Gwent A&E units still fall short of target

In what proved a difficult month for A&E units across Wales, those at Nevill Hall and the Royal Gwent Hospitals dealt with the highest percentages of patients inside four hours.

But the target – that a minimum 95 per cent of A&E attenders be dealt with inside four hours – once again proved elusive in all 13 major emergency units in Wales.

At Nevill Hall during February, 91 per cent of A&E attenders were dealt with inside the target time.

And at the Royal Gwent the rate was 89 per cent.

A total of 9,219 people attended these units in February, the lowest for several months, and this may have been a factor in improving the performance against the 95 per cent target.

Initiatives such as introducing a Frail Older Persons Assessment and Liaison (FOPAL) team – to try to ensure elderly patients with complex needs are taken to the appropriate ward as quickly as possible so their immediate needs can be met, and planning can then begin for them to go home – is also intended to ease the burden on A&E units.

Staff are also increasingly assessing people out, where appropriate.

For instance, staff will redirect patients to their GP if the condition for which they have come to A&E is treatable elsewhere.

The extra beds made available in Gwent hospitals during the winter – up to 125 depending on demand – may also have played a part in ensuring a smoother flow through A&E into the rest of the hospital system.

Sharp and sudden increases in demand at the hospital ‘front door’ remain a problem for A&E staff to manage however.

And it is these occasions when many of the breaches of the four-hour target occur.

Last month, despite the performance in Gwent’s A&E units being the best in Wales, 929 patients waited longer than four hours.

Of these, 458 waited longer than eight hours and 149 longer than 12 hours.

This was the highest numbers in these categories for some months, and an indication that units remain under severe pressure.