Tag: delayed discharges

RCEM issues urgent budget call to Scottish government ahead of ‘gruelling’ winter

The Royal College of Emergency Medicine has joined calls for the Scottish government to address ‘delayed hospital discharges’ in the upcoming budget announcement.

Delayed discharges are when people are considered medically fit enough to leave hospital but are unable to, often because the required social care support is not available. 

The latest A&E performance figures from Public Health Scotland released today Tuesday 3 December 2024 revealed during the month of October more than 2,000 beds every day were occupied by people who were well enough to go home – the highest figure since 2016.

This issue means that the whole system for admitting people grinds to a halt and people can end up stranded in A&Es often waiting hours and even days for a ward bed to become available.

The latest data release comes as the Auditor General of Scotland published a damning report into the state of the Scottish health system which concluded that the Scottish Government has no clear plan to reform the country’s NHS, or to address pressures on the service.

Auditors found:

  • commitments to reducing waiting lists and times have not been met
  • the number of people remaining in hospital because their discharge has been delayed is the highest on record
  • and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.

The issue of delayed discharges has also been highlighted by the Royal College of Physicians Edinburgh (RCPE) which has written an open letter to the First Minister calling on him to address this ‘urgent issue’ in his Government’s budget which will be unveiled tomorrow (4 December 2024).

Dr Fiona Hunter, The Royal College of Emergency Medicine’s Vice Chair for Scotland said yesterday: “Delayed discharges are a key reason that patients get stuck in Emergency Departments, often on trolleys in corridors – often experiencing extreme waits which are dangerous.

“So we join, and fully support, the calls from RCPE, and the Auditor General to address this issue. It must be prioritised as a matter of urgency.

“Today’s data is another timely reminder of scale of the issue. Just think about what it shows. More than 2,000 people every single day stranded in in hospital when they are well enough to go home.

“People – through no fault of their own, lying in beds which could be used for other patients who need to be admitted – who themselves are probably on a trolley in the Emergency Department, waiting for that bed to become available.

“We have to be able to move patients through our hospitals and out again when they are well enough. To do that takes a functioning and resourced social care system working alongside a functioning and resourced health system. They are inextricable.

Dr. Hunter concluded:“Tomorrow’s budget is an opportunity for the Government to #ResuscitateEmergencyCare, ahead of the depths of winter which is shaping up to be a gruelling several months ahead, for both patients and staff alike. They must take it.”

In an RCEM survey in November, 100% of Scottish A&E leaders that responded said they feel patients are coming to harm because of conditions.

Health secretary Neil Gray responded to the Audit Scotland report:

A&E waiting times hit all time high in Scotland

‘UNDERFUNDED, OVERCROWDED and, at times, UNSAFE’


New data released yesterday (5 March 2024) for Scotland reveals January was the worst month on record for people waiting to be seen in A&E.

The figures published by Public Health Scotland show that, in January 2024:

  • 41,161 (38%) patients waited over four hours in major Emergency Departments, a 21% increase compared to last January (33,962) 
  • 17,077 (16%) of patients waited eight hours or more in Emergency Departments, almost 13 times higher than in January 2016 (1,338) 
  • 8,402 (8%) of patients waited twelve hours or more in Emergency Departments, the largest amount for any January since records began and 36 times higher than in January 2016 (232). 

There were 1,866 beds occupied due to delayed discharges, an increase of 53 compared to December 2023. 

Dr JP Loughrey, Royal College of Emergency Medicine Vice President for Scotland said: “This is beyond exasperating. Most people attend A&E in desperate need – to be seen by a medical professional quickly and with dignity.

“Already struggling, patients are having to endure overcrowded waiting rooms and corridors – for hours. If admission is required, they must wait for a bed – for hours.

“This latest data makes for grim reading, and it is incredibly demoralising for my colleagues to be working under such strenuous circumstances.

“They are working all out to put patients first whilst also having to carry the burden of working in an underfunded, overcrowded, and at times unsafe emergency care system. We need intervention from the Government and policy makers to ensure we never reach this nadir again.”

The data also reports:

In January 2024, there were 108,427 attendances at major Emergency Departments in Scotland. This is marginal decrease of 0.25% compared to the previous month. 

  • 62% of patients were seen within four hours at major (Type 1) Emergency Departments. This is the worst four-hour performance for any January since records began.
  • This is a decrease of 0.5 percentage points compared to December last year and a decrease of 3.2 percentage points compared to January 2023. 
  • 41,161 (38%) patients waited over four hours in major Emergency Departments. This is a 1% increase compared to December last year (40,763) and a 21% increase compared to January 2023 (33,962). 
  • The number of patients waiting more than four hours has increased by more than three times compared to January 2016 (9,808). 
  • 17,077 (16%) patients waited eight hours or more in Emergency Departments. 
  • The proportion waiting this long has increased by 2% compared to the previous month, December 2023 and has increased by 2.3% compared to the previous year, January 2023. 
  • The numbers waiting more than eight hours is almost 13 times those in January 2016 (1,338). 
  • 8,402 (8%) of patients waited twelve hours or more in Emergency Departments  
  • This is the largest amount for any January since records began. 
  • The proportion waiting this long has increased by almost 1% compared to December last year and has increased by more than 1% compared to January 2023. 
  • The numbers waiting more than 12 hours is 36 times those in January 2016 (232). 
  • There were 1,866 beds occupied due to delayed discharges, an increase of 53 compared to December 2023. 

RCEM Scotland calls for urgent increase in bed numbers amid warning of ‘devastating winter’

Latest data show that more than 4,000 patients faced 12-hour delays in Scottish A&Es as RCEM calls on the Scottish government to increase bed numbers and avoid ‘devastating winter’.

Monthly A&E performance figures for Scotland for September 2023 published by the Scottish government show:

  • In September 2023, there were 113,864 attendances at major A&Es in Scotland.
  • 66.50 % of patients were seen within four-hours at major A&Es (Type 1 EDs)
    • 38,114 (33.5%) patients waited over four-hours in major Emergency Departments, this is a 1.7% increase from the previous month and a 2.3% decrease from September 2022.
    • This is a decrease of 1.4 percentage points from the previous month.
    • The number waiting more than four-hours has increased by 145.5% compared with September 2019 (15,526).
  • 11,788 (10.4%) patients waited eight-hours or more in an Emergency Department
    • This is an increase of 1.1 percentage points from the previous month, and a 1.5 percentage point decrease compared with September 2022.
    • The number waiting more than eight-hours has increased by more than eight times (701%) compared with September 2019 (1471).
  • 4263 (3.7%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred.
    • This figure has increased by 0.4 percentage points from the previous month. And has decreased by 1 percentage point compared with September 2022.
    • The number waiting more than 12-hours has increased by 14 times (1307%) compared with 2019 (303).
  • There were 1,811 beds occupied due to delayed discharges, the second most for any September on record.

Commenting on these data, RCEM Scotland Vice President, Dr John-Paul Loughrey said: “As we head into winter, we expect many people to attend A&Es with a multitude of conditions and illnesses, and many of them will require admission to hospital for further care.

“It is vital that with this clear expectation comes the necessary winter planning to resource A&Es, and support both clinicians and their patients through the colder months.

“We are concerned that the Scottish government’s winter plan fell short of delivering what is needed ahead of what will likely be a difficult period for emergency care.

“We desperately need to see an increase in bed numbers. This will help to reduce the dangerously high levels of bed occupancy, reduce long and dangerous delays in A&Es, and help to ensure patients are admitted to a bed more promptly.

“We continue to engage with the Cabinet Secretary and his team in good faith and raise the concerns of our members.

“To avoid what could be a devastating winter, we again urge the Scottish government to heed our calls to adopt our priorities to #ResuscitateEmergencyCare.”

The data come as figures obtained through Freedom of Information requests revealed that nearly 4,000 people faced 24 hour waits in Scotland A&Es in the six months up to June this year.

As Dr Loughrey said: “24 hours in A&E belongs on TV, not in daily reality for patients and staff”.