New data released yesterday (5 March 2024) for Scotland reveals January was the worst month on record for people waiting to be seen in A&E.
The figures published by Public Health Scotland show that, in January 2024:
41,161 (38%) patients waited over four hours in major Emergency Departments, a 21% increase compared to last January (33,962)
17,077 (16%) of patients waited eight hours or more in Emergency Departments, almost 13 times higher than in January 2016 (1,338)
8,402 (8%) of patients waited twelve hours or more in Emergency Departments, the largest amount for any January since records began and 36 times higher than in January 2016 (232).
There were 1,866 beds occupied due to delayed discharges, an increase of 53 compared to December 2023.
Dr JP Loughrey, Royal College of Emergency Medicine Vice President for Scotland said: “This is beyond exasperating. Most people attend A&E in desperate need – to be seen by a medical professional quickly and with dignity.
“Already struggling, patients are having to endure overcrowded waiting rooms and corridors – for hours. If admission is required, they must wait for a bed – for hours.
“This latest data makes for grim reading, and it is incredibly demoralising for my colleagues to be working under such strenuous circumstances.
“They are working all out to put patients first whilst also having to carry the burden of working in an underfunded, overcrowded, and at times unsafe emergency care system. We need intervention from the Government and policy makers to ensure we never reach this nadir again.”
The data also reports:
In January 2024, there were 108,427 attendances at major Emergency Departments in Scotland. This is marginal decrease of 0.25% compared to the previous month.
62% of patients were seen within four hours at major (Type 1) Emergency Departments. This is the worst four-hour performance for any January since records began.
This is a decrease of 0.5 percentage points compared to December last year and a decrease of 3.2 percentage points compared to January 2023.
41,161 (38%) patients waited over four hours in major Emergency Departments. This is a 1% increase compared to December last year (40,763) and a 21% increase compared to January 2023 (33,962).
The number of patients waiting more than four hours has increased by more than three times compared to January 2016 (9,808).
17,077 (16%) patients waited eight hours or more in Emergency Departments.
The proportion waiting this long has increased by 2% compared to the previous month, December 2023 and has increased by 2.3% compared to the previous year, January 2023.
The numbers waiting more than eight hours is almost 13 times those in January 2016 (1,338).
8,402 (8%) of patients waited twelve hours or more in Emergency Departments
This is the largest amount for any January since records began.
The proportion waiting this long has increased by almost 1% compared to December last year and has increased by more than 1% compared to January 2023.
The numbers waiting more than 12 hours is 36 times those in January 2016 (232).
There were 1,866 beds occupied due to delayed discharges, an increase of 53 compared to December 2023.
‘We must not normalise crisis or celebrate small improvements – our patients and our members deserve more.’That is the response of the Royal College of Emergency Medicine to the latest A&E performance data.
Yesterday (14 December 2023) two sets of data published by NHS England, have been released: the latest Urgent and Emergency Care (UEC) Daily Situation Reports 2023-24 (also known as Winter Sitrep); and monthly A&E performance figures for November 2023.
While there have been some small signs of improvement in certain areas the overall situation remails extremely challenging with A&E departments declaring critical incidents this week, clinicians describing things as the worst they have experienced and ambulance chiefs expressing serious concerns about the pressure their service is under.
The most recent Winter UEC Sitrep data which covers the period 4-10 December 2023 paints a worrying picture with bed occupancy running dangerously high at almost 95% (the level considered ‘safe‘ is 85%) and two-thirds of ambulances not meeting the 15-minute target to hand over patients.
There was a small uplift in the number of beds available within hospitals, but these do not appear to have helped to ease pressure elsewhere in the system, and there remain thousands of patients, who are well enough to go home, but have not been discharged – occupying beds which are needed for other people.
The November performance data reveals that last month more than 144,000 people who visited an A&E within the month were there for more than 12 hours – the target is four hours.
Reacting to these figures, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “While the data suggest a marginal improvement compared to last year, it’s just deja-vu and we must not allow this permacrisis to become accepted as ‘normal’.
“Ambulances are queueing outside A&Es, Trusts are declaring critical incidents, patients are facing dangerously long waits in overcrowded and uncomfortable A&Es. Conditions are intense and difficult for staff, and the experience of patients is distressing and undignified.
“Clinicians are doing their very best, despite the circumstances, to deliver optimal and compassionate care, and mitigate any potential risks to patients but it is taking its toll on them too.
“It is welcome to see small increases in bed numbers, but it is not enough and patients continue to endure long waits.
“Significant and urgent action is required now to address these issues – this is what our members and their patients need and deserve.”
Data in detail:
The latest Urgent and Emergency Care Winter sitrep data for week ending 10 December (week 4 of publication for 2023/24) published today by NHS England show:
Bed occupancy levels at Trusts with a major A&E (Type 1 acute Trust) was 94.9%.
There were 99,497 beds open at Trusts with a major A&E, 1,521 more than the same week last year.
The Government promised that by winter 2023/24 there would be 5,000 more beds open when compared to October 2022 (97,287). For this week, there was an increase of 2,210 Type 1 beds compared with October 2022.
On average, one third of ambulance handovers involved a delay of over 30 minutes, while only one third of patients arriving at A&E were handed over within 15 minutes as per national guidance.
On average, 46,929 patients occupied a bed for more than seven days at a Trust with a major A&E.
On average, 384 beds were general and acute beds were occupied by patients with flu.
On average, 12,927 patients remained in hospital while no longer who were ready to be discharged.
There was an average of 49,020 daily staff absences at Trusts with a major A&E.
This is 7,547 fewer than the same week last year.
Published today (14 December 2023) by NHS England, the latest A&E performance figures for November 2023 show:
There were 1,385,701 attendances to major A&Es (Type 1 EDs) in November 2023. This is a 1.97% decrease compared with the previous month.
In November 2023, 144,085 patients waited 12-hours or more from their time of arrival. This accounts for 10.9% of all major A&E attendances in November. This means that more than one in 10 patients waited 12-hours or more.
The four-hour target at major A&Es stood at 55.4%, this is the fourth worst four-hour performance on record and the lowest so far in 2023.The aggregate four-hour target stood at 69.7%, the lowest so far in 2023. This is 6.3 percentage points lower than the Government’s intermediary threshold target of 76% to be hit by March 2024.
42,854 patients waited 12 hours or more from decision to admit (DTA) to admission. This is a 4% decrease when compared to the previous month. It is a 13.2% increase when compared with November 2022.
Beds data for October 2023 show bed occupancy stood at 94.8%.
Data show there were 98,844 Type 1 General & Acute beds available. This is an increase of 1,473 beds from October 2023 (97,371). And an increase of 1,636 beds from November 2022 (97,208).
Since it was announced in January 2023 that 5,000 new beds would be made available by winter 2023/24 compared with October 2022 (when there was 97,287 beds available), there has been an increase of 1,557 beds.
There were 396,755 emergency admissions at major A&Es. This is a 1.19% decrease since the previous month (401,523). This is the second highest number of admissions so far in 2023.
Latest data show that more than 4,000 patients faced 12-hour delays in Scottish A&Es as RCEM calls on the Scottish government to increase bed numbers and avoid ‘devastating winter’.
In September 2023, there were 113,864 attendances at major A&Es in Scotland.
66.50 % of patients were seen within four-hours at major A&Es (Type 1 EDs)
38,114 (33.5%) patients waited over four-hours in major Emergency Departments, this is a 1.7% increase from the previous month and a 2.3% decrease from September 2022.
This is a decrease of 1.4 percentage points from the previous month.
The number waiting more than four-hours has increased by 145.5% compared with September 2019 (15,526).
11,788 (10.4%) patients waited eight-hours or more in an Emergency Department
This is an increase of 1.1 percentage points from the previous month, and a 1.5 percentage point decrease compared with September 2022.
The number waiting more than eight-hours has increased by more than eight times (701%) compared with September 2019 (1471).
4263 (3.7%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred.
This figure has increased by 0.4 percentage points from the previous month. And has decreased by 1 percentage point compared with September 2022.
The number waiting more than 12-hours has increased by 14 times (1307%) compared with 2019 (303).
There were 1,811 beds occupied due to delayed discharges, the second most for any September on record.
Commenting on these data, RCEM Scotland Vice President, Dr John-Paul Loughrey said:“As we head into winter, we expect many people to attend A&Es with a multitude of conditions and illnesses, and many of them will require admission to hospital for further care.
“It is vital that with this clear expectation comes the necessary winter planning to resource A&Es, and support both clinicians and their patients through the colder months.
“We are concerned that the Scottish government’s winter plan fell short of delivering what is needed ahead of what will likely be a difficult period for emergency care.
“We desperately need to see an increase in bed numbers. This will help to reduce the dangerously high levels of bed occupancy, reduce long and dangerous delays in A&Es, and help to ensure patients are admitted to a bed more promptly.
“We continue to engage with the Cabinet Secretary and his team in good faith and raise the concerns of our members.
“To avoid what could be a devastating winter, we again urge the Scottish government to heed our calls to adopt our priorities to #ResuscitateEmergencyCare.”
The data come as figures obtained through Freedom of Information requests revealed that nearly 4,000 people faced 24 hour waits in Scotland A&Es in the six months up to June this year.
As Dr Loughrey said: “24 hours in A&E belongs on TV, not in daily reality for patients and staff”.
More than TEN TIMES as many people waited over 12 hours in Scottish A&Es in August 2023 than in August 2019 – an increase branded ‘dangerous and shameful’ by the Royal College of Emergency Medicine.
The figure has been calculated using data published yesterday (3 October 2023) by Public Health Scotland and reveals how many people visited a major Emergency Department in Scotland in August 2023.
116,673 people visited a major Emergency Department in Scotland – almost 6,000 more than the previous month (110,854).
67.90% of patients were seen within four-hours at major Emergency Departments.
This is a decrease of 1.7% from the previous month.
37,415 patients waited more than four-hours in major Emergency Departments, which is a 9.8% increase from the previous month and an 5.3% decrease from August 2022.
10,793 (9%) patients waited eight-hours or more in an Emergency Department
This is an increase of 2% from the previous month. But a 1.9% decrease compared with August 2022.
3,847 (3%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred
This figure has increased 0.9% from the previous month, but decreased by 1% compared with August 2022.
There were 1,797 beds occupied due to delayed discharges, the most for any August on record.
Responding to the figures, Dr John-Paul Loughrey, RCEM Vice President for Scotland, said: “When you compare figures month-on-month you only get a snapshot of what is happening, but when you take a longer view it reveals the bigger, much more concerning picture.
“To think that in just three years we have seen the percentage of people experiencing extreme waits increasing so significantly is shocking.
“But worse than that it is shameful, and it is dangerous. We know long waits increase the risk of people dying.
“The system is stretched to beyond capacity. Nobody wants to be in this situation – not patients and certainly not clinicians. And this should not be blamed on the pandemic – it is symptomatic of a much wider issue.
“In the short term, we need decisive and urgent action from the Scottish Government to avert what is looking like an inevitable winter A&E crisis, but we also need and effective long-term strategy to reverse this unacceptable situation.”
LOTHIAN MSPs have spoken out following a critical report on safety issues at the Royal Infirmary of Edinburgh at Little France. Inspectors reported safety concerns following visits to the hospital’s A & E Department in February and subsequent follow-ups.
Conservative Lothian list MSP Miles Briggs said: “These are very serious concerns in regards to overcrowding at Royal Infirmary of Edinburgh and the fire safety risk it creates.
“The A&E department at the hospital has been running over capacity for a number of years now, with SNP Ministers showing an ability to make any progress.
“Patient and staff safety must be the number one priority at the RIE and urgent improvements must be made.
“I have written to NHS Lothian to ask for further details and a timetable for when these improvements are being made .”
Labour list MSP Foysol Choudhury added: “It is incredibly disappointing and worrying that inspectors raised numerous serious concerns about safety in the A&E department at Royal Infirmary Edinburgh (RIE).
“Constituents in Edinburgh need to be sure that they can safely attend hospital for care and treatment. Instead, patient safety, care and dignity were called into question.
“This is terrifying for those patients in the region who need to be able to rely on and trust the A&E department should they ever need it.
“I’m very concerned that our hardworking NHS staff may also be put in danger by this crisis in the NHS, with concerns raised over staff wellbeing at RIE. Our hospital staff work incredibly hard to provide the best service possible.
“Patients at RIE and their relatives spoke highly of the compassionate care they received from staff. “This makes it all the more disappointing that staff and patients alike are being affected by 16 years of SNP incompetence.
“Staff and patients are crying out for help. Will the new Health Secretary answer their call and reverse years of damage done by Humza Yousaf when he held the post?”
NHS Lothian says the concerns expressed in the report are already being addressed. Alison Macdonald, nurse director at NHS Lothian, told the BBC the HIS visit came at a time of “unprecedented pressure” on the hospital.
She said: “We accept and acknowledge the findings of the HIS report and we sincerely apologise to patients for longer than usual waiting times in the emergency department and a poorer experience of care.
“We had already begun our own improvement work when the inspectors carried out their first visit.
“When they returned for their follow-up, it was clear to see that improvements had already been made, but more was required. We are now focused on our improvement and safety action plans.”
HEALTHCARE IMPROVEMENT SCOTLAND’S REPORT
HEALTH watchdog Healthcare Improvement Scotland carried out an unannounced inspection to the Royal Infirmary of Edinburgh, NHS Lothian on Monday 20 to Wednesday 22 February 2023 using our safe delivery of care inspection methodology.
During our inspection, we:
inspected the ward and hospital environment
observed staff practice and interactions with patients, such as during patient mealtimes
spoke with patients, visitors and ward staff (where appropriate), and
accessed patients’ health records, monitoring reports, policies and procedures.
As part of our inspection, we also asked NHS Lothian to provide evidence of its policies and procedures relevant to this inspection. The purpose of this is to limit the time the inspection team is onsite, reduce the burden on ward staff and to inform the virtual discussion session.
On Tuesday 14 March 2023, we carried out an unannounced follow-up visit to the Royal Infirmary of Edinburgh to establish if concerns we raised during our initial visit had been addressed.
On Thursday 16 March 2023, we held a virtual discussion session with key members of NHS Lothian staff to discuss the evidence provided and the findings of the inspection.
As a result of serious concerns about patient safety within the emergency department identified during this inspection we wrote to NHS Lothian to formal escalate our concerns in accordance with level 1 of our escalation process in the Healthcare Improvement Scotland and Scottish Government: operating framework.
A copy of the letter has been published with this report.
Summary of our findings
At the time of inspection, the Royal Infirmary of Edinburgh, like much of NHS Scotland, was experiencing a significant range of pressures including increased hospital admissions, increased pressures in the emergency department and admission units and reduced staff availability. During our onsite inspections the hospital was operating at over 100% capacity.
In ward areas, senior managers were visible, wards were generally calm and well organised and we observed good leadership and care being delivered. Patients and relatives spoken with described a good experience of care and helpful staff.
During the safety huddles we attended, we observed a strong focus on patient care needs across the hospital. However, serious patient safety concerns within the emergency department were identified during this inspection.
Inspectors raised a number of serious patient safety concerns regarding the emergency department during both our onsite inspection and return visit regarding the delivery of fundamental care for patients, patient safety, care and dignity, the current operating environment, leadership and coordination of care in the emergency department, as well as concerns about staff wellbeing.
Other areas for improvement identified during the inspection include the management of intravenous fluids, medicine administration processes, locked doors policies and procedures, and feedback to staff following incident reporting.
NHS Lothian senior managers responded quickly to concerns raised during the initial inspection. However, during our return visit on 14 March 2023, we remained concerned that the immediate actions put in place by NHS Lothian did not lead to significant improvements in the delivery of safe and effective care within the emergency department.
This resulted in us writing a formal letter of non-compliance to NHS Lothian in accordance with level 1 of our escalation process, setting out the serious patient safety concerns that required immediate action.
NHS Lothian promptly responded to this escalation, providing a detailed plan of improvement action to address each of the concerns. We will seek assurance on progress with planned improvement actions in accordance with our published inspection methodology.
This inspection resulted in five areas of good practice, three recommendations and 13 requirements.
RCEM launches campaign to resuscitate Emergency Care as polling reveals the public’s lack of confidence in UK government’s policies to tackle the crisis
The Royal College of Emergency Medicine has outlined five priorities for UK governments to tackle the crisis in Emergency Care, after polling carried out by Ipsos on behalf of the College found 59% of respondents expressed a lack of confidence that the UK Government have the right policies to tackle long patient waiting times in A&E departments in hospitals.
The campaign launches amid the worst Emergency Care crisis on record, as reflected in A&E performance figures across all four-nations.
Five Priorities for UK Governments to #ResuscitateEmergencyCare lays out what UK governments must focus on to tackle the crisis, improve patient care, retain staff, and prevent harm.
The five priorities are:
Eradicate overcrowding and corridor care for patients
Provide the UK with the Emergency Medicine workforce it needs to deliver safe care
Ensure our NHS can provide equitable care to emergency patients
Focus on evidence-based interventions to tackle overcrowding
Introduce meaningful and transparent metrics to facilitate performance and better outcomes for patients.
More patients than ever before across the UK are facing long and dangerous waits. It has been widely reported that crowding, corridor care and long waiting times for patients in Emergency Departments are associated with patient harm and patient deaths.
The public are acutely aware of the issues and pressures in A&E departments, with an Ipsos poll, commissioned by the College, showing that:
Nearly half of those polled by Ipsos expressed that they did not feel confident they would be treated in an appropriate area if they personally had a medical emergency in the next week that required them to attend their local A&E.
Meanwhile, two-thirds did not feel confident that a hospital bed would be available if they personally had a medical emergency in the next week and needed to be admitted to hospital.
Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “There can be no denying it; the Emergency Care system is failing and not functioning as it should.
“We can argue about numbers and calculations of excess deaths or we can work together and take the urgent and necessary action to prevent any further harm or deaths occurring. Patients and staff are rightly concerned, they deserve to see honesty and meaningful action from our political and health leaders. This is our plan to tackle the crisis.
“The roots of the problem lie in the lack of adequate capacity in hospitals, lack of staff, and lack of social care in the community. Since 2010, more than 29,000 beds have been removed from the system despite the increasing complexity of population healthcare needs.
“While for many years, social care has faced devastating cuts, meaning patients medically ready to leave hospital do not have the support they need to leave – so they reside in hospital for longer than they should preventing others from being admitted.
“The inability to discharge patients and the inability to admit patients is causing severe exit block – our hospitals are completely gridlocked, meaning Emergency Departments are becoming dangerously crowded and patients are facing extremely long waits.
“These delays and crowding impact heavily on the existing workforce, which has been stretched to its limit for too long. There are significant shortfalls of staff in Emergency Medicine; Emergency Departments across the UK are not safely staffed and the public recognise that.”
Polling shows that just 18% of respondents surveyed agreed their local A&E had enough staff to care for them in a timely way while just 23% expressed agreement that their local A&E had enough staff to care for patients in a safe way.
Dr Boyle said: “Clinicians are doing all they can and what they can to bridge the gap between an under-resourced system and the quality of care patients require, but it’s plain as day to anyone that we have too few staff.
“We are in a dire place right now, but it is fixable. We know what needs to be done to tackle the crisis and improve patient care, but this requires sustained and continued cross-party political willingness and investment to engage with the issue and tackle it root and branch.
“Our campaign to resuscitate Emergency Care shows the way forward for governments, with five key priorities to address. The first priority must be on improving flow through our hospitals to end corridor care and overcrowding.
“UK governments must open more staffed beds, where safely possible, and run hospitals at no more than 85% bed occupancy. In tandem with this, UK governments have been right to invest in community and social care but this can no longer be short-term; we need sustained expansion, resource and funding for social care to ensure patients are discharged safely and promptly when their medical care is complete.
“There must also be recognition of the impact of the crisis on the workforce, they do excellent work, but they cannot continue to flirt with burnout or this will lead to burn away. UK governments must urgently work to retain our highly-skilled frontline clinicians – but they must feel supported, listened to and valued.
“Lastly, performance is at an all-time low and metrics are currently documenting a failing service. Together with the expansion of capacity and resourcing of social care, we must see a renewed effort to improve performance and meet the four-hour waiting time target in Emergency Departments.
“We cannot afford to be in a performance vacuum any longer, metrics must have meaning and drive improvement and better patient care. In England, this must start with monthly publication of 12-hour waits from the time a patient arrives – as it is in the rest of the UK – rather than the misleading and dishonest current metric which measures 12-hours from the time a decision to admit a patient is made.”
Humza Yousaf must be sacked for ‘dangerous negligence’, Scottish Labour MSP Sarah Boyack has said, as the party revealed that the number of patients waiting over 12 hours to be seen in Accident and Emergency in Lothian has soared.
Statistics have shown that, in the year from November 2021 to October 2022, a shocking 15,936 people in NHS Lothian spent more than 12 hours in A&E waiting to be seen – despite an SNP government commitment to see 95% of patients within four hours.
This figure has spiralled in recent years, with the number of people waiting more than 12 hours now around 18 times higher than the same period in 2018/19.
With A&E services in disarray and the situation only worsening throughout the winter, Scottish Labour is warning that lives will be lost due to the SNP-created A&E crisis.
Scottish Labour MSP Sarah Boyack said: “The facts are plain for all to see – NHS Lothian’s A&E services have been plunged into a deadly freefall by Humza Yousaf’s dangerous negligence.
“Despite the efforts of hardworking staff, the number of patients spending a shocking 12 hours waiting in A&E has soared this year.
“The SNP’s mismanagement of our NHS is putting lives at risk – we urgently need a real plan to put a stop to this chaos and protect services in Lothian.”
The Scottish Conservatives are also calling for Yousaf’s sacking. A spokesperson said: “With each passing week, Humza Yousaf continues to preside over complete chaos in our A&E departments.
“His tenure as Health Secretary has been nothing short of a disaster and Nicola Sturgeon must sack him immediately.”
Number of A&E patients waiting more than 12 hours:
Responding to the latest Emergency Department performance figures for Scotland for September 2022 Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said:“The situation as we enter winter is dire. Month-on-month, more and more patients face longer and longer waits – that we know are associated with patient harm and even death.
“Emergency Medicine staff and our paramedic colleagues are doing all they can to ensure the urgent and emergency care system continues to function and patients continue to receive care. We want to thank health care workers for their hard-work and diligence at this incredibly challenging time.
“We know that patients are deeply worried about the crisis. Emergency Medicine staff are worried too, distressed that they are unable to move patients through the hospital or take in patients from ambulances to the Emergency Departments.
“The difficulty in discharging patients from hospital when they are medically fit to be discharged is causing exit block in hospitals. The lack of social care is preventing these patients from being discharged.
“This is leading to a lack of flow throughout the hospital and leading to long waits in Emergency Departments, long waits in ambulances outside Emergency Departments, and long waits for an ambulance in the community.
“The Scottish Government must get a grip of this crisis and urgently boost the social care workforce, only then will we be able to discharge patients, free up beds and reduce these long waits throughout the system.”
“These are the second worst data on record. Too many patients are waiting too long. We know long waits contribute to patient harm. In August over 29,000 patients waited over 12 hours after a decision to admit was made, with some patients waiting up to three days for a bed.
“We think the consequence of this is shown in the ONS data as 500 excess deaths a week. We must not accept these long stays as normal. We need to see leadership and meaningful action that gets to grips with this crisis.
“We urge the new Prime Minister, Liz Truss, and incoming Health and Social Care Secretary, Therese Coffey (above), to make tackling the crisis in Emergency Care a priority.
The scale of patient harm occurring is shocking. The Emergency Care system is failing to its core functions; it is vital that we mitigate the impact of this crisis ahead of winter and do all we can to keep patients safe and reduce these dangerous waiting times.
“The Prime Minister and Health Secretary must urgently bolster the social care workforce. Thousands of beds are occupied by patients who are medically fit to be discharged, but the lack of social care service means that getting patients home is a slow and complex process.
“This means that hospitals have difficulty in discharging patients in a timely way, leading to exit block, poor flow throughout the hospital and subsequent problems in Emergency Departments and ambulance waits. The need for investment in social care couldn’t be clearer.
“Staff are exhausted, overwhelmed and in the midst of the worst crisis the NHS has ever faced. Widespread shortfalls of staff across all grades and departments mean health care workers are spread increasingly thinly and more prone to burnout – there are currently around 130,000 vacancies in the NHS almost 10% of its workforce.
“The Prime Minister must deliver the fully funded long-term NHS workforce plan that the government pledged to deliver in 2019. Emergency Care is in crisis and there is a shortfall of 2,000-2,500 Emergency Medicine consultants and widespread shortages of vital nursing staff, trainees, SAS doctors and junior and supporting staff are contributing to the challenges.”
There were 1,304,378 attendances at major Emergency Departments
There were 1,988,779 total attendances at all Emergency Care facilities
28,756 patients were delayed for 12 hours or more from decision to admit to admission
This is the second highest number of 12-hour waits on record, just 561 short of the previous record in July 2022
There have now been 178,770 12-hour waits (from decision to admit to admission) so far this year
Four-hour performance at major Emergency Departments was 58.0%, this is the second worst four-hour performance on record, the lowest was recorded the previous month, July 2022
More than 2 in 5 patients were delayed by four-hours or more
Type 1 admissions stood at 350,618 (a daily average of 11,310)
130,528patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)
Bed occupancy stood at 92.8% (far higher than the recommended 85%)
‘this should ring alarm bells to all political and health leaders’ RCEM says
Responding to the latest Emergency Department performance figures for Scotland, Dr John-Paul Loughrey, Vice Chair of the Royal College of Emergency Medicine Scotland, said:“The latest Emergency Department performance figures for July should ring alarm bells to all political and health leaders.
“These are the worst performance figures since records began, with over 4,000 patients waiting 12-hours or more in major Emergency Departments in Scotland – equal to nearly one in every 25 patients.
“The depth and scale of this crisis is deeply concerning. Patients are already coming to harm, a consequence of long and dangerous waiting times. These data must be a call to action, especially as winter is fast approaching.
“The government must urgently expand capacity where safely possible; we know there is a shortfall of 1,000 beds in the health system in Scotland. The Scottish government and local authorities must also bolster the social care workforce. Good social care underpins an effective health service.
“Ensuring the timely discharge of patients, which relies on good social care, is crucial for freeing up beds, admitting patients and encouraging flow throughout the hospital.
“Lastly, we must see a long-term workforce plan for the NHS in Scotland. Staff have been pushed to the brink; burnout and distress are leading to health workers considering leaving the workforce.
“We must do all we can to retain staff as well as look to recruiting new staff into the health service. Without the workforce, more and more patients will face longer and longer waits and come to further harm.
“Our priority is patient safety and delivering effective care, that is only possible with a workforce that is not overwhelmed, not burnt out and not undervalued.”
