The Society for Acute Medicine (SAM) in Wales is calling on all political parties to make urgent reform of acute and emergency care a central focus as the 2026 Senedd election next month (7 May) draws closer.
Recent work from partner organisations has highlighted the severe consequences of front-door overcrowding and dangerous delays. The Royal College of Emergency Medicine’s Wales report on long waits and associated excess mortality emphasised the real harm caused by prolonged delays to care, with over 900 excess deaths linked to long A&E waits last year.
The RCEM’s accompanying Wales election manifesto further set out priorities for improving urgent and emergency care – but SAM Wales emphasises that this challenge does not stop at the doors of A&E.
Acute medical units (AMUs) and same day emergency care (SDEC) services are also operating under extreme pressure, with many SDEC units routinely “bedded down,” preventing them from functioning as intended.
“Overcrowding is not solely an emergency department issue. Our AMUs and SDECs are equally affected, and patients experience delays and poorer outcomes across the whole front door of our hospitals,” said Dr John Hounsell, SAM’s representative in Wales.
Whole system problem driven by social care delays
As highlighted in the Royal College of Physicians (RCP) Wales 2026 election manifesto The road to recovery, the most significant barrier to improving hospital flow remains the inability to discharge medically fit patients due to gaps in social care capacity.
Dr Hounsell explained: “Until social care reform becomes a genuine political priority, hospitals will remain gridlocked. Patients who are ready to go home cannot leave, downstream beds stay full, and this pushes risk and delay directly onto AMUs, SDECs and emergency departments.”
Workforce: A pressing challenge across Wales
SAM Wales supports calls for a long-term workforce plan. Staffing pressures are acute in rural areas of North and West Wales, where services rely heavily on multidisciplinary teams including advanced clinical practitioners and physician associates.
“Safe staffing underpins patient safety, but it also underpins staff morale and retention. Wales needs a credible plan that supports every member of the acute care workforce, with structured career pathways in acute medicine,” said Dr Hounsell.
Digital modernisation must be joined-up and clinically usable
Many acute medical services in Wales continue to rely on paper notes and drug charts. SAM Wales warns that digital transformation will only succeed if systems are fully interoperable and backed by real-time IT support.
“Digital tools must help clinicians deliver care, not slow them down,” added Dr Hounsell. “We need modern, connected systems and responsive IT teams who can address issues the moment they arise.”
A call to every party ahead of the 2026 Senedd election
SAM Wales urges all parties to make concrete commitments to:
- Reduce overcrowding across ED, AMU and SDEC
- Deliver meaningful social care reform and reliable discharge pathways
- Invest in a sustainable, multidisciplinary workforce
- Modernise digital infrastructure with strong, practical support.
Dr Hounsell said: “These challenges are shared across the four nations but Wales has the opportunity in 2026 to take decisive action. We cannot afford further years of overcrowding, avoidable harm and exhausted staff.”