The number of consultants working in A&E departments across Wales is "dangerously low" and could compromise the safety of patients, it is claimed.
A Freedom of Information (FoI) request made to all health boards by the Welsh Conservatives revealed that Wales' major hospitals are falling well short of recommended staffing levels in emergency departments.
The Royal College of Emergency Medicine (RCEM) sets a 'baseline' for the number of WTE (whole-time equivalent) consultants which should be employed in the department to guarantee safe cover.
At present no hospital is close to meeting this baseline in Wales, placing patients in potential danger.
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The most understaffed A&E units were in the Cwm Taf Morgannwg University Health Board - an area serving patients of RCT, Merthyr Tydfil and Bridgend - with all three of its major hospitals recording staffing levels between 32% and 35% of the recommended baseline. This meant it had three of the four lowest in Wales.
Merthyr Tydfil's Prince Charles Hospital only had eight funded consultants, less than half of the 18 recommended by the RCEM. The figures emerged following news that inspectors found visiting the hospital was "tortuous" for patients whose safety and dignity was put at risk, while staff were "in tears and ashamed to work".
Ysbyty Glan Clwyd in Denbighshire and Withybush Hospital in Haverfordwest also recorded under 40% of the RCEM's baseline, 34% and 39% respectively.
The below table shows the number of consultants available to staff A&E departments in the first full week of September 2021 and how they compare to the recommended RCEM baseline. FoI requests were sent the same month, but the final figures were only returned shortly before Christmas.
Health Board |
Hospital |
Recommended WTE baseline |
Available WTE |
Available baseline percentage |
Betsi Cadwaladr |
Ysbyty Gwynedd |
13.7 |
9.5 |
69% |
Betsi Cadwaladr |
Ysbyty Glan Clwyd |
15.75 |
5.4 |
34% |
Betsi Cadwaladr |
Wrexham Maelor |
15.45 |
8.46 |
55% |
Hywel Dda |
Glangwili Hospital |
8.9 |
5.18 |
58% |
Hywel Dda |
Bronglais Hospital |
2 |
1 |
50% |
Hywel Dda |
Withybush Hospital |
8 |
3.1 |
39% |
Swansea Bay |
Morriston |
24 |
13.4 |
56% |
Cwm Taf Morgannwg |
Prince Charles |
18 |
5.7 |
32% |
Cwm Taf Morgannwg |
Royal Glamorgan |
18 |
5.9 |
33% |
Cwm Taf Morgannwg |
Princess of Wales |
18 |
6.3 |
35% |
Aneurin Bevan |
The Grange |
34 |
19.75 |
58% |
Cardiff & Vale |
University of Wales |
30 |
24.42 |
75% |
Dr Suresh Pillai, vice president of the Royal College of Emergency Medicine Wales, said: "The latest figures uncovered by the Welsh Conservatives correspond with our own estimations on the shortfall of whole-time equivalent consultants in Wales. But seeing these figures officially drives home the reality of the current situation - a shortfall of over 50% of consultants in Wales, with every health board under baseline figures.
"And this does not even paint the full picture. We know there are also shortages of junior staff and trainees, SAS doctors supporting staff, and critically, emergency medicine nurses.
"Current pressures are relentless but are made even more challenging with workforce shortages. Staff are burned out, stressed, worried about the coming weeks, many are working in extremely tough conditions. They continue to work incredibly hard to ensure patients are safe and to deliver effective care.
"Yet the mounting pressures are leading to frequent ambulance handover delays, long waiting times, dangerously crowded emergency departments, and unsafe and undignified corridor care.
"The pandemic has highlighted how thinly existing staff are spread, so with the release of these figures the government must now commit to publishing a long-term workforce plan for the health service in Wales. Any workforce plan must include measures to retain existing staff as well as recruit new staff trained in emergency medicine."
Welsh Conservative and Shadow Health Minister Russell George MS said: "It's clear from these figures that A&E units remain dangerously short-staffed, and the knock-on effect is that Welsh patients are facing dangerously long waits to be seen in an emergency.
"That not a single hospital across Wales is meeting the baseline of required staffing is disgraceful and the lack of some to fund that minimum level shows something deeply wrong with in the Labour-run NHS.
"The latest statistics showed the worst-ever A&E waits on record in Wales. This autumn also saw one month where more people in Wales had to wait over 12 hours to be seen in A&E than the whole of England. This is totally inadequate and far below what the people of Wales expect and deserve.
"We know that the pandemic is putting stress on the NHS, but as overcrowded A&E services are the result of being unable to access other services like GPs, it shows a total lack of leadership from the top. Labour have lost their grip on the health service and patients and staff are paying the price."
In response, s Welsh Government spokesman said: “All health boards have put in place plans to deal with winter pressures and the pandemic, which includes ensuring emergency departments are staffed by a multi-disciplinary workforce to meet the expected demand.
"Staff illness and Covid-related absences have had a significant impact on staffing levels in recent months, but we are committed to ensuring accident and emergency departments have significant numbers of staff to ensure safe care for people.
"Earlier this month we announced record levels of more than £260m for training healthcare professionals in Wales. The investment for 2022/23, which is a 15% increase from 2021/22, will see the highest ever number of training opportunities in Wales.
"It will be the eighth consecutive year funding to support health professional education and training in Wales will increase.
"This shows our commitment to training the next generation of healthcare workers and providing the necessary resilience and capacity to NHS Wales.
"We expect our accident and emergency to be very busy over the winter period and would urge everyone to Help US, Help You by considering how they access care.
"Your local pharmacy and the 111 online service can provide advice for minor illnesses and ailments."
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