Twenty-four hours in A&E is now “no longer a documentary”, leading medics have warned, as figures show almost 400,000 patients spent a day or more in an emergency department in England last year.

The Royal College of Emergency Medicine (RCEM) said the very long waits are a “matter of national shame”.

Figures uncovered by the college and shared with the PA news agency show 399,908 people waited 24 hours or more in an emergency department in England in 2022-23.

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The college warned there could be a similar situation this year, with Dr Adrian Boyle, its president, cautioning that patients are coming to avoidable harm as a result of long waits.

“We know that long stays in emergency departments are harmful,” Dr Boyle said.

“There is good scientific data that shows that once people spend more than about six hours, and they need to be admitted into hospital, actually their mortality starts to get worse.

“I think it should be a matter of national shame that we have these very long waits for admitted patients.”

He said people caught up in the long waits are “often elderly and vulnerable”.

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Political parties urged to end overcrowding

The RCEM has made a number of calls to political parties in its general manifesto, including:

• To end overcrowding in emergency departments, including by ensuring there are enough hospital beds to prevent people being stuck in emergency departments when they need a bed on a ward.

• More funding for social care to prevent a system where people who no longer need hospital care can be discharged when ready.

• More emergency medicine staff to deliver “safe and sustainable care” and for more work to retain current staff.

• More data to be published on hospital performance.

• A call to “resource the NHS to ensure the emergency system can provide equitable care to all”.

Record number attend A&E

A record number of patients attended A&E in England in 2022-33, 25.3 million, up 4% from the previous year, according to figures released last week.

The data also shows 71% of people spent four hours or less in A&E in 2022-23.

The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours, with further improvements expected the following year.

An NHS England spokesperson said: “This data relates to last year and winter, when services were facing record demand, industrial action and a twindemic of COVID and flu, but since we published our urgent and emergency care recovery plan in January we have seen significant improvements.

“Thanks to the hard work of NHS staff Category 2 ambulance response times are now an hour faster than in December, A&E four-hour performance is up from 69% to 73%, and the proportion of patients waiting 12 hours in A&E is down a sixth.

“We know there is more to do, which is why we set out our winter plans earlier than ever before this year, expanding care ‘traffic control’ centres, delivering additional ambulance hours and extra beds to boost capacity and reduce long waits for patients, and other initiatives like same day emergency care units and virtual wards which can mean patients are able to get the care they need without an unnecessary trip to an emergency department – this is better for them, and means A&E staff can continue to prioritise those with the most urgent clinical need.”

One of Hong Kong’s principal financial regulators, the Securities and Futures Commission (SFC) has vowed to step up efforts to combat unregulated cryptocurrency trading platforms in its jurisdiction.

According to a Sept. 25 announcement, the SFC said it will publish a list of all licensed, deemed licensed, closing down and application-pending virtual asset trading platforms (VATPs) to better help members of the public identify potentially unregulated VATPs doing business in Hong Kong. 

The SFC said it will also keep a dedicated list of “suspicious VATPs” which will be featured in an easily accessible and prominent part of the regulators’ website.

The new rules come immediately in the wake of the ongoing  JPEX crypto exchange scandal, an affair which local media outlets are describing as one of the worst cases of financial fraud to ever hit the region. JPEX stands accused of promoting its services to Hong Kong residents despite not having applied for a license in the country.

Speaking at a Sept. 25 press briefing on the new rules and the JPEX scandal, Kit Wilson, the SFC’s director of enforcement explained that due to “evasive” behavior from stakeholders and unsatisfactory responses to requests for information, JPEX was placed on their alert list in July 2022.

Wilson shared that the SFC then launched a complex investigation involving multiple parties across a range of jurisdictions, which escalated in April 2023 after the organization received its first official investor complaint.

“In June 2023, an AMLO (Anti-Money Laundering Ordinance) came into full effect. At that time enforcement commenced a more formal fraud investigation. As a result of that investigation we issued a formal warning on Sept. 13 and referred the matter to the police.”

The financial fallout from JPEX is estimated to reached around $178 million at the time of publication, with local police havi received more than 2,200 complaints from affected users of the exchange. 

A total of 11 people including crypto influencers, YouTubers, and employees of the allegedly fraudulent crypto exchange have been taken into custody for questioning.

Related: Troubled crypto exchange JPEX applies for deregistration in Australia

In a statement, the SFC said the resulting fallout from JPEX “highlights the risks of dealing with unregulated VATPs and the need for proper regulation to maintain market confidence.”

The regulators added that it would be working with local police to establish a dedicated channel for citizens to share information on suspicious activity and potential legal breaches by VATPs, as well as better investigating the JPEX incident to help “bring the wrong-doers to justice.”

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