Tag: crisis

Stopping “haemorrhaging” of crucial NHS staff must be an urgent priority, says BMA Scotland

‘Sticking our heads in the sand – or using the NHS as a political football to exchange snappy soundbites – will not cut it anymore‘

The number one “quick fix” priority for Scotland’s NHS as we move into 2023 must be the retention of our invaluable healthcare professionals, the chair of BMA Scotland said today (Wednesday, Dec 28th).

Dr Iain Kennedy said any plan for further recruitment, investment in the systems and aspirations of improvement will “fall flat on its face” unless there is a laser like focus on keeping the experienced staff our NHS already has.

Dr Kennedy, who was speaking as he delivered his annual festive message for doctors, added that the need for an open discussion on the NHS is now greater than ever.

His renewed call for a national conversation on the future of the health service comes as BMA Scotland shares more than 100 testimonies from doctors about what working in the NHS is like at the moment and their concerns for what the future holds.

Comments included:

  • “There have been a number of critical incidents in the last six months involving unsafe staffing levels. The acuity of the workload has increased. Patients are generally getting sicker and more complex, but we have less resources or time to care for them. It’s hard to keep them safe. I wouldn’t want to be an inpatient at the moment, and hope everyone in my family remains well for the foreseeable.”
  • “It feels unsafe – because it is. It’s not safe for patients, and it’s not safe for staff either. I have gone from being a passionate committed GP to being a shadow of my former working self. I want to leave the profession and I am devastated by this.”
  • “Things are very bad. Chemotherapy can only be delivered four weeks after seeing a consultant because of a chemotherapy nurse shortage. Radiotherapy preparation scans can only be done two weeks after seeing a consultant because of lack of radiotherapy staff/physicists – and it’s another two or more weeks before radiotherapy can actually be delivered.”

Dr Kennedy said: “The NHS is haemorrhaging crucial staff – staff who we urgently need now more than ever before – and the government must step up to stop it. They can talk as much as they want about recruitment of staff, of investment in the system or of plans for improvement, but every single one will fall flat on its face unless there is a laser like focus on keeping the staff we have.

“That is why the retention of healthcare professionals – keeping them in the service – needs to be the number one priority in terms of the quick fixes to help us just make it through this winter with the NHS in Scotland somehow intact.

“I desperately want to be optimistic and forward looking, to set out some hope for the future – for the medical profession that I am so proud to be a part of, and the Scottish health service that I am equally proud to work in.

“But it’s not easy to find that indication of a brighter future – especially after reading the, frankly, harrowing comments from some of my NHS colleagues about what they are experiencing day in, day out. No one working in the health service would give me any credibility if I gave an upbeat description of the way our NHS will, or can, get better and how the working conditions of those caring for the people of Scotland will miraculously improve.

“All the statistics tell us that it’s a desperate state of affairs. Things are as bad, or worse, than they have ever been. Winter is a meaningless term now – this entire year has been winter.

“But looking beyond the statistics, looking at the people behind the statistics, the picture being painted is even more grim and concerning. The experiences my colleagues have shared speak louder than anything I could say, and anything any official stats could imply.

“We face crises across workload, workforce, working conditions, pay and pensions – all of these are hitting efforts to retain doctors, which we are already short of across both primary and secondary care. Hospitals have too many vacancies – indeed the current vacancy rate for consultants alone is 14.32% – and GP practices are falling over, with the Scottish Government not even close to being on target to deliver their promised 800 additional GPs by 2027.

“In the face of everything else pay and pensions are – incredibly – fairly quick fix issues. The government can make a decision to improve pay for NHS workers. And the UK Government can finally once and for all sort out the pension taxation issues that penalise senior doctors across primary and secondary care and force them to cut hours or face massive and unexpected bills.

“These two things will make a difference in staff retention – junior doctors will feel more valued and be more likely to stay in the NHS instead of looking to move abroad where they will be paid more and have a better work life balance.

“Senior doctors will be less likely to reduce their hours and more likely to work waiting list initiatives if they know they won’t receive a huge tax bill for doing so. We are beyond crisis point now – urgent action is needed to save our NHS and that simply must focus on investing in the workforce.

“Looking beyond that, of course we need to finally get a proper long-term workforce plan in place. But even more fundamentally we need, as a whole society, to grasp the nettle, face up to hard truths that have been brushed under the carpet for too long, and have a proper grown up, depoliticised national conversation about the future of the NHS in Scotland.

“Sticking our heads in the sand – or using the NHS as a political football to exchange snappy soundbites – will not cut it anymore.

“It’s clear we need to reflect on what we ask of our NHS and the levels of funding we, as a country, are prepared to provide to meet those asks, and to ensure the health service stays true to its founding principles and remains free at the point of delivery. The current approach of pushing insufficient resources harder and harder, then blaming staff when standards fall has failed and is failing patients every single day. I know doctors across Scotland are suffering moral injury as a result.

“Let’s stop putting healthcare workers in the impossible and insidious position of having to constantly be apologising and being the bearer of bad news.

“We need politicians on all sides to be brave and act – by bringing us together and finally actually properly talking about a plan for a future NHS we can all confidently get behind. And a better NHS will be better not just for Scotland’s doctors, but for the many people who rely on it for care.”

Health crisis in NHS Lothian can no longer be ignored, warns Boyack

More than 90 dentists withdrew from NHS Lothian dental list from 2021 to June 2022, a Freedom of Information request submitted by the Scottish Labour has revealed.

Sarah Boyack warns of a health crisis as waiting times for A&E and NHS dentistry continue to spiral, while delayed discharges have gone up.

Scottish Labour’s FOI request revealed that between 2021 and June 2022, 92 dentists withdrew from NHS Lothian dental list. As at beginning of June this year, out of the 163 general dental practices in Lothian, only 51 confirmed that they are accepting patients, with some accepting children only.

Since 8th May 2022 and up until 11th  December, there has been only one week during which the percentage of people seen within Scottish Government’s 4-hour target was above 70 per cent – in the week ending 11th December more than 1,756 people were stuck in A&E for more than four hours – only 63.6 per cent of those attending NHS Lothian’s emergencies were seen within 4 hours. In the same week, 353 people were stuck in A&E for more than 12 hours.

This comes as the recent monthly report on delayed discharge shows rates in NHS Lothian for October 2022 soaring to 1,644 compared to 1,420 in September 2022.

This makes NHS Lothian the second-worst performing health board in Scotland, only topped by NHS Greater Glasgow and Clyde, with 3,848 delayed discharges in October 2022.

October recorded the highest average number of beds occupied per day due to delayed discharges in Scotland since the current guidance came into place in July 2016.

Scottish Labour MSP for Lothian Sarah Boyack said: “Another month, another set of damning statistics from NHS Lothian.

“On top of the cost of living crisis, which is taking its toll on people’s mental and physical health, we see piling pressure on our NHS, worsening patients outcomes and huge waste of public money.

“With the freezing cold, people will get sick and they will require care. That’s why we need support to GPs to allow them to respond to the rising demand and handle cases, whenever possible, at primary care level.

“These are not just figures – it is someone’s dad, friend or life partner; it’s the NHS staff who is overworked and underpaid; it’s the people who left our health service because they simply couldn’t cope.

“With a general election approaching, now is the time focus on what really matters and make a difference for millions of people.”

‘Focus on simple solutions’ RCEM says, as patients continue to face long waits amid crisis in Scotland

Responding to the latest weekly Emergency Department performance figures in Scotland Dr John-Paul Loughrey, Vice President of The Royal College of Emergency Medicine Scotland, said:

“We are deeply concerned about this winter; the crisis continues to escalate. Patients continue to face exceptionally dangerous long waits. We estimate that one in 72 patients waiting between eight to 12-hours in an Emergency Department can die as a result of these waiting times (30-day all-cause mortality).

“But these are data, the reality is Emergency Departments are overcrowded and in extremis. Patients with an array of different needs and care are packed in, facing high-risk and uncomfortable waits on trolleys in corridors. There is a lack of privacy, a lack of dignity, staff are stretched thinly meaning patients find it difficult to get the things they need – be it food or water or bathroom facilities, while they wait hours for a bed. Meanwhile, ambulances queue outside our Emergency Departments with more patients waiting to simply get in.

“Emergency Medicine staff and ambulance crews and paramedics are highly skilled, highly trained competent professionals, but the inability to move patients through the system means they are overstretched and overwhelmed, and unable to provide the high-quality care that they are trained to provide. Patients are worried and anxious, staff are increasingly distressed, unable to provide the real care that they want and should be providing.

“The solutions are simple; bolster the social care workforce to ensure the timely discharge of patients; tackle the recruitment and retention crisis among all health workers; increase capacity by opening an additional 1,000 beds in the acute system across Scotland. These will begin to address the root of the crisis.”

Addressing the concern around Strep A and the increase in attendances at Paediatric Emergency Departments in Scotland, Dr JP Loughrey said: “In recent weeks we have seen a marked increase in the number of children attending our Paediatric Emergency Departments, cases of Strep A remain high.

“We know parents are worried at this time. The College has issued advice and guidance together with the Royal College of Paediatrics and Child Health and the Royal College of General Practitioners.

“Emergency Departments remain open to those who need it. If children have symptoms, or parents are unsure, please seek care first through NHS 24, your GP or local pharmacist. If the symptoms are severe or your child’s condition worsens, do not hesitate to seek the necessary emergency care. We are here to help.”

Scotland’s latest weekly Emergency Department performance figures show:

  • There were 25,450 attendances at Emergency Departments
  • Four-hour performance stood at 63.4%, the fourth lowest on record
  • 9,314 patients waited more than four-hours in an Emergency Department
    • More than one third of patients were waiting for more than four hours in an Emergency Department
  • 3,048 patients waited more than eight-hours in an Emergency Department
    • Nearly one in eight patients were waiting for more than eight-hours in an Emergency Department
  • 1,276 patients waited more than 12-hours in an Emergency Department
    • One in twenty patients were waiting more than 12-hours in an Emergency Department

Charity warns of looming educational crisis for deaf pupils in Scotland

  • Teachers of the Deaf numbers in Scotland have fallen by 40% in a decade The fall in numbers is twice that of other parts of the UK
  • Almost half (45%) are due to retire in the next 10 years
  • Deaf young people in Scotland are twice as likely as their hearing classmates to leave school with no qualifications and half as likely to go on to university

Thousands of deaf children across Scotland are not getting the support they need in school after a 40% fall in the number of specialist support teachers for deaf children over the last decade, the National Deaf Children’s Society is warning.

A new report published by the Consortium for Research into Deaf Education (CRIDE), also shows that Teachers of the Deaf numbers in Scotland have fallen at twice the rate compared to other parts of the UK. In addition, around 45% of Teachers of the Deaf in Scotland plan to retire over the next 10 years – so unless action is taken urgently things will only get worse.

Teachers of the Deaf play a vital role in supporting the language and communication development of deaf children. They give advice to families of newly identified deaf children, visit deaf children at school or college – to give them any extra help they need – and provide guidance to mainstream teachers and schools on deaf awareness and inclusion.

However, as the number of fully qualified Teachers of the Deaf in Scotland has fallen, increasing numbers of deaf children are missing out on this support.

Families of deaf children have told the National Deaf Children’s Society that in some areas their local Teachers of the Deaf have too big a caseload to work with deaf learners on a one-to-one basis.

The charity is calling on local authorities across Scotland to commit to returning qualified Teacher of the Deaf numbers to 2011 levels over the next decade.

The National Deaf Children’s Society also wants the Scottish Government to develop and deliver a Scotland-wide workforce strategy for Teachers of the Deaf, and to ensure they are properly paid for the extra responsibilities they take on, in recognition that their specialist expertise is valued.

Such a workforce strategy will involve fully funded places being available for teachers wanting to study for the mandatory qualifications, so a new generation of Teachers of the Deaf can be trained to replace those who are leaving.

Without this, the charity warns deaf children will continue to fall behind and the gap between them and their hearing classmates’ risks becoming wider.

Gemma, from Fife, whose 13-year-old daughter Megan is deaf, described her Teacher of the Deaf asan “absolute necessity” who quickly solves any issues.

She said: “We are a hearing family and although my daughter’s hearing needs are not as big as other young people’s, the Teacher of the Deaf has helped validate my daughter’s past experiences, educate myself on my daughter’s needs and empower her to be confident in the school.”

Mark Ballard, Head of Policy and Influencing for Scotland with the National Deaf Children’s Society, said: “Every deaf child in Scotland should, as a fundamental right, be able to get the support they need from a fully qualified Teacher of the Deaf to help them reach their full potential. We are very concerned that these new figures show a 40% fall in the numbers of qualified Teachers of the Deaf in Scotland, twice the decline in other parts of the UK.

“With the right support in place, deaf children can achieve anything their peers can, but sadly, this simply isn’t happening. The latest Scottish Government statistics show they’re twice as likely to leave school with no qualifications and half as likely to go to university.

“That’s why we want to see a commitment from local authorities and the Scottish Government to work together to return the number of fully qualified Teachers of the Deaf employed across Scotland to the 2011 level, over the next ten years.”

Mr Ballard pointed out that a lack of funding means many teachers in Scotland who want to become a qualified Teacher of the Deaf must often cover the costs themselves.

He added: “There are great courses available to give teachers the extra skills and knowledge they need to become qualified Teachers of the Deaf, but we must make sure the funding and incentives are in place to support teachers to undertake the training.”

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Homeless Project Scotland to hold peaceful protest this morning

“It is said that the mark of a civilised society is how we treat our most vulnerable citizens; what does this say about our society?“

Homeless Project Scotland are holding a peaceful protest outside the Glasgow City Chambers in George Square this morning at 10:00 am.  

A spokesperson for the campaign group explained: “The aim of the peaceful protest is simply to demonstrate to elected members that Homeless Project Scotland’s call for a building will not be ignored. Our soup kitchens are now becoming a service operating 7 days per week and are attracting over 200 members on average. 

“We have asked Council Leader Susan Aitken and Scotland’s First Minister to bring our most vulnerable and those experiencing homelessness in doors to have warmth, care, compassion and nourishment that is essential to us all to survive. The time for talking is over. It is now the time to cut the keys. 

“We are hearing time after time from people on social media outlets that we are bringing people into the city centre, in actual fact it is the council.

“Since 2020 the council has had 4 Glasgow Hotels all located walking distance from our current unit under the Central Station Bridge and indeed, the removal of dinner from these accommodations is, among the cost of living and the COVID-19 pandemic, to a sharp incline. Poverty is now becoming the fastest spreading epidemic and we need action now. 

“Our peaceful assembly is welcome for everyone to come and partake in and is potentially going to the circuit Scotland’s Streets.

“Homelessness is not invisible, these are people, it is ridiculous that in this day and age that people are pushed to choose heat or eat. There is a tenfold increase in the number of service users we are seeing and a tenfold increase in the number of street outreach clients. 

“It is said that the mark of a civilised society is how we treat our most vulnerable citizens; what does this say about our society? “

There will be refreshments and a good old fashioned Scots Broth Soup for those in attendance.

Aberlour Children’s Charity seeks urgent assistance as fund for disadvantaged families runs out 

·        Aberlour Children’s Charity is launching a new national ‘Poverty Relief Appeal’ on Monday, 14th November to secure donations for its Urgent Assistance Fund 

·        The Fund, which provides cash for essentials such as food, bedding, clothing and heating, is currently closed to new applications due to extreme demand during the cost-of-living crisis

·        In the last eighteen months, the Fund has awarded over £1M to struggling families in Central Scotland – the most of any Scottish region

Aberlour Children’s Charity, one of the largest Scottish children’s charities, is launching a new national fundraising drive to secure critical donations for its Urgent Assistance Fund, which provides vital financial support to the most disadvantaged families in Central Scotland.  

Following the Covid-19 pandemic and amid the cost-of-living crisis, the charity has had to close the Fund, which delivers cash grants, typically within 48 hours, for essentials such as food, clothing, and energy costs, to new applications. 

Over 12,000 people across Scotland have received grants from Aberlour worth £1.44 million since April 2021.   

In the Central Belt*, 2,862 grants have been made since April 2021, supporting 9,377 individuals. The average grant value awarded is £373.36, and the most requested item that families are seeking to buy with grants from the Urgent Assistance Fund in the region is clothing, followed by food, bedding and then money towards utility bills.

Aberlour’s new Poverty Relief Appeal launches today – Monday, 14th November – across national TV, radio, press and digital.

The TV advert follows seven-year-old ‘Emma’ whose normal family life is turned upside down as they struggle to cope with the financial pressures of the cost-of-living crisis. We see an empty wall where a radiator once stood followed by an empty plate once filled with nutritious food, and, eventually, Emma looks into a bedroom with no bed as she prepares for another night sleeping on the floor.  

SallyAnn Kelly, Chief Executive at Aberlour Children’s Charity, said: “This is one of the most challenging periods families have faced in decades and Scotland’s poorest children face a dark, cold winter. 

“The worst-off families in our communities can simply no longer afford to put the lights on, heat their homes, put food on the table, or buy basic necessities for their children such as a bed or bedding.  

“Every penny donated to Aberlour goes directly to families and our Urgent Assistance Fund has been a vital means to many. However, the reality is that we are only able to help one out of four existing applications and, unfortunately, the Fund is now closed to new applications until we can secure more donations.

“Christmas is a time when families struggle more than any other. As the cost-of-living increases daily, the impact could be devastating, and we are asking anyone that is in a position to contribute – however big or small the amount – to donate via our website to support those in need.”

Chloe Taylor, support worker for Aberlour based in Glasgow, added: “We work daily with families who have always lived normal lives but sadly the impact of the Covid-19 pandemic and the cost of living crisis has created extreme stress in the household.

“When there are so many families looking for support, it can be very easy to be forgotten, so initiatives and financial support such as the Urgent Assistance Fund are absolutely vital for struggling families in the Central Belt.”

Aberlour’s Urgent Assistance Fund can provide immediate relief to families with children (aged 21 and under) who are suffering extreme hardship.

Money is paid straight to families who apply via a sponsor (health professional, social worker, teacher, third sector organisation, clergy or other professional). 

Donations to Aberlour’s Urgent Assistance Fund via:

www.aberlour.org.uk/povertyrelief 

Information on the Urgent Assistance Fund: www.aberlour.org.uk/get-help/urgent-assistance-fund

RCEM: Emergency care ‘in dire crisis’

Devolved governments call for more cash for NHS pay

The UK Government has been urged to increase the amount of funding available for NHS pay.

Ahead of the Autumn statement, Scottish Health Secretary Humza Yousaf and Welsh Health Minister Eluned Morgan have written to UK Health Secretary Steve Barclay to ask for additional funding to help avert strike action this winter in the NHS.

The letter reads:

“We wanted to write to you in advance of the Chancellor’s Autumn Statement on 17th November to once again make the case for additional funding for our hardworking NHS staff.

“In recent weeks the Deputy First Minister of Scotland and the Welsh Government Minister for Finance and Local Government have written to His Majesty’s Treasury to make clear the need for additional funding for public services.

“The Royal College of Nursing have announced a sweeping legal mandate for industrial action across the UK. In Scotland, they have joined several other unions representing NHS staff in gaining a legal mandate for industrial action with ballots expected to confirm a mandate in the rest of the UK.

“The risk to the NHS of industrial action this winter is profound, and we all need to do all we can to avert industrial action in any form. The NHS across the UK continues to feel the effects of the pandemic as it recovers and remobilises, and any action is likely to have catastrophic effects in all parts of the UK.    

“We are experiencing a cost of living crisis and the anger of NHS staff is entirely understandable. Sky rocketing inflation combined with high interest rates, a direct result of the havoc caused by the UK Government’s mini-budget, means that we are simply unable to come close to matching the expectations of NHS staff across the country. While the support provided by the UK Government on areas such as support for energy bills is welcome, it has not gone nearly far enough.

“Media reports suggest that the Chancellor is considering reimposing austerity on the people of the UK again, for which there is no mandate, through extensive spending cuts. That would be a disaster for our public services, including the NHS, at a time when they need more investment, not less.

“We would therefore implore you to work with us to make the case to the Chancellor in advance of his Autumn Statement for increased funding for the NHS and the devolved governments as a whole, primarily to pay our hard working NHS staff a fair pay rise in the face of the cost of living crisis this winter, and avoid what could be catastrophic industrial action in the NHS.”

Responding to the latest Emergency Department performance figures published by NHS England for October 2022, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “The crisis in Emergency Care is dire. October saw nearly 44,000 patients face a 12-hour DTA wait – we know 12-hour waits measured from decision-to-admit are just the tip of the iceberg and hides the reality.

“We know far more patients wait for 12-hours measured from their time of arrival. NHS England and the Department of Health and Social Care will still not commit to publishing this data, despite it being collected by all Trusts. We believe this is a barrier to tackling the root of the crisis.

“We know excessively long waits and dangerous crowding are associated with patient harm and increased risk of mortality. Scientific studies have shown that there is one death for every 67 patients waiting between eight and 12-hours from their time of arrival in the Emergency Department.

“The ONS continue to report worryingly high excess mortality figures and we believe that dangerous crowding, long delays, and the crisis in urgent and emergency care are contributing to a significant proportion of these excess deaths.

“We are increasingly concerned about the winter and the health system’s ability to cope. We are already at 94.3% bed occupancy for all general and acute beds and each month patients face the longest waits on record. The system is failing in its core function – the quick and effective delivery of emergency care.

“We need meaningful action now – sticking plasters like setting up tents or handover units will do nothing to resolve these long-waits and may actually cause more harm to patients. We know we need to be able to admit patients, we know ambulances need to handover patients quickly, we agree that it is vital that ambulances must return to Urgent and Emergency calls in the community – but to achieve this we must tackle the issue of poor flow in our hospitals.

“Many patients in hospital no longer meet the criteria to reside, they are occupying beds to which we could be admitting patients. Around 13,000 people are in hospital unable to be discharged. We urgently need an effective social care workforce to help with the discharge of these patients, so we can admit patients, receive patient handovers promptly, and get ambulances back out to the community.

“It is crucial that those in power understand that this is not a demand issue, attendances are not causing crowding and long waits. Crowding and long waits are a consequence of the inability to move patients through the hospital, a consequence of patients who are unable to be discharged because of severe cuts to social care.

“If you can’t discharge patients, beds are indefinitely occupied and the whole system is blocked. The government must get a grip of the social care crisis to fix flow.”

Commenting on the news that the RCN have voted in favour of strike action, Dr Adrian Boyle said: “In Emergency Medicine there is a retention crisis, particularly amongst our nursing colleagues.

“Emergency Medicine nurses are a critical part of the workforce – EM is a team sport. We know and understand that many EM staff, including nurses, are burned out, exhausted and overwhelmed.

“They are skilled, competent professionals who deliver excellent care for our patients. It is vital that our nursing colleagues feel valued and appreciated.”

The latest Emergency Department performance figures published by NHS England for October 2022 for show:

  • There were 1,399,916 attendances at major Emergency Departments
    • This represents a 7.5% increase compared with September 2022, and a 1.7% increase compared with pre-pandemic levels (October 2019)
    • There were 2,000,493 attendances at all Emergency Care facilities
  • 43,792 patients were delayed for 12-hours or more from decision to admit to admission
    • This is the highest number of 12-hour waits on record
    • It is 520% higher than the same month last year, October 2021, and it is 5932% higher than October 2019
    • There have now been 255,334 12-hour DTA stays recorded so far in 2022 – three times as many as were recorded in the 137 months prior to 2022
  • Four-hour performance at major Emergency Departments was 54.8%, this is the worst four-hour performance on record
    • This is a 7.1 percentage point decrease from October 2021, and a 19.7 percentage point decrease compared with October 2019
  • Type 1 admissions stood at 366,964 (a daily average of 11,838)
  • 26.2% of type 1 attendances were admitted, this is a one percentage point decrease from September 2022
  • 150,922patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)
    • This is the highest figure on record and is a 14.5% increase from September 2022
  • Delays to admission stood at 29.8%, this is the highest on record and a 2.8 percentage point decrease from September 2022

The latest beds data for October 2022 show:

  • Last month there were 97,350 general and acute beds available, an increase of 0.71% from September. The occupancy rate was 94.3%, 0.7 percentage points higher than September, the highest monthly figure on record
  • The occupancy rate for adult general and acute beds was 95.6%, also the highest figure on record.

The latest Hospital Episodic Statistics published by NHS Digital for September 2022 show:

  • Patients leaving the department before being seen stood at 5.2%. This is a decrease of 0.2 percentage points from August 2022, but a decrease of 0.7 percentage points from September 2021. 
  • Unplanned reattendance rate was 8.5%. This is 0.4 percentage points lower than September 2022, but 0.3 percentage points higher than September 2021.  
  • Median time in department for admitted patients was 404 minutes. This is an increase of 29% compared with September 2021 (314 minutes). For all patients, the median wait was 192 minutes. 

Patients in mental health crisis twice as likely to spend 12-hours or more in Emergency Departments than other patients

A new report from The Royal College of Emergency Medicine finds that patients presenting with mental health problems are twice as likely to spend 12-hours or more in Emergency Departments than other patients.

National data show that nearly one in eight (12%) mental health patients presenting to an Emergency Department in crisis face a 12-hour stay from time of arrival, compared with nearly one in 16 (6%) of all attendances.

A recent SNAP survey of Emergency Departments found that more than one third of clinical leads reported patient stays of 72 hours or more in the last week, for patients with mental health needs.

‘Mental Health Emergency Care’ is the latest report in our series of explainers looking at the web of issues facing Emergency Departments. The report highlights that while patients with mental health presentations account for a very small proportion of Emergency Department attendances, they spend a disproportionate amount of time waiting for a mental health bed if they need admission.

Often, it is the patients who are most unwell and vulnerable that wait the longest. Those of greatest concern are patients waiting for a mental health bed, patients waiting for an assessment under the Mental Health Act, and Children and Young People presenting in crisis.

The prevalence and complexity of the mental health needs of children and young people increased during the pandemic, while capacity is struggling to meet surging demand.

Half of Emergency Departments in England reported waits of 12 to 24 hours for a child or young person to see a specialist mental health professional, despite the accepted standard for adults being a one hour wait to be seen.

If admission is needed, 46% of Emergency Departments reported that children and young people will wait more than 48 hours for a bed, with two respondents reporting a wait of five days in the Emergency Department.

The report looks in detail at factors contributing to these long waits, such as the reduction in mental health beds, inadequate numbers of children and adolescent mental health professionals, and poor organisation of professionals to assess patients under the Mental Health Act. It also examines the consequences for patients and departments and makes wide reaching recommendations.

Commenting on the findings of the report, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The system is failing patients who present to Emergency Departments in mental health crisis.

“Those waiting the longest are children and young people, patients waiting for admission to a bed, and patients waiting for assessment under the Mental Health Act. It is unacceptable.

“We know long waits in a busy and crowded environment are harmful for any patient, but for these patients it can cause deep distress and upset and worsen their mental state. We must do more to ensure that these patients are seen, treated, and directed to the right care quicker.

“These patients presenting to Emergency Departments are extremely vulnerable, they are in crisis and seeking Emergency Care, yet are left waiting for hours and even days, before being treated and admitted.”

The explainer also shows that the UK has only 37 psychiatric beds per 100,000 population – far lower than the OECD average of 71 psychiatric beds per 100,000 population – and that since 1987, over 48,000 NHS mental health beds have been cut in England, with 5,000 mental health beds having been cut since 2011 alone.

Dr Henderson said: “Data show that bed occupancy at mental health trusts averaged nearly 90% between 2017-20, 5 percentage points higher than the recommended 85%. The NHS mental health bed numbers are clear; capacity does not meet demand.

“While the move towards a provision of community mental health care has been positive, the cuts to emergency mental health care beds have been devastating. Now, the most vulnerable and desperate patients are truly suffering.

“We urgently need to see an increase in mental health bed capacity, so we are able to admit these patients to a bed and provide the care they urgently need. We regularly hear heart-breaking stories of young people being admitted a long way from their home and family.

“We urge the new Prime Minister and new Health Secretary to prioritise Mental Health care provision in Emergency Departments, especially ahead of winter.

“We are failing these patients and they are suffering; our report and supporting survey show the extent of this crisis. We need urgent action now. To ensure we are able to quickly and effectively help vulnerable patients in crisis the government must increase mental health bed capacity in Trusts.

“Capacity for Children and Adolescent Mental Health Services (CAMHS) is especially important, and CAMHs should be expanded to 24/7 so that children and young people can be assessed and triaged whenever they present at Emergency Departments, rather than face long waits for these services to open.”

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Persistent understaffing of NHS a serious risk to patient safety, warns Westminster committee

‘We now face the greatest workforce crisis in history in the NHS and in social care’

The NHS and social care face the greatest workforce crisis in their history, compounded by the absence of a credible government strategy to tackle the situation, say MPs in a new Health and Social Care Committee report.

In the NHS, persistent understaffing poses a serious risk to staff and patient safety in routine and emergency care.

The Workforce: recruitment, training and retention report outlines the scale of the workforce crisis: new research suggests the NHS in England is short of 12,000 hospital doctors and more than 50,000 nurses and midwives; evidence on workforce projections say an extra 475,000 jobs will be needed in health and an extra 490,000 jobs in social care by the early part of the next decade; hospital waiting lists reached a record high of nearly 6.5 million in April.

The report finds the Government to have shown a marked reluctance to act decisively. The refusal to do proper workforce planning risked plans to tackle the Covid backlog – a key target for the NHS.

The number of full-time equivalent GPs fell by more than 700 over three years to March 2022, despite a pledge to deliver 6,000 more. Appearing before the inquiry, the then Secretary of State Sajid Javid admitted he was not on track to deliver them. The report describes a situation where NHS pension arrangements force senior doctors to reduce working hours as a “national scandal” and calls for swift action to remedy.

Maternity services are flagged as being under serious pressure with more than 500 midwives leaving in a single year. A year ago the Committee’s maternity safety inquiry concluded almost 2,000 more midwives were needed and almost 500 more obstetricians. The Secretary of State failed to give a deadline by when a shortfall in midwife numbers would be addressed.

Pay is a crucial factor in recruitment and retention in social care. Government analysis estimated more than 17,000 jobs in care paid below the minimum wage.

A separate report by the Committee’s panel of independent experts (Expert Panel) published today rates the government’s progress overall to meet key commitments it has made on workforce as “inadequate”.

Health and Social Care Committee Chair Rt Hon Jeremy Hunt said: “Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long term plan by the government to tackle it.

“We now face the greatest workforce crisis in history in the NHS and in social care with still no idea of the number of additional doctors, nurses and other professionals we actually need. NHS professionals know there is no silver bullet to solve this problem but we should at least be giving them comfort that a plan is in place.

“This must be a top priority for the new Prime Minister.”

‘Pandemic-level response’ is needed to address the energy bills crisis, says Holyrood’s Net Zero Committee

A targeted emergency response, on a par with action taken during the pandemic, is needed to address the energy bills crisis, says Holyrood’s Net Zero, Energy & Transport Committee in a report published today.  

The report, which lays out the Committee’s findings following an inquiry into rising energy prices, says the Scottish and UK Governments must provide more immediate, carefully targeted support to those struggling with increasing fuel bills.

The report highlights three areas where the Committee believe immediate action and targeted support for the most vulnerable could be improved. These include additional financial help for households, better energy education and advice services and acceleration of programmes to retrofit and insulate homes.

It also says that medium and long-term plans and strategies must accelerate to reduce future exposure to volatile energy prices and help meet net zero targets.

Dean Lockhart MSP, Convener of the Committee, said: “This is a crisis unfolding in real time and one which we are told threatens ‘a catastrophic loss of life’ if swift action is not taken.

“We recognise some of the actions taken by the UK and Scottish Governments even over the short period of our inquiry, but more can and must be done now and in a more targeted way to get help to those most in need.

“Over the medium to longer term, it is also clear that we need to escape dependence on volatile international energy markets and accelerate all our efforts to enable this.

“For now, our message is clear: the Scottish Government must demonstrate a targeted emergency response to this crisis, on a par with action taken during the pandemic, to ensure the least well off are not vulnerable to death or serious ill-health due to rising energy costs and associated cost of living expenses.”

In the report, the Committee agrees with the Scottish Government on the need to take action through available welfare provisions but asks them to set out how social security and other assistance will be targeted specifically at lower-paid families with young children, those with disabilities and health conditions, older people, and those identified as experiencing or at risk of experiencing fuel poverty.

The report says that a national publicity campaign – akin to those used during the pandemic – and increased support and funding for those providing advice and advocacy at a local level is needed, so that everyone in Scotland looking for help can find it. 

The Committee also recommends that plans for a programme of home heating and insulation, towards which the Scottish Government has committed an investment of £1.8bn, be accelerated and targeted at those most in need.

The Committee is writing separately to the Minister of State for the UK Government, Greg Hands MP, calling for similar urgent action in relation to matters for which he is responsible. 

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