Tag: accident and emergency

RCEM: We have a serious problem in Urgent & Emergency Care

Emergency Department performance figures published by NHS England for June 2021 show the highest number of Type 1 attendances ever recorded, the worst four-hour performance for the month of June, and the highest ever number of total emergency admissions for the month of June.

The data show that in June 2021 1,436,613 patients attended Type 1 Emergency Departments, the highest ever figure since records began.

A total of 400,826 patients were admitted via Type 1 Emergency Departments, the highest ever recorded figure for the month of June.

Four-hour performance in Type 1 departments was 73.2% which is by far the lowest June percentage on record.

1,289 patients were delayed by 12-hours or more in an Emergency Department – almost double the figure of the previous month. It is also the highest ever recorded figure for the month of June, and almost triple the previous highest figure for June recorded in 2019.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “We have a serious problem in urgent and emergency care. We are deeply concerned. We are facing record breaking figures in the high summer. We can only begin to imagine what this winter may bring.

“We are facing record breaking attendances with a tired workforce and fewer beds; it is seriously challenging. Busy departments are a threat to patient safety, it increases the chance of crowding and corridor care, this risk is significantly increased if covid and non-covid patients are sharing the space for long periods of time.

“We ask that there is a transparent discussion about how the whole of the health service deals with the current levels of demand. Emergency care does not happen in a vacuum but is often the canary of the system. Managing demand in Primary care, the elective backlog and what is happening at the front doors of hospitals is all connected and there is urgent need for a plan that balances these needs in a way everyone can understand.

“The data show what is happening on the ground, and it is likely that things will worsen in the coming months, especially as we enter the winter. The government must realize there is a looming crisis and take swift and urgent action – this is critical ahead of Winter.

“Hospitals can only do all they can to boost capacity, in the face of serious resourcing constraints. And we would ask patients to only attend Emergency Department if they need urgent and emergency care, and seek alternative care, like from their GP or NHS 111, if they have a minor injury or mild condition.

“Despite now being in the middle of summer, our Summer to Recover: Winter-Proofing Urgent and Emergency Care for 2021 contains the necessary actions the government and the NHS can take ahead of Winter.

“If no action is taken, we may soon be in the middle of a crisis worse than any previous winter.”

Scotland’s Emergency Departments experience worst ever May performance

The latest data released yesterday by the Scottish Government for May 2021 show that attendances at Emergency Departments have risen significantly.

In May 2021 there were 112,563 attendances to major Emergency Departments across Scotland. This is a 12% increase compared to April 2021, a 24% increase when compared to March 2021, and a 45% increase compared to May 2020.

Following this increase, four-hour performance deteriorated, 86% of attendances to major Emergency Departments in Scotland were seen within four hours. 15,706 patients were delayed by four-hours or more in an Emergency Department, this is the highest figure since January 2020, and it is the highest figure ever recorded for the month of May. This means one in seven patients were delayed by four hours or more before being seen.

In May 2021, 393 patients spent 12 hours or more in an Emergency Department, this is double the figure for April 2021. This is the highest number of 12-hour delays for the month of May ever recorded, and it is more than double the previous highest May figure of 189 12-hour delays that was recorded in 2019.

Data also show that 1,680 patients spent eight hours or more in a major Emergency Department, this is an increase of nearly 50% compared to April 2021 and it is the highest figure ever recorded for the month of May.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said: “The data is deeply concerning and very much reflects what is happening on the ground. Departments are busier than ever, especially for the summer period with some record-breaking figures for the month of May, and it is becoming increasingly challenging.

“These figures come at a time when reports suggest Scotland has the highest covid infection rate in Europe. We are battling community admissions, elective care patients seeking treatment, as well as increasing covid patients attending our departments, all within the context of reduced bed-stock.

“Departments are filled with patients, some who may have covid, waiting to be seen. While long-stays alone can put patient safety at risk. This risk is increased as some patients could contract the disease in a busy Emergency Department.

“The College’s recent Emergency Medicine workforce census in Scotland revealed an Emergency Medicine workforce that was not adequately staffed to deliver the highest quality patient care in Emergency Departments in Scotland.

“We have shortages across the board, but particularly among consultants and senior decision-making clinicians. These shortages are currently exacerbated by the soaring covid infection rate, meaning there are a large number of absent NHS staff due to covid in Scotland.

“We are doing all we can to maintain flow and maximise patient safety, but the pressures are increasingly intense and are faced by the existing but short-staffed workforce that are facing continued burnout and exhaustion.

“The data show the growing demand for urgent and emergency care, Emergency Departments are where people turn to for treatment when there is nowhere else to go, so they must be adequately staffed with trained Emergency Medicine staff, properly funded, and equipped with enough capacity and resources to cope with severe demand.”

“We urgently need the Scottish Government to support the urgent and emergency care system to cope with these pressures.”

Two NHS Grampian hospitals have announced this week that they are at capacity as Covid cases rise.

Scotland was expected to move to level zero on 19 July, with remaining legal restrictions lifted on 9 August, but First Minister Nicola Sturgeon conceded yesterday that th planned dates are not “set in stone”.

She will be holding a media briefing at lunchtime today:

The Right Care in the Right Place

A&E always there for those who need it

The way people access A&E services is changing to keep patients and NHS Scotland safe this winter – making sure everyone gets the right care in the right place.

Local A&E departments remain open for those who have a life-threatening emergency. 

However, to ensure patients have the fastest access to the treatment they need, anyone with a non-life threatening condition who would usually go to A&E should now call NHS 24 on 111 first, day or night, to be directed to the right NHS service. 

If A&E is the most appropriate place to provide the right care, patients will either be directly referred to A&E by NHS 24 or a telephone or video consultation with a senior clinical decision maker. 

The remote consultation approach is designed to avoid unnecessary waits in crowded waiting areas and offer care much closer to home whenever possible. If senior clinical decision makers determine the patient needs to go to A&E, they may be offered an appointment to attend, and the team will know to expect them so they can be seen directly at that time.

NHS 24 on 111 is also there for those who need urgent medical attention but can’t wait for their GP practice or dentist to re-open.  

Those with life-threatening conditions including suspected heart attacks or strokes, severe breathing difficulties, severe bleeding, or severe injury should continue to go straight to A&E or call 999.

This new way of delivering urgent care –  which is being supported by a £20 million funding package – has been designed to help people get the right care in the right place this winter, at time when there is increased pressure on NHS services.

From December, the public are asked to:

  • use the NHS inform website to access advice on common symptoms, guidance for self-help and where to go if further medical care is needed
  • contact their local GP practice during the day for an appointment or over-the-phone advice
  • call 111 day or night when they think they need A&E but it is not life-threatening
  • call 111 and select the Mental Health Hub to access mental health advice and guidance or call the Breathing Space telephone helpline on 0800 83 85 87
  • call 111 or use NHS inform out of hours when they are too ill to wait for their GP practice to open, or for worsening symptoms of COVID-19
  • use NHSinform.scot to access the location of their local minor injuries unit for non-life threatening but painful injuries such as a deep cut, a broken or sprained ankle or a painful burn injury

Health Secretary Jeane Freeman said:

“The NHS is always there for you. However, for many of us, A&E is not the right place for the care we need. That is why we are making it easier to get the right care in the right place. From December, if you think you need to go to A&E for care that is not life-threatening, the NHS 24 telephone service on 111 will be available day and night to direct you to the care you need.

“Your GP Practice is also always there for you and can be contacted for urgent but non-life threatening conditions. However, in an emergency, you should continue to call 999 or go to your nearest A&E department.

“By doing so, we will continue to help our doctors and nurses through this pandemic, and ensure A&E provides the fastest and most appropriate care for people when they really need it. Help us keep you and our NHS safe by making the right call at the right time to access the right care in the right place for you and your family.”

More information on the Redesign of Urgent Care Programme is available online.

New Year A&E record reveals Scotland’s GP crisis

A record-breaking number of people attending accident and emergency in the first week of January is a symptom of the country’s GP crisis, the Scottish Conservatives have said. Continue reading New Year A&E record reveals Scotland’s GP crisis

NHS Lothian A&E waiting times worst in Scotland over February

Latest figures have revealed that NHS Lothian is the worst performing Health Board in Scotland for A & E waiting times. Tory health spokesman Miles Briggs MSP says it’s another example of SNP Ministers failing people in Lothian. Continue reading NHS Lothian A&E waiting times worst in Scotland over February

Health services under pressure: Flu cases are more than double last year’s figure

The number of people suffering from flu in Scotland has more than doubled compared to the same time last year. New statistics published by Health Protection Scotland (HPS) show around 46 Scots in every 100,000 were suffering from the virus during the last week in December 2017 – this compares to 22 in every 100,000 for the same week in 2016. Continue reading Health services under pressure: Flu cases are more than double last year’s figure

Full to bursting: Health services struggle to cope with 20% rise in numbers over Christmas

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

Ambulance service reports big increase in Hogmanay calls

Calls on Hogmanay were up almost 40% on last year’s levels, the Scottish Ambulance service has reported. The Service experienced a big increase in demand over Hogmanay, with Control Centres receiving 2,565 calls between 7pm on 31st December and 7am on 1st January – an increase of 38.4% compared to the same time last year. Continue reading Ambulance service reports big increase in Hogmanay calls

Contracts signed for new Sick Kids hospital

RHSC and DCN view from above alt_jpgConstruction of a major new healthcare facility is set to start after the financial contracts were agreed yesterday. The new £150 million building will see services from the Royal Hospital for Sick Children, Department of Clinical Neurosciences and Child and Adolescent Mental Health Service brought together in a modern and high-quality setting at Little France.

Construction works will start over the next few weeks and the new building, which will adjoin the Royal Infirmary of Edinburgh, is expected to open in autumn 2017.
The six storey building (including basement) will have a large atrium with a shop and café, a stunning skylight linking both hospital entrances, a helipad on the roof and a link building adjoining adult and paediatric emergency departments.
It will also bring with it an increase in single rooms with ensuite facilities and a range of new technology.
Health Secretary Shona Robison said: “This is a momentous date for this project and I’m personally very pleased that work will soon be about to begin on the new co-located Royal Hospital for Sick Children and Department of Clinical Neurosciences.
“The new development brings paediatric care, specialist neonatal care, neurosciences and adult and children’s emergency departments all together in one place, making access to services much easier for patients and health professionals alike.
“The Scottish Government is investing over £2 billion in Scotland’s health infrastructure over the spending review period, with this development being one of many that demonstrate the Scottish Government’s commitment to continually improving health services. The investment in this development will ensure the hospital campus at Little France can continue to develop as a modern hub of research and medical practice.”
Susan Goldsmith, Finance Director, NHS Lothian said: “We are delighted to have reached this point and now look forward with anticipation to seeing the new facility taking shape over the coming years.
“This is an extremely exciting time in the proud history of the Royal Hospital for Sick Children, along with the Child and Adolescent Mental Health Service and Department of Clinical Neurosciences, which will find a high-quality new home at Little France from 2017.
“The building designs have been heavily influenced by staff, patients and families and, in addition to offering a modern, light and spacious environment, will also enhance the clinical services we deliver.”
RHSC and DCN view from above_jpg
Mark Bradshaw, IHS Lothian and Macquarie Capital said: “We are excited that construction will soon start on The Royal Hospital for Sick Children and Department of Clinical Neurosciences. This state-of-the-art facility will allow the delivery of quality healthcare services to the people of the Lothian region and beyond for decades to come.
“It has been a pleasure to partner with the Lothian NHS Board and the Scottish Futures Trust to develop an innovative and competitive financing structure that will ensure value for money over the next 25 years.”
Peter Reekie, Scottish Futures Trust, deputy chief executive and director of investments said: “This is a fantastic deal for NHS Lothian and its partners, bringing investment into the Lothians and allowing construction to start on a great new building which will support many hundreds of jobs as it is built.”
Some key features of the new facility include:
  • 233 beds and 10 theatres. 154 beds in the Royal Hospital for Sick Children, 67 beds in the Department of Clinical Neurosciences and 12 beds in the Child and Adolescent Mental Health Service.
  • 11 beds will be added to the critical care department within the Royal Infirmary of Edinburgh.
  • The specifically designed family hotel will mean that the experience for families whose child has to spend time in hospital is more homely.
  • Conjoined children’s and adult Emergency Departments will mean that the most appropriate services are available to teenagers who currently do not always fit well into either service.
  • Patients in the Child and Adolescent Mental Health Service suffering from physical illness and mental health problems will benefit from the immediate availability of both specialities.
  • The Department of Clinical Neurosciences will make neurology and neurosurgery available to all age groups on a single site, meaning potentially quicker treatment is available. One advantage will be that patients who present to the Emergency Department at Royal Infirmary of Edinburgh and who subsequently turn out to need neurosurgery will no longer need to be transferred to the Western General Hospital.
  • The most modern imaging equipment within the Department of Clinical Neurosciences along with its adjacency to the Anne Rowling Regenerative Neurology Clinic and the Clinical Research Imaging Centre will allow the Department of Clinical Neurosciences to further enhance its position as a leading clinical and academic neurosciences centre.