Health leaders have issued fresh warnings about pressures on the NHS over the winter as a new report found thousands of deaths were caused by crowding in emergency departments.
The report by the Royal College of Emergency Medicine (RCEM) suggests at least 4,519 patients died as a result of crowding and 12-hour stays in A&E departments in England in 2020-2021.
It said the discovery adds to NHS England’s own findings that one in 67 patients staying in the Emergency Department for 12 hours comes to excess harm.
Dr Adrian Boyle, vice president for policy of the RCEM, said: “To say this figure is shocking is an understatement.
“Quite simply, crowding kills. For many years we have issued warnings about the harm that dangerous crowding causes, but now we can see the number of excess deaths that have occurred as a result.”
He added October saw 7,059 12-hour stays – the highest number ever recorded and a 40% rise from September.
Dr Boyle also warned of harder months ahead, following a trend of the number of long stays rising “drastically” over the last six months.
A report by the Association of Ambulance Chief Executives also revealed as many as 160,000 patients may be coming to harm each year due to delays in ambulance staff handing over to hospitals on arrival.
The college is calling on the Government to publish a long-term workforce plan, including provisions to retain existing staff who are reaching burnout and obtaining new recruits.
The RCEM said there was a shortfall of 2,000 to 2,500 emergency medicine consultants and shortages of essential emergency medicine nurses and junior and supporting staff.
Dr Boyle said: “This is the beginning of a long winter and an extremely challenging time for the current workforce as pressures will rise and patient safety will continue to be put at risk.”
Responding to the RCEM report, Matthew Taylor, chief executive of the NHS Confederation, said the heath service was under “critical and unsustainable pressure”.
“NHS leaders and staff are doing their utmost to provide patients with the treatment that they need. However, the health service requires urgent support to address severe workforce shortages as well as a waiting list for elective care which now stands at 5.82 million patients”, he said.
NHS Providers, the membership organisation for the NHS hospital, mental health, community and ambulance services, said trusts were working “flat out” while “already working beyond full stretch”.
Miriam Deakin, its director of policy and strategy, said: “We highlighted trust leaders’ concerns about this in our State Of The Provider Sector report earlier this week.
“Trusts are working flat out to deliver the best possible care for patients under extremely challenging circumstances.
“But when we consistently run our health and care service at the limit of its capacity it doesn’t take much extra pressure to increase risk to patient safety and quality of care.”
NHS Providers has recommended providing a £500 retention bonus to workers in the social care sector and for the Government to give “greater leadership” on public health through stronger messaging on how to manage the risks of coronavirus in addition to a long-term workforce plan.
Dr Nick Scriven, past president of the Society for Acute Medicine, said: “While we support the aims of the RCEM for the next phase, any solutions must not simply move people and pressure on to another part of the system without the resources and infrastructure to deal with it.
“This then leads us back to the same issues us and many others have been talking about for many years – crisis in social care, lack of beds, staffing and funding shortfalls, poor estates, fragmented services.”
An NHS spokesperson said: “NHS staff have gone above and beyond over the last 18 months treating 500,000 seriously ill Covid inpatients and as most recent data shows, they also contended with the busiest October ever for major A&Es and for life-threatening ambulance call outs in a single month.
“As set out in our 10 point plan, the NHS is maximising the availability of urgent care services to provide alternatives to A&E so anyone who needs care should come forward through NHS 111 Online so staff can help sign post you to the best option for you.”
The Department for Health and Social Care have been contacted for comment.
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