24.03.17
RCEM: A&E special measures regime won’t address ‘chronic spiral downwards’
Plans for regulators to introduce a new “special measures” regime for underperforming A&E departments will not be enough to tackle the major issues which EDs are currently struggling to deal with, the Royal College of Emergency Medicine (RCEM) has warned.
While the Royal College has welcome the plans, which aim to increase accountability and improve patient outcomes, as a step forward, it said that implementing this policy alone risks “missing the fundamental need to address the chronic under resourcing of our EDs”.
“This College welcomes the focus on performance and the wider discussion on better quality indicators,” a statement from the RCEM read. “Patients expect and deserve to see the four-hour standard being met and our Members and Fellows work hard in very difficult circumstances to provide the best possible emergency care.”
But the college went on to point out the many “longstanding issues” are putting enormous strain on A&E wards across the country, which the government has periodically failed to properly address with very little provision made available for the NHS in the Spring Budget earlier this month.
A shortage of emergency physicians, insufficient acute care beds and problems with social care capacity are just some of the problems that are leading to hospitals operating above standard bed occupancy levels, something which is leading to overcrowding and a serious risk to patient safety.
The RCEM’s view is one shared by other organisations in the NHS, including providers who this week warned that already 2017-18 targets for emergency care in England was going to be “mission impossible” to achieve.
RCEM president Dr Taj Hassan said: “Whilst there are systems that may well benefit from best practice and this proposed special measures regime, we have been taking that approach for a long time and remain on a chronic spiral downwards.
“There are fundamental challenges that need addressing to provide sufficient emergency physicians to staff our emergency departments to meet the increasing demands and complexity of work they are expected to manage.”
Dr Hassan added that whilst staff were doing their utmost to deliver care to an ever-growing number of patients, recruitment and retention was a persistent issue for hospitals, and employers did not currently need a “big stick” approach to management from regulators.
“The key to creating stability is to create the right vision, culture and leadership supported by intelligent use of resources to transform the large locum spend budget into high quality permanent emergency physicians,” he argued. “Failure to do that will neither attract nor retain the expertise we need on the frontline of emergency care in this country.”
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