Northern Ireland A&E doctors warn of ‘utterly brutal winter’ as emergency departments struggle
Tuesday 20 October 2026
Northern Ireland’s leading emergency doctors have issued a stark warning that hospital emergency departments are already struggling to cope, with fears that the coming winter could push services into an even deeper crisis.
A new survey by the Royal College of Emergency Medicine (RCEM) has revealed widespread concern among senior A&E doctors, with seven of the eight Northern Ireland clinical leads who responded describing themselves as either very or extremely worried about the pressures their departments will face this winter.
All eight reported that pressure in their emergency departments was already high or very high, while the vast majority said their services were unprepared for winter and conditions were worse than at the same point last year.
The findings have prompted an urgent appeal to the Northern Ireland Executive to take immediate action to improve patient safety, reduce overcrowding and free up hospital beds before seasonal demand increases.
Doctors warn of dangerous conditions
Dr Michael Perry, RCEM Northern Ireland Vice President, warned that emergency departments have been operating under sustained pressure throughout the year, leaving little capacity to cope with additional winter illnesses.
He said:
"Winter is fast-approaching. It will bring extra demand to Emergency Departments, the 'front door' of the hospital in the form of flu and other seasonal illnesses.
"What EDs need for winter is the ability to stretch to meet this demand, so that we can keep our patients safe over the cold months. But that is not the case.
"EDs have been running hot all year round, in a state of perpetual crisis, with thousands of patients left waiting more than half a day, corridor care the norm. Patients who come to us are subjected to undignified and dangerous conditions.
"This survey shows the breadth of concern among my colleagues across Northern Ireland. Politicians must heed our warnings ahead of what we worry will be an utterly brutal winter."
The warning raises serious concerns for patients attending emergency departments across Northern Ireland, including Antrim Area Hospital, where services must manage both emergency arrivals and patients requiring admission to hospital wards.
When hospital beds are unavailable, patients can remain in emergency departments for prolonged periods, reducing the space and resources available to treat new arrivals.
Urgent action demanded from the Executive
RCEM is calling on ministers and health service leaders to address problems across hospitals, rather than expecting emergency departments alone to manage increasing demand.
The College has identified three immediate priorities:
• Free up beds in hospital wards by tackling delayed discharges, allowing patients waiting in emergency departments to be admitted more quickly.
• Extend opening hours in hospital services responsible for discharging patients, helping to improve the availability of beds.
• Maintain the existing two-hour ambulance patient handover provision under the 'release to rescue' policy, rather than reducing it to 45 minutes over winter.
The recommendations reflect concerns that overcrowding in emergency departments is closely linked to pressures elsewhere in hospitals, particularly when patients who are medically ready to leave remain in beds.
UK-wide survey reveals scale of crisis
The Northern Ireland findings form part of a wider RCEM survey involving 163 emergency department clinical leads across the United Kingdom.
The UK-wide results revealed:
• 91% were very or extremely concerned about emergency department pressures this winter.
• Just 3% believed their emergency department was well prepared for the colder months.
• 67% described their emergency department as unsafe.
Dr Ian Higginson, RCEM President, said the findings exposed a deeply concerning situation across all four UK nations.
He warned:
"Overcrowding, corridor care and the impending surge of demand from winter are creating a perfect storm for EDs.
"Colleagues from across the four nations have been crystal clear: we simply are not ready for winter, and can barely manage as we are.
"We have patients lining our departments, many stuck in trolleys for hours upon hours. The sickest and most injured among them can't get into a hospital bed and end up stuck with us, sometimes for days.
"It's a disgraceful state of affairs and I cannot believe it has been allowed to get this bad."
Patient safety at the centre of winter concerns
The survey presents a troubling picture of emergency care before the expected increase in winter demand, with senior doctors warning that hospitals have little remaining capacity to absorb additional pressure.
For patients and families, the concerns go beyond longer waiting times. Overcrowded departments, prolonged trolley waits and difficulties accessing hospital beds can affect the dignity, safety and experience of people requiring urgent treatment.
RCEM's message to the Executive is that action cannot wait until winter pressures reach their peak. With emergency departments already reporting severe strain, the College wants changes across the wider hospital system now to give frontline teams a better chance of keeping patients safe in the months ahead.
