System-wide solutions needed to tackle emergency care crisis

The Royal College of Nursing has said that more integration in the care system is needed to tackle the huge challenges facing nursing staff working in emergency departments.

The latest NHS England performance data reveals that in March this year, 22,506 people waited for more than 12 hours in an emergency department to be admitted for treatment. This is up from 331 in March 2019 and 668 in March 2020.

The RCN claims that the situation has been exacerbated by delays in the transfer of care from hospital to community locations, due to workforce issues in the community, the availability of care package and placements in care homes. Additionally, more patients are presenting in emergency departments with mental health needs and more elective cases are being scheduled as the NHS attempts to clear the NHS backlog.

The organisation argues that improved reporting on emergency department activities is needed, as current data collection processes do not provide true reflection of what nursing staff and other health care staff are experiencing.

Sarah Cato, chair of the RCN Emergency Care Association, said: “There’s less capacity for inpatients right now which means patients are waiting longer to be admitted to wards, creating a backlog in emergency departments. This also has an impact on ambulance waiting times, that delay ambulance response times in the community.  

“The pressures on nursing staff are constant, with no signs of improvement as ongoing sickness absences, isolation and high vacancy rates create constant challenges. Many experienced emergency nursing staff feel they have no choice but to leave, which is having a further impact on the skill mix of remaining staff.”