Accident and Emergency units (A&E) are “places of terror” for elderly and vulnerable people, the nursing union’s congress has heard.

The Royal College of Nursing (RCN) said older people are bearing the brunt of a year-round crisis, not just the winter crisis as was previously understood. 

Reports show the target 95% of patients seen at A&E has been missed over the last 100 weeks. The RCN’s general secretary and chief executive, Peter Carter, said there is no doubt about who was being left to wait longer. “It’s not people who’ve had road accidents, subarachnoid haemorrhages; it’s elderly people with respiratory problems,” he said.

“They are the people that end up [spending] eight, 10, 14 increasingly 20 hours on the trolleys. It’s very distressing they haven’t got food, proper toilet facilities. They get very frightened and disconcerted. It doesn’t exactly fill you with confidence if you are on a trolley for hours in a corridor.”

Carter said mental health problems that are not being cared for by the community, as well as those drunk or on drugs, are being forced upon the A&E units which end up leaving the elderly waiting on trolleys for up to 20 hours.

Carter pointed blame for the loss of 5,500 district nurses (46%) since 2003 on the abolishment of the NHS Direct, which led to the loss of 300 nursing jobs. He also mentioned independent research commissioned by the RCN, which looked at 33 hospitals and found a fifth (18%) of permanent nursing posts in A&E departments are unfilled, rising to almost a quarter (23%) of posts for newly qualified nurses. 

Mark Boothroyd, from RCN’s south-east inner London branch, said: “Our hospitals are massively overstretched. They are running at 100% to 105% capacity every day...Patients are still queuing in corridors to be admitted and this is in the middle of summer when we don’t have all the seasonal illnesses of autumn and winter.”

The charity, Age UK said the results come as no surprise. Charity director Caroline Abrahams said “We know there’s been a marked rise in extraordinarily long wait times in A&E departments across the country, including cases where older people have been left on trolleys in corridors for hours, without food or water.

“So it wouldn’t be surprising if many older people see A&Es as a place of terror rather than somewhere they will be safe and well treated, this being another disturbing result of the pressures on our hospitals.

“The government’s planned £10 billion-cut in social care funding by 2020 is set to load extra pressure on A&Es. Unless policy makers act to properly resource the social care system, and ensure older people can receive the out-of-hospital support they badly need, these terrible long waits are likely to get even worse.”

An NHS England spokesman said: “England has amongst the best A&E services in the world, and patients regularly rate the quality of care as excellent, but equally there needs to be far more emphasis on helping keep older people out of hospital.”

A Department of Health spokeswoman said: “This kind of regrettable language gives the wrong picture.”

SU/HA