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Consultants from accident and emergency departments across Wales have written to the First Minister saying "safety is currently compromised in all of our departments to an unacceptable level".

A total of 46 doctors from across the six health boards in Wales have signed the letter that highlights problems which they say are happening on a daily basis and say the situation in Wales is worse than it is in England.

It follows a similar letter from health boards across the UK to Theresa May last week highlighting the “appalling” and “intolerable” state of hospital A&E departments.

They write: "The letter sent to the Prime Minister mentioned the many reports in the media of how appalling the situation has become in many departments.

"The EDs in Wales are no exception – indeed, in some ways the situation is even worse.

"The 4-hour target figures for our best performing hospitals are similar to those from some of the worst performing hospitals in England."

They go on to apologise to "patients for being unable to provide the safe and efficient emergency service we wish to" and thank "all of our staff for their dedication and hard work under extreme conditions".

The doctors say:

More patients in the Emergency Department (ED) are waiting for ward beds than the ED can actually accommodate, with no space to see any newly presenting patients

Staff arriving for shifts to find the patients they cared for the previous day (and often the day before) still in the ED

Makeshift arrangements are made to accommodate extra patients in hospitals, often with not enough staff

Staff are in tears at work as they do not feel they can deliver the care their patients need

EDs in the precarious position of having nowhere to treat a newly presenting critically ill patient

Multiple ambulances waiting outside every ED, with a knock-on effect on WAST’s service delivery to the Welsh public

(Image: Richard Williams)

The letter says: "We feel compelled, as our colleagues in England did, to speak out in support of our hardworking and dedicated nursing, medical and allied health professional colleagues, and to share the very serious concerns we have for the safety of our patients.

"Safety is currently compromised in all of our departments to an unacceptable degree. This is despite the enormous efforts made by our staff to keep patients safe in extremely challenging circumstances.

"We do not dispute that great effort was put into winter planning for NHS Wales at both Welsh Government and Health Board level. Unfortunately, our experience from the clinical front line is that these plans have fallen well short of what was required to maintain adequate care for our patients.

"We acknowledge that our Health Boards are doing everything they can to create capacity and more beds in the short term, and we are grateful to them for their continued assistance in such a time of crisis. We also acknowledge the help and support given to the Emergency Departments by our colleagues in other specialties and disciplines across our hospitals.

"We appreciate the financial constraints under which the Welsh Government must operate. However, we feel that the current situation demonstrates that both the Welsh NHS and Welsh social care are severely and chronically under-resourced. We have neither sufficient staff, nor sufficient beds (in either acute hospitals or the community) to cope with the needs of our ageing population.

"As you will know, a number of scientific publications have shown that crowded Emergency Departments place patients at increased risk. This risk (in terms of both increased morbidity and mortality) increases in line with the amount of time patients spend in the ED after their initial treatment is complete.

"The letter sent to the Prime Minister mentioned the many reports in the media of how appalling the situation has become in many departments. The EDs in Wales are no exception – indeed, in some ways the situation is even worse. The 4-hour target figures for our best performing hospitals are similar to those from some of the worst performing hospitals in England."

They add: "Recruitment and retention of staff in Welsh EDs has been a particular challenge over the last few years. As a direct result of the relentless pressure our EDs are under, we are now seeing a worrying number of talented medical and nursing staff leaving a specialty they love, to pursue careers in other areas of the NHS or overseas.

"We acknowledge the collaborative efforts made by the Royal College of Emergency Medicine, Wales Deanery and the Welsh Government to find a solution to address this problem. However, if we are unable to rectify this soon, then the situation will deteriorate further with every coming winter."

The group are calling for a significant increase in Social Care Funding, a review of the number of hospital beds that are available for acute care, abolishing the Welsh Government's four-hour breach exclusion criteria and prioritisation of a workforce strategy to improve recruitment and retention.

One of the signatories, Dr Tim Rogerson, a consultant in emergency medicine at Newport's Royal Gwent Hospital, told the BBC: "We're on our knees as far as emergency care [is concerned].

"We have patients coming into emergency departments that are already full."

He added: "There's good evidence that if patients are seen in emergency departments which are crowded, that are full, their treatment is delayed.

"That can actually cause an increase in the length of stay, it can make their illness more severe and in some cases it can cause death, so for safety and patient care we're very, very worried."

Health Minister Vaughan Gething recently said that plans are in place to try to ease winter pressures, but there has been huge demand.

He told WalesOnline: "For all the plans we have made, some of the pressures over-topped some of the plans and reasonable assumptions we made."

The full list of signatories