People needing urgent and unplanned hospital care will benefit from a new national improvement programme aimed at reducing waiting times.
The Urgent and Unscheduled Care Collaborative will see health boards adopt a number of measures to reduce A&E waiting times and improve patient experience, including offering alternatives to hospital–based treatment.
People will also be offered scheduled urgent appointments to avoid long waits in A&E. The programme will also determine how the discharge process can be simplified to ensure patients don’t face unnecessary delays in leaving hospital. Health boards will share more than £50 million of funding this year (2022-23) to support this national integrated approach with work already underway in some areas.
Earlier this week the Scottish Government’s Resource Spending Review was published, setting out priorities for the next five years, including investment and 2reform of health and social care services.
Health Secretary Humza Yousaf said: “It is absolutely crucial we ensure people are receiving the right care at the right time and in the right place. That’s why I’m pleased to confirm today’s £50 million investment to help achieve our national urgent and unscheduled care priorities.
“Our twin approach of investment and reform in urgent and unscheduled care will help boards see people who need urgent attention more quickly. For many, A&E may not be the best place for their healthcare needs and our £50 million improvement programme will offer patients alternative routes to urgent care.
“Last year 4,500 patients received care from a Hospital at Home service – without this these patients would have experienced an acute hospital stay, we are determined to build on this success.”
73.8% of attendances were seen and resulted in subsequent admission, transfer or discharge within four hours – an increase of 3 percentage points compared to the previous month, October 201
There were 103,726 attendances, a 4% decrease when compared to the previous month, October 2021
More than one in four patients were delayed by four hours or more
5,697 patients were delayed by eight hours or more, equal to 5.5% of all attendances
1,729 patients were delayed by 12 hours or more
Responding to these figures, Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said:“The reality on the ground is that many Boards are under enormous strain, as there has been a significant increase in staff absences due to the surge in covid. Staff are isolating with a positive test or due to a contact with someone with a positive test.
“Emergency Departments were overstretched prior to the new variant. But current winter pressures met with widespread staff absences mean staff are put under more and more strain on each shift which affects the quality of care provided and both the patient and staff experience alike.
“For many staff, there hasn’t been a Festive break, and they have had no rest or respite but continue to work tirelessly in Emergency Departments.
“The pressures are mounting on the health service once again. It is imperative that we are able to continue delivering vital care to patients.
“But the surge of covid across Scotland is affecting all parts of the system, not just Emergency Care.
“It is a deeply concerning situation to be in, and what concerns us most is the functionality of the health system and our ability to continue delivering urgent and emergency care to those who need it.”
NHSGGC issues urgent public A&E appeal as staff struggle to cope with demand
Amidst unprecedented and unsustainable demand on emergency services, NHS Greater Glasgow and Clyde is urging the public not to attend A&E without a very urgent or life-threatening condition and to use more appropriate services instead.
A&Es across the health board remain extremely busy, with all operating well over normal capacity which is having a huge impact on service provision.
Unless very urgent or life-threatening, patients should not attend A&E without first calling NHS24 on 111. This will ensure they are directed to the most appropriate urgent service for their needs and A&Es are safeguarded those who need them.
Commenting Dr Scott Davidson, Deputy Medical Director for Acute Services for NHSGGC, said: “Our A&Es remain open and continue to assess, treat and admit emergency patients, however they are extremely busy and staff are facing huge challenges to ensure we’re able to treat patients safely and as quickly as possible.
“We continue to see large numbers of people attending with symptoms that could be managed by speaking to a GP, local pharmacy, or, by calling NHS24 on 111 before attending A&E.
“As a result of current demand at A&E, people are facing long wait times and our staff are under severe pressure.
“There are other services geared up and ready to see and treat you. If you’ve had a slip, trip or fall, we have numerous Minor Injuries Units (MIUs) across NHSGGC which can look after you, including if you’ve broken a limb.
“GP practices across Greater Glasgow and Clyde are operating normal hours, and community pharmacies are also open to help you get the treatment you need.
“Unless very urgent or life-threatening, please do not attend our A&Es unless you are referred.”
Across NHS Greater Glasgow and Clyde there are three standalone Minor Injuries Units (MIUs) – at the Vale of Leven Hospital, Stobhill Hospital and the New Victoria ACH.
MIUs operate in a similar manner to A&Es and can take care of a vast range of injuries.
Patients who attend MIUs following a call to NHS24 are far more likely to be seen, treated and discharged quicker than if they present to an A&E. They will also be helping to protect vital frontline A&E services for those people whose lives are at risk.
16,000 additional beds may be needed for the NHS to cope this winter
The NHS urgently needs a rapid increase in bed numbers if it is to meet potential demand this winter according to new analysis from the Royal College of Emergency Medicine.
The College’s new briefing document ‘RCEM Explains: Hospital Beds’ looks at how bed numbers have declined in the past decade, the impact of covid, and the potential number of beds needed this winter, based on previous levels of demand.
The briefing uses the ratio of emergency admissions to beds to model the numbers of beds that will likely be needed, based on the levels of demand seen each winter prior to the pandemic.
In the last five years in England this figure has fluctuated between 11.07 admissions per bed (winter 2015/16) and 12.50 (winter 2018/19). Excluding the most recent winters (both of which saw demand and capacity fall due to the pandemic), there was an average of 11.77 admissions per bed.
If the NHS is to achieve a similar ratio this winter, and there are a similar number of admissions as in the winter of 2017/18, the NHS will need just over 7,500 additional beds. If demand is similar to 2018/19, then this figure rises to 15,788 extra beds.
President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “We are currently seeing record levels of attendances at Emergency Departments and if this continues into winter – an extremely likely situation – the NHS will have too few beds to be able to cope.
“The consequences of having too few beds could be dire. If we do not have the capacity to admit patients into hospitals, then A&E waiting times will go up, patients will end up being treated in corridors – a very real threat to their safety before the pandemic, but now with the added risk of hospital acquired infection – and the elective backlog will grow further as beds earmarked for surgeries will be used for emergency patients.”
The briefing also makes clear the relationship between high bed occupancy and an increased rate of cancelled elective operations.
Dr Henderson said: “Too few beds means higher rates of occupancy, which in itself puts patient safety at risk, but it is clear that this has a huge knock-on effect on elective care. Lack of beds is one of the top reasons for cancellation of surgeries and if we do not address the shortage now, before winter, the elective recovery will fail.
“We know that access to services is an issue throughout the NHS at the moment with resources short all-round, but Emergency Departments act as the safety net for the NHS – if they cannot function properly the entire system stalls – so it is vital that the new Secretary of State does all he can to enable the NHS to expand hospital capacity.
“The safe restoration of bed capacity to pre-pandemic levels is no easy fix though – as we’ve seen with the Nightingale initiative, capacity cannot be expanded if we do not have enough doctors, nurses, and clinicians.
“The capacity and staffing issues we face now have been over a decade in the making. Social care is still unfixed. Waiting lists are growing. Structural reconfiguration is in progress. Covid is less of an immediate threat but is unlikely to disappear. The Secretary of State has much to do, but he must start by making the beds.”
Accident &Emergency attendances in the week leading up to Christmas Day rose by almost 20 per cent compared to the same period last year. Across Scotland, 26,569 people visited A&E in the week ending 24th December, up almost 20% or over 4,000 attendances on the same week last year. NHS 24 also reported their busiest period in the service’s fifteen year history.Continue reading Full to bursting: Health services struggle to cope with 20% rise in numbers over Christmas
Alison Johnstone MSP, Health spokesperson for the Scottish Greens, has urged Scottish Ministers to focus on staffing after figures showed a further drop in the number of patients being seen within four hours of arriving at hospital emergency departments.
The Scottish Government target is that 95 per cent of patients are seen within four hours. Yesterday’s figures show that in December only 92.6 per cent were seen within that time, the latest month-on-month fall from a peak of 95.8 in July.
The Health Secretary says Scotland’s A&E departments are outperforming other areas of the UK.
Alison Johnstone, Health spokesperson for the Scottish Greens and MSP for Lothian, said: “Rather than comparing our hospitals to those south of the border, the Health Secretary should be striving to deliver the kind of health service Scotland wants. The seasonal drop in performance at A&E shows that not enough planning and investment went into the system in advance, and responsibility lies squarely with the Health Secretary.
“Greater effort is needed in recruitment and retention of staff, not just in A&E but in our GP surgeries and in social care, so that we minimise the need to visit and stay in hospital where possible.”
Alison Johnstone MSP, Health spokesperson for the Scottish Greens,has welcomed a review of NHS staffing as figures showed a big increase in the number of people waiting to seen at Accident & Emergency departments.Continue reading Johnstone welcomes A & E staffing review
