In January 2015, I wrote about how the NHS was struggling to cope with demand over the winter and that Accident and Emergency waiting times were on the increase. Four years on and the situation has unfortunately not improved. It was this week revealed that Accident and Emergency waiting times are now at their worst level since the four-hour target was introduced in 2004.

In January 2019, only 84.4% of patients arriving at A&E departments in England were seen and either admitted or sent home within four hours which is far below the target of 95% of patients. That means that 330,000 patients waited longer than four hours in A&E. It should be noted that the previous worst level was set after the “Beast from the East” storm in March 2018. It is therefore particularly concerning that last month’s performance was so poor when levels of flu and winter illnesses are actually lower than usual for the time of year. Just two of England’s major Accident and Emergency departments met the 95% target last month.

The pressures on NHS staff in emergency medicine are intolerable with considerable problems in staffing levels and ever-increasing workloads. Not only are patients waiting longer to be seen, ambulances are queueing outside Accident and Emergency departments and patients admitted from A&E are waiting longer than ever for beds. The continuing failure of the Government to fund proper social care for patients on discharge means that patients are staying in hospital for longer which again puts more pressure on Accident & Emergency staff to find beds. Last month over 83,000 patients endured “trolley waits” of four hours or more before a ward space was found for them.

Dr Taj Hassan, President of the Royal College of Emergency Medicine, said:

“These are the worst figures on record, showing that despite the positivity around the NHS Long Term Plan, the suffering affecting our patients in Emergency Departments in England has not gone away at all.

Sadly the situation afflicting our Emergency Departments has become seemingly normalised with a ‘chronic crisis mode’ that does not allow staff to deliver the quality of care they would wish and patients should rightly expect. The evidence on resultant crowding in departments is clear – it adds to the risk of harm to patients leading to excess deaths and disability.”

It is clear that the long-term lack of investment in emergency care and staffing has resulted in the ongoing crisis levels within Accident and Emergency departments around the country. It is inevitable that this impacts on the quality of care that patients receive and ultimately on patient safety. With the uncertainties of Brexit looming, this is only likely to worsen.