COVID-19: call for social distancing in emergency departments

Royal College of Emergency Medicine says move would help to prevent avoidable deaths

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Enforced social distancing is needed in emergency departments to ensure the safety of patients and healthcare staff, the Royal College of Emergency Medicine (RCEM) has urged.

The college published a position statement that calls for a redesign of emergency care facilities as the COVID-19 outbreak moves from a pandemic to an endemic state.

The document, COVID-19: Resetting Emergency Department Care, states there is ‘a moral imperative to ensure emergency departments [EDs] never become crowded again’, and that they do not become a source of hospital-acquired infection.

The statement lists six key recommendations:

  • Improved infection control – including a possible end to waiting rooms
  • Reducing crowding and improving safety – by only allowing referrals of non-time critical patients to emergency departments by GPs, NHS 111 or 999 screening
  • Patients already under the care of a specialist team who present with a health problem relating to that specialty should be managed through their existing team
  • Physical ED redesign – including enough side rooms for vulnerable patients most at risk of dying from hospital-acquired infection
  • Timely COVID-19 testing for best care – patients should leave the ED as soon as they are ‘ready to progress’, and should not be delayed awaiting the outcome of screening swabs
  • Metrics to support reduced crowding – NHS England should implement metrics that identify the maximum occupancy rate in EDs 

College warns against return to overcrowding in EDs

RCEM president Katherine Henderson said going back to pre-COVID-19 crowding levels would endanger staff as well as patients.

‘It was just four months ago when we were seeing overcrowding on a record scale in EDs,’ she said.

‘It was unacceptable then and put lives at risk; to go back to that now will lead to avoidable patient and staff illness or death.’

Social distancing vital in the NHS 

Dr Henderson added that changes seen in the wider society should be matched in EDs.

‘We must have a way to enforce social distancing in EDs to ensure that patients do not become infected while seeking healthcare,’ she said.

‘If supermarkets can get this right, then the very institution that people entrust with their health must do so too.’

Read the Royal College of Emergency Medicine position statement

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