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12th September 2013

Older people waiting longer than most in under-pressure A&E

A report published today (September 12) by the auditor general for Wales, Huw Vaughan Thomas, says unscheduled (emergency) care services across Wales are deteriorating.

The report highlights problems for NHS emergency care services including staff shortages, confusion over whether people should attend A&E and the flow of patients through hospitals.

A particular problem is that too many patients, especially older people, are staying too long in A&E - sometimes spending more than 12 hours in accident and emergency departments.

Since the last report by his department in 2009, Mr Thomas says A&E waiting times have generally increased and that problems then identified as urgently needing attention have not gone away.

Problems highlighted in the Auditor General's report into 'unscheduled care' in Wales in 2013

  • Patients face a "complex and confusing" range of options when in an emergency situation, such as whether to call 999 or go to A&E. This needs to be simplified.
  • The need for older patients to be admitted quickly to wards is hindered by problems with bed availability and the speed at which specialist doctors can come to A&E to assess patients.
  • At times of peak demand, problems with patient flow through the hospital result in significant pressure being placed on A&E departments, which become over-crowded, with patients facing long waits and ambulances needing to queue outside A&E departments to hand over people needing treatment.
  • The time it takes for ambulances to hand over patients to hospitals has got worse since 2009.
  • Problems recruiting doctors in Wales has made the pressure on emergency units worse. No A&E departments in Wales are able to meet the College of Emergency Medicine standards for consultant presence on the "shop floor".
  • There can also be problems with the recruitment and retention of doctors to work in GP out-of-hours services.

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