Written Statement: Quality Statement for Care in Emergency Departments

Today, I am publishing the Quality Statement for Care in Emergency Departments (ED) which sets out the outcomes and standards people should expect to receive when accessing care in high-quality, emergency departments throughout Wales. 

This statement complements commitments made in our Six Goals for Urgent and Emergency Care policy handbook and should be read in the context of the wider improvement work already in train, as part of our whole system approach to provide more care closer to people’s home and ensure people are discharged from hospital in a timely manner.

Emergency department staff work tirelessly every day to deliver the best care to seriously ill and injured people, often under incredible pressure and in difficult circumstances. They are there when we need them the most. I am very thankful for their hard work, commitment and expertise. 

This quality statement is the product of engagement with NHS staff and the public and has been developed in collaboration with clinical leaders and is supported by the Royal College of Emergency Medicine. It is shaped around our new Health and Care Quality Standards. 

It provides health boards with clear direction on what good looks like for care in emergency departments, focusing on a number of key aspects, including timeliness of access and effective communication and the delivery of the right care, in the right place, first time. 

I expect health boards to immediately adopt this quality statement as a framework for enabling optimal care and treatment in emergency departments. Health boards will focus their plans in 2024-25 on the delivery of small number of clinically-endorsed priorities: 

• Reduce risk of harm caused by crowding in emergency departments.
• Improve patient experience by better quality facilities and alignment of the right workforce capacity to respond to patient demand.
• Deliver faster triage and assessment processes, which support clinical prioritisation,
• Deliver faster and more effective patient referral and streaming processes to help people receive the right specialist care more quickly.
• Deliver sustainable working practices to support decarbonisation and maximise efficiencies.
• Develop improved data quality to support planning and improve experience and outcomes.
• Review and implement emergency department measures that reflect what matters most to patients and staff.

Health boards will be supported to deliver the quality statement and the priorities by the NHS Executive through the national Six Goals for Urgent and Emergency Care programme, and the strategic clinical network for critical care, trauma and emergency medicine.

To kick-start progress, we are launching a national “Green ED” accreditation framework across all of emergency departments in Wales, in collaboration with the Royal College of Emergency Medicine. This Welsh Government-funded programme has been welcomed by clinicians and will embed sustainable working practices in emergency departments and positively impact on the reduction of emissions, waste and costs.

Additionally, a national tool developed by the GIRFT (Getting it Right First Time) programme will be launched to bring together emergency department demand, capacity, outcomes and flow information. This will enable health boards to establish a clear understanding about the emergency care needs of their local population, and the workforce and infrastructure requirements to target improvements in patient care. This year we have provided £2.7m to enhance environments for better patient and staff experience in emergency departments and minor injury units in Wales.

Members will be aware the Office for National Statistics recently published a report assessing the comparability of emergency department performance statistics across the UK. I welcome the findings, which support our position that statistics for major emergency departments in England, Scotland and Wales are broadly comparable. 

To build on this independent piece of work, I have established a national task group to review emergency department measures. It will consider whether there are better measures of quality, value, experience and outcome for care provided in emergency departments to help inform the Welsh public about what to expect when accessing these services and to help drive improvements. We will focus on what matters most to people and what is clinically meaningful. 

We will report on further progress against all of the priority actions ahead of winter 2024-25.