Tag: crisis

Emergency Department performance figures worst on record – YET AGAIN

‘Health system remains in dire crisis’

The latest performance figures for March 2022 for Emergency Departments across Scotland show:

  • There were 111,996 attendances at major Emergency Departments
  • 68.4% of patients were seen within four-hours
  • This is the lowest four-hour performance since records began
  • This meant that over 35,000 patients were waiting more than four-hours to be seen, admitted, discharged, or transferred.
  • 10,475 patients were waiting more than eight-hours before being seen, admitted, discharged, or transferred
  • This is the highest number of eight-hour waits since records began
  • It is a 65% increase on the previous month, February 2022
  • It means that around one in 10 patients were waiting eight-hours or more in a major Emergency Department
  • 3,889 patients were waiting more than 12-hours before being seen, admitted, discharged, or transferred
  • This is the highest number of 12-hour waits since records began
  • It is almost a 70% increase on the previous month, February 2022
  • It means that around one in 28 patients were waiting 12-hours or more in a major Emergency Department

Responding to the latest Emergency Department performance figures for Scotland, Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said:

“Once again, the figures show the worst performance since records began, meaning record numbers of patients facing extremely long waits. March 2022 also saw the highest number of attendances since September 2021.

“There are immense pressures on our health system. Patient safety is compromised, staff are burnt out, ambulance services are severely struggling, and Emergency Departments are dangerously over-crowded.

“During this difficult time, we commend all staff in our Emergency Departments for their resilience and hard work. These are unprecedented and extremely challenging circumstances, a result of a broken health system in dire crisis. We know morale is very low right now, and we know the challenges in providing effective care, but frontline staff across all grades continue to do their very best to keep patients safe.

“Opening 1,000 beds in the health system in Scotland and addressing the staffing crisis in social care is urgently needed to begin to tackle the current situation and to move patients appropriately and timeously through the system. This is an unsustainable situation, month-on-month performance deteriorates, and patients are coming to harm as staff face severe moral injury.”

One in four ambulances delayed 30 minutes or more as Emergency Care falls deeper into crisis

The latest Winter Sitrep data for the week ending 27 March show:

  • There were 79,588 ambulance arrivals, 2.7% less than the previous week.
  • More than one quarter of ambulances experienced delays of 30 minutes or more, equal to 21,051 ambulances – an increase of 7.4% on the previous week
  • This is the highest proportion of ambulance delays on record
  • More than one in nine ambulances were delayed by more than 60 minutes, a 10.2% increase on the previous week, setting a new record high for this reporting period.
  • The average number of delays for this winter has continued to creep up, increasing from 0.3% up to 21.3%. The previous highest weekly average number of delays was 14.3% in 2019-20.

The Royal College of Emergency Medicine and The College of Paramedics have collaborated on this Ambulance Handover Options Appraisal guidance that details the ways in which Paramedics and Emergency Medicine staff can reduce ambulance handover delays.

Dr Ian Higginson, Vice President of The Royal College of Emergency Medicine, said: “The data show Emergency Department crowding, long “hidden” within the walls of EDs, has become more visible as handover delays have dramatically increased, leading to ambulances waiting outside EDs with their patients still inside.

“It is vital that ambulances return to active service whenever possible and safe to do so. Delaying ambulance handovers should be a last resort. Holding patients in ambulances leads to unnecessary delays to their care, leaving seriously ill or injured patients in the community requiring an ambulance to wait longer.

“Ambulance handover delays are almost entirely caused by dangerous crowding in Emergency Departments. The root cause of these problems is “exit block” where there are delays for patients to be admitted to inpatient beds from the ED. Patients suffer harm or die unnecessarily when they cannot get an ambulance in time, when they are held in ambulances on arrival in ED, or when they are treated in crowded EDs.

“Emergency Departments must have sufficient capacity to meet demand, and constant flow from the Emergency Department into inpatient beds, otherwise they will not be able to keep patients and staff safe. This means that risk must be properly shared within organisations, and through systems.

“When this does not happen leadership teams tend to look for mitigation. Unfortunately, this mitigation is usually focused at the front door of the hospital, rather than being directed at the root cause of the problem. The Royal College and The College of Paramedics have produced this joint guidance to support good decision making when managing ambulance handover delays in an effort to tackle ambulance handover delays and dangerous Emergency Department crowding.”

Tracy Nicholls, Chief Executive of The College of Paramedics, said: “We hear from our members how consistently challenging this situation is and, whilst we can see that paramedics, ambulance clinicians and hospital ambulance liaison officers are doing everything they can, the system is now at breaking point. 

“Those who need an ambulance are continuing to wait an unacceptable length of time and those paramedics and ambulance clinicians who are running to their next job can clearly see how long their next patient has been waiting and know they are going to be met with frustration, anxiety or fear.

“It seems incongruous that additional measures are being taken at the front door when the whole system flow of patients still needs to be addressed, but we suspect that there are now few options left without further risk to both those who are using the ambulance services and those who are working within them.

“Ambulance operations centres are still fielding calls at record numbers because callers want to know when an ambulance will arrive and are often calling back time and time again.

“It is difficult to hear that an ambulance might be delayed but imagine how a caller feels when their 999 call isn’t answered straight away. The moral injury is not just with the paramedics, but also with all of those involved directly with patients and their care.

“The College supports RCEM’s call for both the reduction in ambulance handover delays and in ED overcrowding.  It is only by working together as a system that we will see this much-needed change and this guidance document outlines the risks associated with the current challenges.”

Scots charity ships thousands of donated items to Ukraine crisis

A SCOTTISH charity has shipped two tonnes of donations destined for Poland’s mobile clinics helping those escaping the ongoing conflict in Ukraine. 

Working in partnership with NHS Scotland Global Citizenship, Artmedis and K&N, Kids Operating Room (KidsOR) has secured the transportation of eight pallets worth of goods from its global logistics centre in Dundee to Krakow, Poland where it will be put to good use by the emergency medics caring for the influx of refugees.

KidsOR is a global organisation focused on providing dedicated operating rooms for children’s surgery with bases in Edinburgh and Dundee.

The donation includes medical products, clothing and footwear as well as items specific items to help in a conflict situation, such as air chambers to assist with ventilation.

Dave Tipping, Director of Global Operations at KidsOR heads up the Dundee logistics centre. He said: “As events continue to unfold in Ukraine, donations are playing a vital role in supporting those most impacted by the conflict.

“That’s why a shipment of medical items once destined for Northern Iraq and Syria, but delayed for two years and eventually unable to be processed due to lack of documentation was, has been redirected to Poland.

“Over the next week, the shipment including blankets, clothing, sheets and gloves – all urgently required – will begin its travel and is expected to reach the mobile clinics within the next week.

“Under such terrible circumstances, we are proud to be able to help in a small way and know these items will be life changing for many.”

The seven-strong team at KidsOR’s Dundee warehouse typically facilitates large shipments of medical equipment to completely fit our paediatric operating rooms. Recent shipments have reached Tanzania, Ivory Coast, Democratic Republic of Congo, Senegal, Zambia and Nigeria.

Founded by Garreth and Nicola Wood, it is the only global organisation focused on the single task of providing dedicated operating rooms for children’s surgery. They work in more than 40 countries to provide world-class surgical facilities and won’t stop until every child has equal access to safe surgery.

For more information on KidsOR, please visit: www.KidsOR.org

Crisis: Scottish Government asleep at the wheel on crisis in NHS dentistry

   
The British Dental Association Scotland has greeted the unanimous support of opposition parties, while accusing the Scottish Government of failing to take needed action to halt an exodus from NHS dentistry and restore access to millions. 
 
In a debate in Holyrood today Scottish Government MSPs voted against a motion on support for NHS dentistry tabled by the Scottish Conservatives and backed by both Scottish Labour and Liberal Democrats.

Ministers have been planning to cut pandemic support from April. While the Government has recently indicated that there will be no “cliff edge”, the BDA has consistently warned that the plans to end Covid support payments and return to a low margin/high volume model of care would devastate dental services across the country.
 
Morale in the profession is at an all-time low, with more than a third of dentists saying they intend to leave the profession in the next 12 months, and 80% planning to reduce their NHS commitment if the Government reverts to pre-pandemic arrangements. Failure to act risks sparking an exodus from the workforce which would mean families across Scotland losing access to NHS dentistry for good.   
 
Over 3.5 million NHS dental appointments were lost in Scotland as a result of the pandemic. As infection prevention and control measures continue to limit the number of patients dentists can see, this unprecedented backlog continues to grow and will likely take years to clear. 
 
The BDA has warned the SNP’s 2021 election pledge of free NHS dentistry for all will be unrealisable without meaningful support and real reform. It is pressing for a workable interim funding model, and long-term change to a system that prioritises prevention, is patient-centred and reflects modern dentistry.   
 
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “NHS dentistry in Scotland is facing crisis, but sadly Ministers seem asleep at the wheel. 
 
“Opposition parties are all seeing the plain facts that Scottish Government plans could devastate services millions depend on and widen already unacceptable health inequalities. 
 
“Promises have been made to the voting public that simply that can’t be kept unless we see meaningful support and real reform as we head out of the pandemic.” 

Urgent action needed to address critical issues in delivery of social care

Action is needed now to change how Scotland’s social care services are delivered so that it meets the needs, and improves the experience of, people relying on care and support, say Scotland’s spending watchdogs.    

The joint briefing by the Accounts Commission and the Auditor General for Scotland says fundamental issues and threats to the future sustainability of Scotland’s social care system need to be addressed. The pandemic has exacerbated long-standing challenges, highlighting the precarious situation of many vulnerable people who rely on social care or support.  

Over £5 billion a year is spent on delivering social care services, yet some services are at near crisis point. There needs to be a shift in how this money is used, with a far greater emphasis needed on preventative care that meets the needs of individual people. Service users do not always have a choice or say about what support works best for them. Nor are carers getting all the support and advice they need, despite existing legislation.  

Now the Scottish Government, together with its partners, must listen and bring together the views and experiences of service users and carers. This will support the delivery of their long-held ambitions for social care. 

The 200,000-strong workforce is under immense pressure and feels undervalued. There is a high vacancy rate and a continuing problem of recruiting and retaining this workforce into roles which often have low pay and poor conditions of employment. At the same time demand for social care services continues to increase. 

Commissioning social care services tends to focus on cost, rather than quality or outcomes. Worrying limitations in social care data has created major gaps in the information needed to inform improvements.  

William Moyes, Chair of the Accounts Commission, said: “There are significant problems with the delivery of social care services. These services are vital, yet we have a workforce that’s not adequately valued or regarded.

“Staffing shortages are a major issue across the sector and not all people’s needs are being met. Too often a focus on costs comes at the expense of delivering high quality services that aren’t at the heart of the needs of individuals. The additional funding to achieve this will be significant. Not taking action now presents a serious risk to the delivery of care services for the people who depend on them.

Stephen Boyle, Auditor General for Scotland, said: “We cannot wait another five years until the planned National Care Service is in place. Action must happen now, and at speed, by the Scottish Government.

“There must be clear timescales for delivery, demonstrating that lessons have been learnt from previous reforms of health and social care services. This will create a strong foundation for the government’s vision to create a National Care Service.”

briefing_220127_social_careDownload

COSLA’s Health and Social Care Spokesperson, Councillor Stuart Currie, responded to the Audit Scotland report on social care: ‘The Audit Scotland report sets out many of the challenges that Local Government has consistently highlighted for many years now.

“There is an urgent need to address these challenges – many of which have been exacerbated by the pandemic – by working with our partners across Scottish Government, in the third and independent sector, and most importantly, people with lived experience.  

“We agree with Audit Scotland  that Social Care reform cannot wait for a National Care Service to be implemented. Local authorities are central to delivering the right care at the right time in the right place.

“Local Government recognises that we cannot stand still if we want to create meaningful change for our communities. We continue to work with Scottish Government to progress our shared commitments outlined in our Joint Statement of Intent so that we can now begin to implement much of the reform that was called for in the Independent Review of Adult Social Care.

“Fundamental to these shared commitments is a recognition that through empowering people, valuing our workforce and embedding a human rights-based approach in social care, we can begin to deliver real solutions for our local communities, unpaid carers, and our workforce.”

Health Emergency: Worst ever four-hour performance “must be a call to action”

“The health service is in the middle of the biggest crisis it has ever faced“

The latest monthly Emergency Department (ED) performance figures published by NHS England for December 2021 show that four-hour performance at major Emergency Departments reached its lowest since records began at 61.2%, meaning nearly two in five patients were delayed by four-hours or more and nearly 1 in 4 admissions experienced a wait of at least four hours from the decision to admit them to admission.

The data also show the highest number of 12 hour waits ever recorded: 12,986 patients spent 12 hours or more from decision to admit to admission. This is a 22% increase on the previous month, November 2021, and it is 250% higher than December 2020.

Responding to the publication of NHS England quarterly and monthly performance figures, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The situation on the ground is extremely bleak. Staff are overwhelmed and burned out; it is increasingly challenging to provide timely and safe patient care.”

Latest Quarterly performance figures published by NHS England show that in 2021-2022 there were a total of 43,218 12-hour delays which is more than all the 12-hour delays over the previous ten years put together (39,608).

The data does not paint the full picture as NHS England record 12-hour waits from decision to admit. Our Winter Flow project, which started at the beginning of October 2021, has so far recorded 71,965 12-hour waits from time of arrival.

It is critical that NHS England commit to reporting 12-hour data from time of arrival and implement the Clinical Review of Standards.

Dr Henderson said: “The health service is in the middle of the biggest crisis it has ever faced, and staff are working harder than ever before with fewer staff and fewer beds.

“When the health service is overwhelmed, it does not cease to function, it is the standards and quality of care that fall. The figures published today show the extent to which these standards have fallen already.

“Performance metrics are intended to hold clinical services to account. They are meant to identify areas in which services are failing with the aim of improving them quickly and effectively.

“The consistent and continuous decline of urgent and emergency care performance, standards, patient experience and patient safety show how this intended function is now entirely lost. With each publication around performance, we commentate with shock and dismay at the latest decline, but our comments are, more often than not, met with inaction or short-term fixes. There needs to be acknowledgment that there is a major public health crisis in emergency care.

“It is the core ability and function of the health and social care service to deliver high-quality and effective care to the acutely ill or injured that is at risk.

“We must now see a vision for recovery and a vision for the health service that includes a vital transformation of the urgent and emergency care system. There must be a plan to implement a framework that is centred around patient care, that drives action and improvement.

“The current framework is simply documenting the health system’s failure to deliver a quality service, and the failure of this framework leaves urgent and emergency care in a performance vacuum.

“We need a decision about either a phased implementation of the findings of the Clinical Review of Standards or an honest discussion about how we performance manage urgent and emergency care differently.

“The current challenges facing the health and social care service are the result of years of stagnation and decline, they are made worse by, but are not just a consequence of, the pandemic. Recognising this is vital to any step towards transformation.

“It is time we saw bolder political willingness to engage on these critical issues. Without action, performance will continue to decline, and this would be a disservice to patients and staff.”

A & E performance reaches record lows once again as fears grow for coming weeks

The latest weekly update of Emergency Department activity and waiting time statistics show:

  • Four-hour performance was second lowest on record at 69.7%
  • There were 24,009 attendances
  • 7,285 patients were delayed by four hours or more, equal to one-third of patients
  • 1,803 patients were delayed by eight hours or more
  • 598 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 latest data is shocking, as performance sinks to record lows once again. Staff are working tirelessly in Emergency Departments, and we anticipate pressures to mount further as covid surges across Scotland, and with this performance to drop even more.

“We are deeply concerned. Our fear is that staff absences due to covid may prevent the health service from delivering effective care. The current pressures are already leading to long waits for patients, ambulance handover delays, dangerous crowding and corridor care. If we lose staff to covid, these consequences will be further exacerbated. We know that long waits in Emergency Departments threaten patient safety and can lead to avoidable harm or death.

“The crisis is extremely worrying. The coming weeks will be a significant challenge, morale is already plummeting as concern for whether the health service in Scotland will be able to cope is escalating.

“We hope the public understand the unprecedented pressures facing the health service and the crisis that is deepening each week. Staff are doing all they can to deliver effective care and to keep patients safe.

“We urge the public to be cautious in the coming weeks, to use face masks, avoid crowded places, get tested and isolate when they have symptoms, and crucially, to get vaccinated or boosted – these steps go a small way to alleviating pressures on Emergency Departments and the wider health service.”

Preventing Homelessness: Scottish Government opens consultation

Views sought on proposed legal duties for public bodies

Health and social care services, children’s services, police and other public bodies will have a legal duty to ‘ask and act’ to prevent homelessness under Scottish Government proposals.

The measures would be part of new laws aimed at preventing homelessness, based on recommendations from an expert group convened by the charity Crisis at the request of the Scottish Government. They would represent the biggest change to Scotland’s homelessness legislation in almost a decade.

Public bodies would have a legal duty to identify anyone at risk of homelessness and either take action themselves or refer on to more appropriate help.

A consultation on the plans, run jointly with COSLA, will give people with experience of homelessness, alongside those from the housing sector, public bodies and others, the chance to share their views and help shape Scotland’s approach to preventing homelessness.

Social Justice Secretary Shona Robison said: “We know that the best way to end homelessness is to prevent it from happening in the first place. These new proposals build on the strong housing rights that already exist in Scotland for people who become homeless.

“Early action should be a shared public responsibility, giving people facing homelessness more choice and control over where they live.

“Homelessness is often a traumatic and unsettling experience that can have a profound impact on the lives of those involved, including children.

“By intervening at an earlier stage, and encouraging services to work together to respond to people’s needs, we can ensure fewer people and families are faced with having to re-build lives affected by homelessness.

“This will further add to our existing ambitious programme of work and investment to ensure everyone has a safe, warm place to call home.”

Jon Sparkes, Chief Executive of Crisis, said: “We strongly support plans for new duties for public bodies to prevent homelessness in Scotland. 

“Scotland has made huge progress in its journey towards ending homelessness in recent years, but while the country has powerful protections in place for people experiencing homelessness, far too many people are being forced to reach crisis point before they get the help they need. 

“Everyone has a role to play in preventing homelessness, and by introducing new duties requiring public services to ask about someone’s housing situation, and offer them the help they need, we can build a truly world leading system of homelessness prevention.” 

Councillor Kelly Parry, COSLA Spokesperson for Community Wellbeing said: “People have a right to a place they can call home. Rough sleeping and sofa surfing is something we have always worked to eliminate.

“We welcome the proposal that the duty to end homelessness will be shared with other public bodies and look forward to being closely engaged in the consultation with other partners”.

Prevention of Homelessness Duties consultation – closes 31 March 2022

Call for Scottish budget for mental health as figures show over 1,900 children have been waiting over a year for treatment

The Scottish Children’s Services Coalition (SCSC), an alliance of leading providers of children’s services, has called for a Scottish Budget for mental health. It urged greatly increased investment in mental health services against a backdrop of concerns over a mental health pandemic as the impacts of Covid-19 on the young become clearer.

The call comes as new figures published today (7th December 2021) from Public Health Scotland indicate that at the end of September 2021, 1,978 children and young people had been waiting over a year for treatment from specialist child and adolescent mental health services (CAMHS) provided by the NHS.

This figure represents a doubling from September 2020 (959).They also represent 16.7 per cent of those waiting for specialist treatment. 

With already under-resourced and overstretched services facing overwhelming pressure due to increased demand, the SCSC has raised concerns over a potential “lost generation” of vulnerable children and young people whose mental health is being impacted by Covid-19. 

Even prior to the pandemic cases of poor mental health were at unprecedented levels and in crisis, and there are a growing number of vulnerable children who cannot access adequate support.

While 3,792 children and young people were treated over the period July to September 2021 by CAMHS, only 78.6 per cent were seen within the Scottish Government’s waiting time target for the NHS of 18 weeks from referral to treatment (met for at least 90 per cent of patients). Nine out of 14 health boards failed to meet this target.

Waiting times (with adjustments) for people who started their treatment from July to September 2021, by NHS Board of treatment.

Health boardTotal number seen% seen within 18 weeks
NHS Scotland3,79278.6
NHS Ayrshire & Arran38199.5
NHS Borders7755.8
NHS Dumfries & Galloway8133.3
NHS Fife34083.8
NHS Forth Valley8764.4
NHS Grampian39294.9
NHS Greater Glasgow & Clyde Valley1,02175.5
NHS Highland17076.5
NHS Lanarkshire18368.3
NHS Lothian66167.9
NHS Tayside35284.1
NHS Island Boards47100.0

In addition to increased investment in mental health services through a Scottish Budget for mental health, the SCSC has called for a renewed focus on expanded prevention and early intervention services, reducing the need for referral to costly specialist CAMHS.

It has also called for greater partnership working between the public, private and third sectors as well as greater awareness of the services on offer, especially those at a community level.

A spokesperson for the SCSC commented: “We are urging the Scottish Government to make the forthcoming budget a Budget for mental health for our children and young people.

“For some time we have raised concerns over a potential lost generation of vulnerable children and young people, whose mental health is being impacted even further by the Covid-19 pandemic.  It is more important than ever that children can access the support they need, when they need it, irrespective of where they live.

“To achieve this there must be a radical transformation of our mental health services, investing in specialist services and with a focus on preventing such problems arising in the first place and intervening early.

“This is a crisis we can overcome, but it will require a similar energy and commitment to that demonstrated for Covid-19 if we are to achieve this and prevent many young people giving up on their futures.”

‘Devastating’: Unite Scotland reveals Scottish Ambulance Service survey findings

Unite Scotland has today revealed the details of a ‘devastating’ survey conducted of nearly 300 Scottish Ambulance Service (SAS) workers. 

The survey conducted over the last month by the trade union among its SAS members reveals a ‘horrifying’ picture of the nation’s ambulance service due to years of ‘chronic underfunding’.

The survey reveals that by huge majorities SAS workers feel under-valued, fatigued; that staff morale has collapsed, with the vast majority of workers stating the nation’s ambulance service is under-resourced and under-staffed. 

Substantial majorities of SAS workers also state that they have considered leaving the ambulance service and reported that they have been abused at work in the last year.

The headline survey findings reveal the following:

  • 98.2% believe that Scottish Government’s extra investment of £20m into the SAS and support from the armed services will ‘not be enough’ during the winter months;
  • 88.2% do not feel valued by the Scottish Government and 84.6% do not feel valued by the SAS;
  • 86.7% of SAS workers felt that staff morale was either poor (30.8%) or very poor (55.9%);
  • 86.4% feel fatigued at work while 78.9% believe the SAS is under-staffed;
  • 81.5% have suffered verbal or physical abuse, or both, while working at the SAS within the last year;
  • 73.6% of respondents said they have considered leaving the SAS;
  • 70% do not get the necessary break times during shifts;
  • 53.8% stated that there were not enough ambulances at ‘station level’; and
  • 44.3% stated that the longest shift they have worked was between 12-15 hours, 30%between 15-20 hours; 17.5% between 10-12 hours while 5.7% stated it was under 10 hours and 2.5% over 20 hours. 

In a previous Daily Record Exclusive on 9 September, Unite called for a ‘major incident’ status to be declared at all hospitals with Accident and Emergency Units, where turnaround times exceed 30 minutes.  

The demand was made by Unite to protect the public who have made 999 calls in the community, amid patient safety concerns due to 6 hours service running times. 

On average, an ambulance response to a 999 call can take between 55 minutes, and 1 hour and 10 minutes, from call to completion. However, ambulances are now missing three 999 calls while located at a hospital waiting for patient handovers.  

The survey findings shed new light on this depressing situation with nearly 71% of respondents declaring that the longest 999 call they have been involved in from call to completion exceeded six hours: (16.3% – over 20 hours), (11.7% between 15-20 hours), (6.3% between 12-15 hours), (4.6% between 10-12 hours), (5.4% between 8-10 hours), and (26.4% between 6-8 hours), with the remainder being under 6 hours. 

Worryingly, 94.5% of survey respondents involved in ambulance 999 call-outs believed the clinical coding to ascertain the severity of the situation was wrong. In addition, 54.7% answered ‘yes’ to the question ‘due to longer service running times has your ‘call’ been involved in an adverse clinical event due to delays and hospital pressures?’

Unite Scotland has repeatedly warned the Health Secretary, Humza Yousaf, that the extra investment and resources for the SAS would ‘not be enough’ to deal with the crises affecting the nation’s health services, which the survey findings conclusively confirm. 

Pat Rafferty, Unite Scottish Secretary, in response to the survey findings, said: “I don’t think I have ever seen such an utterly depressing and horrifying situation with massive implications for the nation.

“The workers at the Scottish Ambulance Service are sending out their own 999 call to the Scottish Government saying that they are undervalued, stressed, and exhausted. It is now beyond breaking point.

“The levels of abuse the workers are suffering is inexcusable. The vast majority of those responding to our survey are going as far as to say they are now considering leaving the ambulance service.

“Shockingly, the survey reveals a culture of extremely long hours, partially due to chronic underfunding over many years, and the overwhelming stresses being placed on the system. This situation is directly leading to paramedics and ambulance staff being increasingly involved in adverse clinical events, and dangerously long response times.

“It is a devasting indictment of the Scottish Government’s approach to the ambulance service. Urgent action is necessary because lives are at risk alongside the fundamental issue of how we value those trying to save those lives.”