RCN South West region concerns about Emergency Department pressures

Published: 24 April 2013

The RCN South West region has raised concerns that Emergency Department pressures are affecting patient safety and dignity, according to recent figures. These pressures are resulting in patients facing long waits in ambulances and on corridors to be admitted for treatment, receiving care in inappropriate settings, and being moved or discharged in the early hours of the morning.

Recent figures from the Department of Health show that 27,247 patients spent more than four hours in a major Emergency Department in the week ending 17 March 2013. This compares to 13,200 patients in the week ending 18 March 2012 – that is a staggering 14,000 more patients facing delays in just one week, compared to the same week the previous year.

This pressure does not look to be easing in the near future, as in England alone Emergency Department attendances are increasing at a rate of over one million per year, from 16,244,934 in 2011 to 17,286,648 in 2012.

The RCN South West region has cautioned that this high level pressure will see the most vulnerable members of society – the elderly, those with mental health needs and the young – being worst affected, as constant pressure drives down standards of care. This situation is putting patient safety at risk, and is demoralising for nurses and other hard working Emergency Department staff, who are doing their best to manage a systemic problem beyond their control and influence.

The factors affecting Emergency Departments include management of patient flow, seasonal pressure, bed and discharge management, in-patients capacity, and availability of appropriate alternative community services.

The RCN South West region believes these Emergency Department issues to be a symptom of systemic problems in the wider care environment, and that they must be dealt with as such, and not in isolation.

South West Regional Director Jeannett Martin said: "Members from across the region are telling us that Emergency Departments are experiencing extreme pressures and nurses are extremely upset that patient safety and dignity are being compromised as patients are having to be nursed on trolleys in corridors because there is no room for them in the Emergency Department.
 
"Ambulances are having to queue outside of hospitals because they are unable to transfer their patients into Emergency Departments that are already overfull.
 
"These pressures on Emergency Departments have occurred because the hospital cannot discharge patients to the community, and this means that there is a constant lack of beds available for Emergency Departments to admit patients on to. This situation is outside of the control of emergency nurses to resolve, it is a whole system problem that needs to be addressed urgently."