Warning of A&E crisis in Wales as new figures records worst 12-hour waits on record

Wales has recorded its worst ever October for long waits in emergency departments, prompting the Royal College of Emergency Medicine (RCEM) Wales to issue a warning that patient safety is at risk and the system is “spiralling”.

New figures released by Stats Wales show that 10,493 patients spent more than 12 hours in major emergency departments before being admitted, transferred or discharged, equivalent to one in every seven people attending.

RCEM Wales said the scale of the delays, combined with the onset of winter, posed a serious threat to public health.

The number of 12-hour waits has risen 4% since last October, despite attendances increasing by less than 2%.

Compared with October 2018, the volume of extreme waits has more than doubled, even though emergency department attendance is marginally lower than it was seven years ago.

Dr Rob Perry, RCEM Vice President for Wales, said the figures were a stark reflection of a system “struggling to keep patients safe”.

“It is dismaying to see yet another worst month on record,” he said. “With temperatures already starting to drop, today’s data is a reminder, if one was even needed, that politicians should listen to the alarm bells ringing from every ED in the country.

“Thousands of people, loved ones seeking help, found themselves waiting on trolleys or chairs for hours on end, in conditions we know put them at risk of further harm. This cannot continue.”

He added that emergency medicine teams were already exhausted heading into winter.

“This has been our reality all year, even in the warmer months when we are supposed to get some respite. The winter surge is about to start, and I fear we are not ready for what’s to come.”

Worsening performance

Across Wales, performance against the key four-hour and 12-hour emergency targets deteriorated compared with September. Just 53.9% of patients were admitted or discharged within four hours—far below the Welsh Government’s 95% target and the lowest October performance on record.

Nearly a quarter (24.8%) of patients waited eight hours or more.

The median time spent in an emergency department was 2 hours 48 minutes—just one minute faster than the previous month—but waiting times remained significantly longer than the same period last year.

The October data also confirmed that:

96,800 people attended emergency departments in total, averaging 3,121 attendances per day.

15,300 patients were admitted after arriving at a major ED, a 3.3% rise from September.

1,493 bed days were lost due to patients stuck in hospital despite being medically fit to leave, continuing a pattern of delayed discharge blocking hospital flow.

Dr Perry said tackling hospital flow and delayed discharges must be the Welsh Government’s priority.

“Its recent announcement of funding for social care was a good first step, but we need sustained support,” he said. “Minor improvements compared to September are welcome, but they are but a drop in the ocean.”

Ambulance pressures

October also saw growing pressure across the wider urgent and emergency care system.

Ambulance response times worsened, with red-category calls, those at risk of cardiac or respiratory arrest, seeing a median response of 8 minutes 49 seconds. Purple calls, for active arrests, averaged 7 minutes 29 seconds.

September’s cancer data also showed worsening performance, with just 58.8% of patients starting treatment within the 62-day target, well below the 75% benchmark.

The Welsh Government says investment is improving system resilience

Responding to the latest figures, Cabinet Secretary for Health Jeremy Miles highlighted signs of progress from the government’s £120m recovery investment.

He said there were 43% fewer hours lost to ambulance handover delays and a 42% fall in hour-long ED handover queues compared with last year.

“I know there is more to be done,” he said, adding that Betsi Cadwaladr University Health Board had been ordered to accelerate emergency and planned care improvements.

But RCEM Wales warned that without urgent, sustained intervention, patients and staff would continue to pay the price throughout winter.

“Emergency medicine staff will step up,” Dr Perry said. “We will get through this, but, I fear, at what cost?”