resourced" with "neither sufficient staff, nor sufficient beds."

Since the New Year, The Royal College of Emergency Medicine in Wales warned that patient safety was being 'compromised daily' due to extreme pressures within departments.

The Welsh Ambulance Service said it saw a 170% increase in calls over the first four hours of New Year's Day compared to a normal day.

The average number of patients visiting A&E in December was 2,656 - 3.8% lower than the month before - but 5.4% higher than December 2016.

2,656
Average number of patients visiting A&E in December (5.4% higher than Dec 2016)
3,741
Patients spent 12 hours or more in A&E in December - an increase of 599 patients from November

The Welsh Government recently announced an extra £10m of funding to help relieve pressures on the health service - from primary care through to social services.

There was an increase in the number of calls to the ambulance service - of 10.7% from the previous month.

1,450
Average emergency calls to the ambulance services

70% of emergency responses to 'immediately life threatening calls arrived within eight minutes which is above the target of 65% - but down from 73.3% in November 2017.

Despite the busiest December on record for our A&E Departments and the busiest ever month for the Welsh Ambulance Service, our NHS has continued to perform under exceptional pressure in delivering emergency and scheduled care. I want to once again thank our NHS and social care staff for their commitment and hard work in delivering care during this extremely busy period. We have worked closely with health boards and partners since last winter to plan for this winter period and invested an additional £60m to help them deliver urgent and emergency care, and ensure planned care activity can continue during this time. We still need to drive up performance in a number of areas but under severe pressure and record levels of demand our NHS has held up and continues to deliver high quality healthcare to patients.

– Vaughan Gething AM, Health Secretary

"We are severely and chronically under-resourced"

Emergency consultants have warned they have no sufficient beds or staff to deal with demand Credit: PA

Emergency hospital consultants have warned safety is currently being compromised in "all departments" to an "unacceptable degree."

In a letter by 46 Emergency Department physicians and consultants it says they felt "compelled...to speak out in support of staff...and to share the very serious concerns we have for the safety of our patients."

The consultants warned planning ahead of the winter have "fallen well short of what was required to maintain adequate care."

Safety is currently compromised in all of our departments to an unacceptable degree. This is despite the enormous efforts made by our staff to keep patients safe in extremely challenging circumstances.

We do not dispute that great effort was put into winter planning for NHS Wales at both Welsh Government and Health Board level. Unfortunately, our experience from the clinical front line is that these plans have fallen well short of what was required to maintain adequate care for our patients.

We appreciate the financial constraints under which the Welsh Government must operate. However, we feel that the current situation demonstrates that both the Welsh NHS and Welsh social care are severely and chronically under-resourced. We have neither sufficient staff, nor sufficient beds (in either acute hospitals or the community) to cope with the needs of our ageing population.

The letter sent to the Prime Minister mentioned the many reports in the media of how appalling the situation has become in many departments. The EDs in Wales are no exception – indeed, in some ways the situation is even worse. The 4-hour target figures for our best performing hospitals are similar to those from some of the worst performing hospitals in England.

– Consultants and physicians in Emergency Medicine in Wales

The letter also highlighted some personal experiences from doctors and medical staff:

  • More patients in the ED waiting for ward beds than the ED can actually accommodate, with no space to see any newly presenting patients
  • Staff arriving for shifts to find the patients they cared for the previous day (and often the day before) still in the ED
  • Makeshift arrangements made to accommodate extra patients in hospitals, often with suboptimal staffing
  • Multiple ED staff in tears at work as they do not feel they can deliver the care their patients need
  • EDs in the precarious position of having nowhere to treat a newly presenting critically ill patient
  • Multiple ambulances waiting outside every ED, with a knock-on effect on WAST’s service delivery to the Welsh public

We ask, as a matter of urgency, that you consider supporting strategies that will reduce crowding in our Emergency Departments. These include:

A significant increase in Social Care Funding to allow patients who are fit to be discharged from acute beds to be cared for in the community.

A review of the number of hospital beds that are available for acute care. A number of independent organisations have confirmed that the UK has an inadequate acute bed base to meet the needs of its population.

Abolish the Welsh Government’s 4 hour breach exclusion criteria. This will provide a more accurate representation of patient flow and experience, and will also release significant amounts of administrative, managerial and clinical time for other tasks.

Prioritisation of a workforce strategy to improve recruitment and retention of ED staff in NHS Wales.

– Consultants and physicians in Emergency Medicine in Wales

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