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”.
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 board
Total number seen
% seen within 18 weeks
NHS Scotland
3,792
78.6
NHS Ayrshire & Arran
381
99.5
NHS Borders
77
55.8
NHS Dumfries & Galloway
81
33.3
NHS Fife
340
83.8
NHS Forth Valley
87
64.4
NHS Grampian
392
94.9
NHS Greater Glasgow & Clyde Valley
1,021
75.5
NHS Highland
170
76.5
NHS Lanarkshire
183
68.3
NHS Lothian
661
67.9
NHS Tayside
352
84.1
NHS Island Boards
47
100.0
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.”
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.”
“To signal the return of a ‘business as usual’ model when the country is still in the grip of a pandemic is utterly reckless”
The British Dental Association Scotland has warned that plans to return NHS practices to pre-COVID models of work will devastate dental services across the country.
Cabinet Secretary Humza Yousaf yesterday wrote to every NHS dental team in Scotland, indicating that all emergency support will be withdrawn by 1 April 2022. Since the first lockdown NHS practices have operated under a COVID support package, reflecting pandemic pressures and tight restrictions that continue to limit capacity across the service.
A return to delivering a low margin/high volume model of care is, BDA Scotland contends, simply unsustainable under current conditions. While some restrictions may ease in the coming months, there are no indications the service is likely to return to anything resembling ‘business as usual’.
With a growing number of staff facing abuse from frustrated patients unable to secure appointments, the BDA has warned the move will only raise patient expectations, while pushing NHS colleagues into the private sector or out of dentistry altogether.
Yousaf has signalled minor changes to the payment system for dentists that will take effect from 1 February 2022, largely covering the treatment of children. While welcome, these reforms will have a negligible impact on capacity within the service and will not ease the pressure on practice finances once the COVID support payments are withdrawn.
The SNP committed to delivering free NHS care for all in Scotland in the recent election. The BDA has stressed this approach runs counter to that vision, and that real focus and energy must be applied to developing a new, sustainable model for delivering care.
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said:“The Scottish Government seems set to pull the rug out from under every dedicated NHS dentist.
“If Ministers had an objective to decimate NHS dentistry, this approach would offer a great starting point. To signal the return of a ‘business as usual’ model when the country is still in the grip of a pandemic is utterly reckless. The net result will be to push colleagues out of the NHS and to leave this profession altogether.
“Ministers put NHS dentistry front and centre in their pitch for government. To deliver on their promises we need real commitment to find a new and better way for delivering for the patients that need us.”
Suicidal Crisis Support Action Group will drive implementation of the Time, Space and Compassion approach
A new group will be set up to make sure that everyone at risk of suicide can access the right support when then need it, following recommendations made by the National Suicide Prevention Leadership Group (NSPLG).
The Suicidal Crisis Support Action Group will drive implementation of the Time, Space and Compassion approach, a new way to improve help for people who are suicidal.
Nigel Henderson, former Chief Executive of Penumbra and member of the NSPLG, has been appointed as National Lead for Suicidal Crisis Support to lead this work.
Wellbeing Minister Kevin Stewart (above) said: “I welcome the report from the NSPLG and the recommendations it makes on improving responses to people in suicidal crisis. We will consider the recommendations in full.
“To deliver the scale of change set out in their recommendations, a dedicated Suicidal Crisis Support Action Group will be established to take forward and oversee the implementation of this work.
“The appointment of Nigel recognises his career in developing compassionate support for vulnerable people, including those at risk of suicide. The group will be accountable to ministers and continue to work in close partnership with NSPLG.
“We know there are some excellent examples of suicidal crisis support services across Scotland already, and we have an opportunity to learn from those to make sure this type of support is available right across Scotland.
“Every day, people in our communities, and those working in statutory and third sector services, are responding compassionately to people in crisis. However, there is more we can do. This report offers a real opportunity to transform how we engage and support our most vulnerable people at times of suicidal crisis.”
Nigel Henderson said: “I am very pleased to have been asked to lead on implementing this work.
“Having been a member of the NSPLG and directly involved in this work, I believe that developing the Time, Space, Compassion approach has the potential to make a positive difference to how we respond to people experiencing suicidal crisis.
“There is much to do, and I look forward to working with people, communities and organisations to take forward the recommendations.”
Scotland’s National Suicide Prevention Leadership Group (NSPLG) has welcomed the Scottish Government’s acceptance of recommendations for improvements to the response provided to people in suicidal crisis.
Established by the Scottish Government, the NSPLG brings together people with lived experience of suicide alongside academic, third sector, and statutory partners to support the delivery of Scotland’s Suicide Prevention Action Plan: Every Life Matters.
These key NSPLG recommendations have been accepted in full by the Scottish Government and will be published on their website today (Wednesday 13 October ).
The NSPLG report uses evidence on the effectiveness of differing models of crisis support to make recommendations to service providers and share best practice.
It deliberately does not recommend a particular model of crisis support. Instead, it sets out an approach which sees suicidal crisis response as a human reaction, not a service model, and sets out the principles of Time, Space and Compassion as the basis of improvement in support for those in crisis.
The recommended approach is at the core of the NSPLG’s vision in supporting delivery of Every Life Matters, ensuring the right support is available for people when they are actively contemplating suicide at a time of crisis.
Time allows a person to discuss their feelings, and Space recognises the need to provide an accessible, quiet, comfortable, pleasant place for a person to talk and/or a virtual space to access support by phone, text or online.
In addition, research shows that Compassion in response to a person in crisis encourages them to disclose details which, in turn, can lead to more effective support being offered and lay the foundations for self-compassion, reducing the need for support from frontline services in the future.
Embedding the principles of Time, Space and Compassion into responses to suicidal crisis in Scotland will require concerted action across national and local government, and services across sectors, communities and citizens.
NSPLG chair Rose Fitzpatrick CBE QPM, said: “We believe that this approach, rooted in Time, Space and Compassion, can be implemented across all sectors and communities, transforming the experiences of those in crisis and at immediate risk of suicide.
“It is important to highlight that this report is not critical of existing crisis support. Based on the experiences of those who have been in suicidal crisis and those around them, it recommends a radically different cultural landscape, and requires a different sort of resourcing to enable this approach to be implemented consistently.
“People with lived experience of the impacts of suicide and those providing services tell us these recommendations have the potential to improve the experiences of those who seek help at a time of suicidal crisis, and ultimately to save lives.”
Member of NSPLG Lived Experience Panel, Shumela Ahmed (39) from Bridge of Allan near Stirling, is the managing director at Resilience Learning Partnership. She has family and friends who have experienced poor mental health and made suicide attempts.
Shumela has also experienced suicidal thoughts herself.
She said: “I believe Time, Space and Compassion is the right approach because it’s trauma informed and it understands that it takes time to build up trust and connect with a person when they are in a suicidal crisis.
“Every interaction is an opportunity for intervention. When a person is at risk of suicide they need a compassionate response from someone who will spend time with them and offer a safe space for them to talk.
“A really kind, compassionate, empathetic human conversation is often what is actually needed rather than following some big, important framework.
“I look forward to these recommendations being implemented in workforces so that staff have the tools and the resources to take this approach.”
The NSPLG recommendations are intended to be a starting point for work in this area and they focus, in the first instance, on the practical support and evidence required to make this culture shift collaboratively, and on ensuring the availability of existing crisis services as we emerge from the pandemic.
GB energy consumers face the biggest ever increase to the energy price cap
Fuel poverty charity National Energy Action (NEA) warns that the average increase of £153 for prepayment customers and £139 from those paying by direct debit using a default tariff is likely to result in more utility debt, 500,000 extra households in fuel poverty and an increase in preventable deaths this winter
Suppliers are putting their prices up in October when millions of people will see a reduction in their incomes, as uplifts to Universal Credit are withdrawn
Charity says new Household Support Fund welcome but not enough to prevent needless deaths this winter
Calls on UK Government to take more action to directly reduce higher prices for the poorest this winter and for Ofgem to do more to protect the most vulnerable consumers when suppliers fail.
Adam Scorer, Chief Executiveat fuel poverty charity National Energy Action (NEA), said: “The massive devastating increases in energy prices will drive over 500,000 more households into fuel poverty, leaving them unable to heat or power their homes.
“Just when they were needed most, the uplifts to Universal Credit are also being withdrawn and inflation is soaring. The new Household Support Fund will provide some welcome support for those who can access it, but on its own it is not enough to halt the erosion in incomes and deal with rising prices.
“Without a wider package of support – keeping UC uplifts and more rebates to protect those on the lowest incomes from spiralling energy prices – vulnerable people are still at dire risk of premature death this winter”.
“Falling through the gaps when suppliers fail”
NEA warns that the current crisis is likely to badly affect vulnerable customers when their suppliers fail. The charity is warning that households on older prepay meters are at risk of not being able to top up with their new supplier if their current supplier fails.
In addition, people in debt who transfer over to their new suppliers may also immediately risk aggressive debt recovery tactics from their previous suppliers’ administrators. People eligible for Warm Home Discount are also falling through the gaps when they move to their new supplier. They often can’t access all elements of this vital support.
Adam Scorer continued: “We know this situation is preventable, but Ofgem must act fast to protect the most vulnerable consumers when suppliers fail. The UK Government must also use the upcoming Budget to provide more additional emergency support so we can guard against the consequences of soaring bills and hits to millions of low incomes.
“This means enhancing current schemes and taking new steps to accelerate the repayment of utility debts across the UK”.
“Many of those on the lowest incomes live in the least efficient homes”
NEA has also stressed that one of the key reasons the situation is bleak for the poorest households is the vicious overlap between the households who live on the lowest incomes and who also live in the least energy efficient homes.
They say in England alone, more than 680,000 households on the lowest incomes also live in the least efficient homes making the impact of the price rises much more severe. Over 3 million fuel poor households will need to be prioritised for retrofits if the goal to meet Net Zero is to be met at the same time as statutory fuel poverty targets.
Adam Scorer again: “These quick emergency fixes are vital to get struggling households through this winter, but we can’t lose sight of the long-term solution to reduce the energy waste in our homes.
“We have some of the least efficient housing in Europe. This has left the UK more exposed to the current soaring gas price than many other countries and we are wasting billions of pounds each year as heat escapes through leaky roofs, floors and ceilings”.
What needs to be done
As a summary, NEA is proposing emergency provision to help fuel poor households to stay warm at home this winter, including:
Providing additional funding towards the Warm Home Discount scheme this winter as an emergency provision to guard against significantly increased gas prices
Supporting more households with the Winter Fuel Payment, especially for those eligible for the Cold Weather Payment in Northern Ireland
Helping accelerate the repayment of utility debts across the UK by enhancing Fuel and Water Direct
Continuing the Winter Grant Scheme through this winter
Additionally, through the Spending Review, NEA propose the following longer-term actions to ensure that fuel poor households can be warm at home for years to come:
Fully implement the Conservative Manifesto for the Home Upgrade Grant Scheme (HUG) and Social Housing Decarbonisation Fund (SHDF)
Ensure the Shared Prosperity Fund (SPF) helps end cold homes across the UK
Extend and strengthen the £20 a week uplift in Universal Credit and Working Tax Credit for low-income households.
Vital plans to invest at least £1.8 billion to make buildings in Scotland net zero were endorsed by parliament this week, just as gas prices surge, threatening to push many more families across the country into fuel poverty.
Figures show that a quarter of households in Scotland are already considered to be in fuel poverty. Scottish Greens Lothian MSP Lorna Slater has said that as well as the need to tackle the immediate problem, the issue shows that the requirement to lower Scotland’s climate emissions goes hand in hand with tackling fuel poverty.
Scottish Greens co-leader and Lothian MSP Lorna Slater said: “The surge in gas prices is a real concern to so many people who rely on fossil fuels to heat their homes, and, yet again, demonstrates why we must end our dependency on volatile, unreliable and climate-destroying fossil fuels.
“That’s why we are accelerating plans to make homes across Scotland more efficient and to switch from fossil fuels to renewable alternatives. To support this, we will invest at least £1.8bn over the next five years.
“It has been galling to see Boris Johnson preach climate responsibility on the world stage while his government is forcing families into poverty in Lothian and beyond. All the while he is doing nothing to decarbonise heating and transport.
“We don’t have time for this kind of reckless approach, which is why, with Greens in government, Scotland will take a different path.”
Julie Lamberth, RCN Scotland Board Chair, said: “I wanted to highlight statistics which have been published today from NHS Education for Scotland, which show a worrying rise in NHS Nursing and Midwifery vacancies.
“Across Scotland a record high of 4,854 nursing and midwifery posts are vacant, which is 7.1% of posts, while in NHS Lothian, 750 nursing and midwifery posts are vacant, which is 6.9% of posts.
“Staffing levels are reaching crisis point across Scotland. As well as these vacancies, a significant number of nursing staff are on work related sick leave through stress and other mental health issues. Unless this is addressed, proposals to remobilise services and increase elective capacity are simply unachievable and the NHS Recovery Plan’s proposals to recruit 1,500 additional staff woefully inadequate.
“RCN Scotland members are clear about what needs to be done. Out of the 39% of members who have told us they are thinking of leaving the nursing profession, 73% of respondents said “improved pay” and 49% said “better staffing levels” would make them feel more valued.
“Implementation of the Health and Care (Staffing) (Scotland) Act 2019, fair pay for nursing staff in all settings and robust workforce planning are needed urgently to ensure Scotland has the nursing staff it needs to remobilise services as we continue to deal with Covid-19.”
Lothian MSP Miles Briggs said: “The number of Nursing and Midwifery posts that we have vacant across NHS Lothian is extremely concerning.
“NHS Lothian staff work incredibly hard to care for everyone who comes through their door, but the current position is unsustainable. These vacancies need to be filled for health boards to recover from the Covid-19 pandemic.
“SNP Ministers have failed to workforce plan pre-pandemic and we are seeing the consequences now, with many nurses considering leaving the profession.”
The number of days that patients who have been delayed from leaving hospital because of no appropriate place to go to has risen to 7,829 for July 2021, the latest month statistics are available for.
This is an increase of 2,004 from 5,825 delays throughout June and triple the number of bed days occupied from delayed discharge at the start of the Covid-19 pandemic when 2,531 delays occurred.
At the start of the Covid-19 pandemic SNP Ministers made the decision to move hospital patients into care homes, to free up hospital space for dealing with the Covid-19 pandemic. It later emerged that patients being moved from hospitals to care homes where not tested for Covid-19 leading to higher rates of Covid-19 deaths in care homes than anywhere else in Scotland.
The level of delayed discharge in NHS Lothian has now returned to pre- pandemic levels with the number of bed days in hospital for delayed discharge being 11 higher than March 2020, 7,278, when hospital patients where moved to care homes.
Edinburgh and the Lothians were in the process of recovering from a Social Care crisis before the pandemic hit, with the peak of delayed discharge in hospitals being in October 2018, when 11,855 combined days when patients were not able to leave hospital, despite being back to health.
Lothian MSP, Miles Briggs, said: “These figures are very concerning, with the number of patients being stuck in hospital without a suitable destination, returning to pre pandemic levels.
“In Edinburgh and the Lothians there has been a long standing challenge to provide social care, which started to shift towards care in the community.
“We are now seeing increasing numbers of patients not able to leave hospital and the Edinburgh Integrated Joint Board are planning on closing more care homes.
“Patients leaving hospital must have a suitable destination to go once recovered, so that we are not in a position where people are waiting days on end in hospital, when they don’t need to be there.”
A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020.
The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day.
One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with seven per cent reporting the longest stay to be more than 48 hours.
Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK.
“Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options.
“We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now.
“The data is stark, and this is August. Our members are really worried about what may come in autumn and winter. We have a duty to our patients and staff. Currently there is extremely high demand – for a number of reasons – but demand is not the whole picture.
“Demand presents a challenge because of the limitations of hospital space, workforce shortages, difficulties arranging quick ambulance handovers, smooth care and safe discharge of patients from wards, and a lack of services and alternatives to admission, particularly in the evenings and at weekends.
“The health service entered the pandemic short of staff, with less beds, and underprepared. Throughout the pandemic these shortages have been felt, but with demand higher than ever before, and with a workforce that is burned out, these shortages are felt more acutely than ever.”
Commenting on the increase in ambulance handover delays, Tracy Nicholls, Chief Executive of the College of Paramedics, said: “The College of Paramedics’ members also speak passionately about the potential for harm to those patients who, as a consequence of these lengthy ambulance handover delays, can wait an unacceptably long time for help. It is deeply concerning.
“Like the Royal College of Emergency Medicine, we recognise that all partners are working exceptionally hard to manage this situation and current demand. The reality is, however, that unless effective actions are taken now to ease the system pressures, more and more patients will face these delays as we head into another difficult winter, and both paramedics and ambulance clinicians across the UK will face the brunt of any further increase in demand.
“We urge NHS leadership to take action now to mitigate this risk wherever possible and protect both patients and our collective workforce from the inevitable pressure that we face if nothing is done.”
The survey also found that over 80% of respondents had little or no confidence in their organisation’s ability to safely and effectively manage the current or predicted combination of pressures as we head into winter.
Dr Higginson continued: “The final response that found an overwhelming lack of confidence signals something deeply troubling.
“The College has consistently warned of the upcoming winter and ongoing pressures. It is time we saw leadership and an equivalent response. There must be a comprehensive plan for the current demand and upcoming winter that include short- and long-term solutions to tackle these serious challenges.
“If ambulance services and Emergency Departments cannot cope with ongoing pressures, then it is patients and the workforce looking after them who will suffer. The winter could lead the health service into a serious crisis. Patients and staff must have assurance that they, their Emergency Department and their hospital will get what they need to manage.”
