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Interactive game dares us to make it as an A&E staff member for a day

With winter being a pressure point for A&E departments across the UK and NHS efficiency coming under scrutiny every year, specialist solicitors Bolt Burdon Kemp reveals ‘Crisis Point: A Day in A&E’, an interactive multiple-choice simulation putting the user in the shoes of various A&E staff. Measuring users’ performance in the same way as real-life A&E wards are assessed, the interactive game dares us to answer a daunting question: Would we survive working in an A&E for 24 hours?

Face the daily A&E pressure and try to earn a high score

‘Crisis Point: A Day in A&E’ will give users a chance to experience one of the busiest departments in the NHS. They will tackle the pressure of a typical day in A&E across two 12-hour shifts, making key patient, staffing and procedural decisions in the process. The aim is to see, admit, treat and discharge as many patients as possible in one day.

Taking turns as four types of medical professional – staff nurse, senior sister (or senior charge nurse, the male equivalent), junior doctor and consultant (with a brief stint as a paramedic) – users will be faced with challenging judgement calls and a variety of medical decisions. Their success will be measured against the strict 4-hour target set by the government, whereby 95% of all patients in A&E need to be assessed, and then treated, admitted or discharged within four hours of entering the department.

Scoring will be based on a simplified version of the OPEL system. NHS trusts started introducing the OPEL system two winters ago to understand the pressures hospitals are under. It divides the status of A&E departments into four coloured levels: level 0 (green) means the department is operating within government targets, while level 3 (black) means the department is in a critical condition that threatens to actively harm patients. Levels 1 (yellow) and 2 (red) are in-between.

First-hand accounts from A&E staff

Following yearly headlines surrounding the NHS winter crisis, the interactive campaign explores the underlying issues of A&Es, based on the real-life accounts of staff working in emergency care. The campaign aims to raise awareness of the brave work undertaken by A&E personnel across the country and the many challenges they face day-to-day.

Insights from their first-hand accounts reveal a dire picture. While staff resolve to put patient care first, pressure from within the system often makes their job harder: ‘If you start to lose sight of the people we’re trying to help – if you see them as a number, you’re seeing them as an inconvenience. The two can’t run together and provide an exceptional service because an exceptional service is patient-centred’, one nurse said. Another staff member described ‘running NHS like a business’, when it should be a ‘scheme to help people’.

Issues in the NHS

Several of the issues revealed from the interviews conducted with A&E staff were used as inspiration for the challenging decisions throughout the game. Some of those include:

  • Increased number of patients: Over the last five years, patient numbers in A&Es have risen 7.3%, which equates to almost 3,000 extra people every day.[1]
  • Problems with NHS funding: Despite increased funding, A&Es struggle to tackle the winter crisis, in part because winter funding tends to be released as late as November.[2]
  • Government targets: The 4-hour target for assessing, treating or discharging 95% of patients is currently suspended by NHS England, as hospitals have not met this since July 2015.[3]

Further highlighting the challenges within A&E, the interactive piece will reveal the potential cost of an unsatisfactory result, with the help of a built-in calculator. Based on recent figures, NHS hospitals get fined £600m a year, with the country’s largest trust alone bearing a fine of £53 million.[4]

The interactive game ‘Crisis Point: A Day in A&E’ can be found here:


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