Tag: emergency departments under pressure

NHS ‘still in the depths of crisis’

“We remain extremely concerned about our patients and their safety and for the welfare of staff who are struggling”, RCEM says

Responding to the latest monthly Emergency Department performance figures for Scotland for January 2023, Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said: “The monthly data make clear we are still in the depths of crisis.

“While it is true that the data for January 2023 show improvements when compared with December 2022, December was the worst month on record. We are relieved that we have mitigated against a repetition of December, but we remain extremely concerned about our patients and their safety, and for the welfare of staff who are struggling.

“January saw continued high numbers of extremely long waits; the third highest number of 12-hour waits on record. While the weekly data from February also show that we cannot let up in our requirement for substantial improvement.

“As the Scottish leadership election begins, tackling the crisis in Emergency Care as well as the crisis in the wider health and social care system must be a priority for the next First Minister. In 2022, a total of 55,095 patients waited 12-hours or more in an Emergency Department in Scotland.

“Analysis by the College shows that consequently, in 2022, there were an estimated 765 patient deaths associated with these dangerously long waiting times – equal to an estimated average of 64 each month. This is entirely unacceptable and a marker of a system that is not functioning as it should.

“To tackle this, in Scotland we urgently need a restoration of the acute bed base, that means opening an additional 1,000 staffed acute beds where safely possible.

“There are also significant shortfalls of staff in Scotland. The Emergency Medicine workforce needs at least 100 more consultants, as well as senior decision makers, ACPs/ANPs/Physician Associates, junior doctors, and vital nurses.

“We welcomed the expansion of Emergency Medicine medical training places in Scotland by 10, but this expansion is considerably short of what is required and there has yet to be any commitment to maintain this each year.

“This winter continues to be the most challenging yet for the NHS in Scotland. A failure for meaningful action now will prolong the risk to patient safety and maintain these dangerously long waiting times at the detriment to staff who are already burned out and exhausted. 2023 must be the year that we see political will translated into action that improves patient care and conditions for staff.”

NHS Lothian hospitals under rising pressure as Covid cases surge again

NHS Lothian has warned that increasing cases of COVID-19 are placing mounting pressure on hospital and community services. Health chiefs said community prevalence of the virus is causing serious capacity issues across the whole system.

An estimated one in 20 people currently have the virus in Scotland with two thirds of the cases identified in the 20-59 age group. This is having an impact on workforce, with one fifth of nursing staff not at work as a result of COVID-19 absence.

Dona Milne, Director of Public Health, NHS Lothian urged people not to forget all that has been learned about keeping the virus under control.

She said: “COVID-19 has not gone away and cases are continuing to rise across Lothian. Our hospital system is under extreme pressure and we need people across Lothian to do their bit to prevent the system becoming overwhelmed.

“We would urge people to take sensible precautions when they are indoors or in crowded spaces and remind them that regular hand hygiene is vital and face coverings should be considered, especially in crowded places.”

Tracey Gillies, Medical Director of NHS Lothian said: “The number of hospital inpatients who have tested positive has increased by 50% since a week ago. This presents many logistical issues as they need to be cared for within COVID-19 specific areas.

“On top of that, and in line with community transmission levels, there are increased numbers of staff testing positive with COVID-19, who must then self-isolate to protect patients.

“All of this means services are stretched right across the system, including community and social care services, resulting in high numbers of patients who are medically fit to leave hospital but who cannot be discharged because they need care in place to support them at home.”

Relatives of patients are also being urged to help where they can by providing transport home for patients who are medically fit to be discharged, rather than have their relative wait for hospital transport.

This speeds up the discharge process and in turn frees up more hospital beds sooner, allowing faster admission for patients from our Emergency Departments where admission queues can form when the hospitals are full.

Relatives are also being asked if they can consider offering support to their loved ones who have been clinically assessed as “medically fit for discharge” but might still need extra help around their home.

Dr Gillies added: “We know that it is better for people to be looked after in a homely setting once they are medically fit to leave hospital. Unfortunately, the pressure on community and social care services means many patients are waiting too long for social care support and as a result spending longer in hospital than they need to.

“When appropriate, we therefore ask families to consider if they can step in and help support their loved one once they are fit for discharge. Again, this helps with the flow of patients through our hospitals and ensures that beds are available for the most urgent of cases.”

Dr Gillies reminded people in Lothian to make sure they get the “Right Care in the Right Place” by considering going to their local pharmacy or GP or by calling 111 to get an appointment with an expert in the Minor Injuries Unit (MIU), rather than automatically going to the Emergency Department.

She said: “If you think you need to visit A&E, but it’s not life threatening, call NHS 24 on 111 first, day or night.

“NHS 24 will direct you to the right care in the right place. They will direct you to an expert in our Minor Injuries Unit, GP or pharmacy and help reduce the length of time spent waiting in busy hospital departments.

“It is important too to remember that there is self-care information on NHS Inform.

“If it is an emergency always call 999 or go to your local A&E.”