Responding to analysis from the Scottish Liberal Democrats, which suggested that there were 871 deaths in Emergency Departments (EDs) associated with a 12 or more hour wait for admission, Dr Fiona Hunter, Royal College of Emergency Medicine Vice President for Scotland, said: “These harrowing figures show that something must change in the approach to fixing the crisis in our EDs.
“Heartbreaking doesn’t cover it. Each of these 871 people may have had families and friends who would have had to face the devastating reality that their loved one died not because they were too sick to treat, but because our hospitals don’t have the capacity to look after them properly.
“Patients enduring these long waits are often the sickest or most injured, in need of further care on a ward. But a lack of beds, driven in large part by delayed discharges, meant they had to wait in A&E – and this can go on for hours and hours.
“Almost 900 people may have paid the ultimate price for this complete breakdown in hospital flow.
“Last year, RCEM published figures for 2024, which suggested there were 818 excess deaths associated with 12 hour waits in EDs. Today’s figures suggest that the problem is getting worse, not better.
“Whoever forms the next government cannot ignore this problem. The numbers speak for themselves: more people will die, who otherwise would go home to their families, if overcrowding and long waits in ED aren’t fixed.
“Addressing the ‘back door’ blockage of hospitals must be a priority for all political parties. Only then will the needless and agonising waits, and the avoidable deaths they cause, stop.
“These are fixable issues and we encourage all political parties to make this a priority. Lives are at stake.”
12-hour waits in EDs joint worst on record for October
The Scottish government must take urgent action on overcrowding and delayed discharges, or Emergency Departments (EDs) in Scotland will be completely swamped – and patients will be the ones who suffer.
ED performance figures, released today (2 December 2025) by Public Health Scotland (PHS) for October 2025, showed that one in 16 (7,362) patients waited 12 or more hours before being admitted, transferred or discharged in that month.
That is the same proportion as last October, which was the worst since records began in 2007 for 12-hour waits.
The figures also showed:
16,659 patients, or 14.1% of all attendances, waited eight or more hours, the worst of any October on record, and an increase of 1,211 on last year
Only 62.8% of patients were seen within four hours at major (Type-1) Emergency Departments, which is the worst four-hour performance for any October since records began and far below the target of 95%
There was an average of 1,981 beds each day occupied by patients medically fit to be discharged
These figures come shortly after the publication of the Scottish government’s winter plan, in which it pledged £20m to tackle delayed discharges across the devolved nation.
Dr Fiona Hunter, RCEM Vice President for Scotland, said: “The figures for October demonstrate the unacceptable pressures our departments are under, and just how bad things are as we go into winter.
“Now, seasonal pressures such as flu are beginning to hit EDs and the system is starting to crack under pressure,which means patients and staff are suffering. And we are only in the early stages of winter so it will likely become even worse for patients if nothing changes.
“As our hospitals deal with the inevitable strains and stresses on vital resources that the colder weather brings we’ll once again see the consequences of the failure to properly tackle the issues EDs face; overcrowding, long delays and avoidable deaths.
“The number of patients experiencing the longest waits is utterly unacceptable and something must change. Clinicians, through no fault of their own, are struggling to provide our patients with the care they deserve and need.
“Last month, we welcomed the government’s £20 million funding announcement to boost social care capacity this winter, and its accompanying plan for the health service to tackle the cold months.
“This showed that the government understood the issue. But we need that understanding to translate into further meaningful short and long-term action. Urgent action is needed to ensure that health boards can make the improvements that are needed to improve patient flow and tackle delayed discharges.
“Our EDs will only get through the coldest months if the government steps in – or we all need to brace ourselves for a truly ugly winter.”
Initiative will save thousands of ambulance journeys every month
Almost £1 million is being allocated to help reduce pressures on A&E departments and improve patient flow over the winter months.
The Scottish Ambulance Service will receive £995,000 to increase staffing for a clinical hub model, which uses GPs to triage patients as calls come in to prevent unnecessary ambulance dispatches and ensure everyone gets the treatment they need.
The system was trialled successfully over a weekend in September this year and it is estimated that it could save 12,000 ambulance journeys over winter as well as safely preventing an additional 4,500 patients being conveyed to Emergency Department front doors.
The funding will also enable the expansion of patient transport hubs in areas where pressures are greatest, using Hospital Ambulance Liaison Officers who help identify and co-ordinate early discharges – reducing handover delays by keeping the flow of patients moving through the system in periods of high activity.
Health Secretary Neil Gray said: “Improving patient care over the winter months is a priority and this funding will see patients treated faster in the setting which is appropriate for them.
“The measures being taken by the Scottish Ambulance Service will help cut unnecessary ambulance dispatches and improve patient outcomes and experiences through earlier clinical intervention.
“Our winter preparations have also seen a £20 million investment for health board initiatives to increase social care capacity and relieve pressure on acute services.
“And, as the temperature drops, we continue to urge those eligible for the flu vaccine to take up the offer.
“As always I thank all our dedicated health and social care staff who continue to work tirelessly to provide excellent care to all those who need it.”
51,400 older people endured dangerous 12 hour waits in Scotland’s A&Es last year
Extreme long waits in Emergency Departments across Scotland are a political responsibility that can no longer be ignored as more than 51,400 older patients endured stays of 12 hours or more last year – the worst on record.
New analysis from the Royal College of Emergency (RCEM) reveals in major EDs, one in every eight patients (51,423) aged 60 or over waited more than 12 hours to be transferred, admitted or discharged in 2024.
That’s 14,407 more patients than the year before (2023).
And is over 16 times more people than in 2019 when just 3,135 older people endured waits of this length.
The figures, obtained by RCEM via Freedom of Information requests to Public Health Scotland, also reveal that, concerningly, the older a patient is the longer they are likely to wait in A&E.
People aged 70-79 have a 12% chance of waiting 12 hours or more – almost 16 times higher than it was in 2019.
Meanwhile, people aged 80-89 have a 16% chance of enduring extreme waits, and the likelihood rises to 19% for those aged 90 and above.
Compare that to patients aged 18-29, whose average likelihood of experiencing a 12-hour wait last year was just 2.2%.
Older patients often arrive to the Emergency Department with more complicated or multiple health issues.
This, when combined with the inability to admit them onto a ward due to the lack of available in-patient beds, means older people can become stuck in Emergency Departments – enduring extreme long waits, often on trolleys in corridors.
And when patients do finally get admitted, they often find themselves stranded in hospital, unable to go home when they are well enough to leave, frequently due to a lack of available social care support.
Public Health Scotland recently revealed that in 2024/25, there was a record 720,119 days spent in hospital by patients whose discharge was delayed – 474,153 of which were experienced by people aged 75 or over. This accounted for two out of every three (66%) delayed discharge bed days.
Dr Fiona Hunter, Vice President of RCEM Scotland, said, “This data is both shocking and shameful, and it is abundantly clear that older people are bearing the brunt of a system in crisis.
“Hundreds of thousands of dearly loved people – great-grandparents, grandmas, grandads, parents – forced to experience extreme long stays in our Emergency Departments every year mainly because we don’t have enough in-patient beds to admit them to when they need one.
“Often enduring these waits on trolleys in areas that aren’t designed to deliver care in – corridors or even cupboards.
“It’s a failure of the system. It’s unacceptable, it’s dangerous and it’s putting lives at risk.
“Enough is enough. The government can’t ignore the ongoing crisis our Emergency Departments – the workforce and patients – continue to face day in, day out.
“We all deserve an Urgent and Emergency Care system that works as it should and not letting people, our most vulnerable, down when they need it most.”
Dr Bob Caslake, Chair of the BGS Scotland Council, said, “This report highlights the urgent attention that is needed across the health and social care system to allow older people to access the care they need at the time they need it.
“The current waiting times faced by older people in Emergency Departments are unacceptable, and reducing these delays is a matter of equity, dignity, and patient safety.”
Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said, “It is disappointing that this information is not routinely collected, analysed and published and it is unacceptable to see so many older people waiting hours — sometimes days — in A&E wards for the care they need.
“These older people are often living with frailty, dementia, and multiple other health conditions. They deserve to be treated with dignity and compassion.
“Long waits for care are neither dignified nor compassionate and can also lead to serious harm. This is not the standard of care we should accept for our parents, grandparents, or neighbours.
“With the numbers of older people in Scotland in need of care expected to increase dramatically, we urgently need a system that prioritises timely treatment and supports frontline staff in delivering the respect and care our older population deserves.”
The figures come after the Royal College of Emergency Medicine published a report earlier this year looking at the care older people, aged 75 and over, receive in Emergency Departments across the UK.
Titled ‘Care of Older People 2023-24’, the research found there was insufficient screening for three common conditions which primarily affect this age group, including delirium and for general frailty.
Unacceptable numbers of people are still being exposed to extreme long waits in Scotland’s Accident &Emergency departments, new analysis by the Royal College of Emergency Medicine shows.
The data reveals for major EDs in Scotland in June 2025:
There were 119,383 attendances at major EDs, a 5% decrease from the previous month of May 2025.
69.7% of patients were seen within four hours (78,857) which is a decrease of 1.1 percentage points on May 2025 but up 1.6 percentage points on June 2024.
Those experiencing long waits also increased with more than one in every 10 patients (10.8%) attending waiting more than eight hours.
And almost one in every 20 patients (4.35%) had to endure a stay of 12 hours or more before they were treated, admitted or discharged.
Responding to the latest data RCEM Vice President for Scotland Dr Fiona Hunter said: “These figures clearly evidence that the issues in our Emergency Departments are not caused by too many people attending.
“In June the number of people coming to our departments fell, but yet performance across every measure worsened when compared to the previous month.
“Most worrying is, that despite fewer attendances, thousands of our patients are still enduing extremely long waits. And we know that those who do are more likely to be the most unwell, often with multiple and complex needs. A fact that is unacceptable, and dangerous.
“The crisis in A&E is something our communities are deeply worried about. Politicians should respond to those concerns now and address these issues. Otherwise in a few short months we will be staring down the barrel of another awful winter where patient safety will again be put a risk.”
Graphic representations of today’s data, as well as the long-term trends, are available on the RCEM Website.
Scottish Conservative and Unionist MSP for Lothian Miles Briggshas accused the SNP of presiding over “horrifying” A&E waiting times in Lothian.
Mr. Briggs’ remarks come after monthly A&E waiting times for November showed that only 58.5% of patients across Lothian were seen within the SNP’s four-hour target waiting time.
In the Royal Infirmary of Edinburgh, the figure is at a shockingly low 44.1%.
This was below the average for Scotland which sits at 65.8%.
The SNP’s own target is for 95% of patients to be seen within that time after arriving at A&E.
Lothian MSP Miles Briggs says these waits are “unacceptable” and “undoubtedly put lives at risk” and insists that the SNP have failed to give dedicated staff the resources they need to see patients quickly enough.
Mr. Briggs says that the SNP’s failures mean A&E services in Lothian are in “permanent crisis” mode and that this could “spiral out of control” over winter.
Mr. Briggs has urged SNP health secretary Neil Gray to come up with a proper plan for the health service, which ensures money gets to the frontline, rather than being wasted on pointless bureaucracy.
Scottish Conservative and Unionist MSP Miles Briggs said:“A&E waiting times in Lothian are absolutely horrifying, and this is mirrored across Scotland.
“Far too many patients are waiting too long to be seen in Lothian and that undoubtedly puts lives at risk.
“These waits are unacceptable and successive SNP health secretaries have left Lothian and the rest of Scotland without the resources to meet the demands of patients turning up in A&E.
“My constituents in Lothian are at even greater risk than other Scots – and the buck stops with the SNP government.
“A&E departments are in permanent crisis mode and as winter continues there is a real danger the waits will spiral out of control.
“These waiting times must finally be the wake-up call for Neil Gray to deliver a proper plan to support Scotland’s NHS.
“This must prioritise getting money to the frontline in Lothian and across Scotland rather than being wasted on pointless bureaucracy.”
Emergency Departments in Scotland are struggling against the combined pressures of extreme weather and a rise in hospital admissions from flu.
The Royal College of Emergency Medicine (RCEM) has described the country’s health service as being “in the depth of a winter crisis” as Scotland braces itself against snow and ice.
Yesterday, after coming under increasing pressure regarding the condition of Emergency Care in Scotland, Health Secretary Neil Gray said A&E demands had been “exacerbated by higher than normal levels of influenza infection in the community”. Data released last week showed hospital admissions caused by flu increased by 12% in a week.
The Health Secretary’s comments come as data released yesterday by Public Health Scotland revealed last November 6,429 patients waited 12 hours or more in Emergency Departments – the highest proportion of 12 hour waits for any November since records began in 2011.
Dr Fiona Hunter, Vice Chair of RCEM Scotland said: “Today’s data, and every previous month’s data, shows just how much pressure Scottish EDs were under coming into this winter.
“The system was already under extreme pressure, and this huge flu surge and cold spell are likely to be the straw that breaks the camel’s back.
“But it cannot – and must not – be blamed as the sole cause of the crisis we are currently experiencing.
“My colleagues are working flat out in very difficult conditions with some departments nearing 400% capacity- four times as many patients as there are cubicle spaces for. We are running on hard work and goodwill, and our patients are receiving unacceptable, undignified and unsafe care in corridors and in the back of ambulances.
“The main issue is that we can’t move our patients who desperately need admission to a hospital bed in to wards or high dependency units. These wards have the highest level ever known of patients who are ready to be discharged but have no available social support to allow them to do so.
“We are predictably gridlocked, in the depth of a winter crisis, and our patients and staff are the ones suffering.”
Curbing sky rocketing A&E waiting times must be the number one priority for the Scottish government with winter just around the corner.
That is the call from The Royal College of Emergency Medicine (RCEM) Scotland as A&E performance data for July represented the worst July since records began in 2011 for extended wait times in Emergency Departments.
This is double the number of people who waited this long in July last year.
The data also shows long waits have increased significantly since the 2010s.
Since July 2017, for example, the numbers of people waiting four hours or more has increased by nearly seven times (5553 to 38,379), eight hours or more by 53 times (248 to 13,146), and 12 hours or more by 279 times (20 to 5,593). This was despite attendances only increasing by 0.9% in the same period.
Delays in discharging patients is a key reason that doctors cannot admit patients into hospitals from their Emergency Departments, therefore causing long waits. In July, there were 61,165 days spent in hospital by people who were well enough to be discharged but unable to be due to a lack of social care provisions. This is equivalent to 167 years.
Dr John-Paul Loughrey, RCEM Vice President for Scotland said: “The Scottish government must take heed and put measures in place to end long wait times in our Emergency Departments.
“These staggering statistics are deeply worrying for the people of Scotland who are facing incredibly long and tiring waits despite it being summer. We have been dealing with ‘winter levels’ of pressure, which does not bode well as we start to head into the colder months. The first day of winter is just three months away, which will inevitably heap pressure on the health care system.
“Continuing to focus on diverting patients away from A&E rather than addressing the capacity problems will not avert the coming crisis. These statistics aren’t just numbers. They are people who have come to our Emergency Departments needing emergency care. They deserve better. Our health care colleagues deserve better.”
A graphical representation of the data can be found here.
This is the response from The Royal College of Emergency Medicine (RCEM) Scotland as the latest Emergency Department performance data reveals that one in every nine people waited eight hours or more to be seen in A&E last month.
The data also shows long waits have increased significantly since the 2010s.
Since May 2017, for example, the numbers waiting four hours or more has increased by nearly five times, eight hours or more by 21 times, and 12 hours or more by 89 times. Despite attendance only increasing by 0.5% in the same period.
Dr John-Paul Loughrey, RCEM Vice President for Scotland said: “It is right that the First Minister has apologised to people who have been forced to withstand treatment in corridors.
“It is unbearable for the people experiencing this loss of dignity at an already difficult time, and for the medical practitioners caring for them in impossible conditions.
“The data clearly shows that extended A&E waiting times due to overcrowding is not a new issue. It is sadly what A&E staff have come to expect.
“We once again call on the Scottish Government to take action to prevent overcrowding in Emergency Departments and the subsequent need to treat people in corridors by increasing the number of hospital beds and improving social care options so people can leave hospital when they are ready.
“I, personally, am growing weary of the inaction to rectify these longstanding issues and the resulting harms.”
“The government is duty-bound to provide the people of Scotland with safe and dignified emergency care, and now is the time to do so.”
“These figures, and our own research, clearly evidence the shameful and shocking reality of poorly patients who need to be cared for on hospital wards having to wait many hour hours, ever days, often on trolleys in corridors because there is not enough capacity in the system.
“There simply are not enough beds to admit people to, often because the people in those beds are medically well enough to go home but can’t because of inadequate or delayed social care support.
“It is not just a matter of inconvenience or lack of dignity – which is bad enough. The longer people’s in-patient admission is delayed, the greater the risk the risk to their life.
“There is no one quick fix, but the problems are fixable. RCEM is ready to work with whoever forms the next Government to begin the process of resuscitating our health system and ending these unacceptable and dangerous long waits.”
