Scottish health service set for gruelling winter as performance deteriorates yet again

The latest Emergency Department performance figures for Scotland published by the Scottish Government yesterday for September 2021 show a deterioration in performance for the fifth consecutive month. The data show the worst four-hour performance on record and both the highest number of 12-hour and eight-hour stays since records began.

In September 2021 there were 113,998 attendances to major Emergency Departments across Scotland, the number of attendances dropped by 3,500 patients (3%) compared to the previous month, August 2021.

Despite the slight decrease in attendances data show that four-hour performance reached a new record low, with 73.8% of patients being seen within four-hours, this is 1.5 percentage points lower than the previous month, August 2021. It is the second time in 2021 that performance has fallen below 75%.

In September 2021 1,840 patients spent 12-hours or more in a major Emergency Department, this is an increase of 31.5% compared to the previous month, August 2021. This number increased for the fifth consecutive month and is once again the highest number of 12-hour stays since records began.

Data also show that 6,413 patients spent eight hours or more in a major Emergency Department. This is an increase of 20%, equal to over 1,000 patients. The number of patients delayed by eight-hours or more increased for the fifth consecutive month and once again this is the highest number of eight-hour stays since records began.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The consistent fall in performance is seriously worrying. What we are seeing: ambulance handover delays; dangerous crowding; long stays; put patient safety at risk and can lead to harm or avoidable deaths.

Data show that for every 67 patients waiting 8-12 hours, one of them will come to avoidable harm – therefore we can estimate that in Scotland between January and August 2021 there have been 231 excess deaths directly caused by a long wait due to a crowded Emergency Department.

“These are unconscionable practices and both ambulance crews and Emergency Medicine staff are under pressure to resolve the problem – together with the College of Paramedics we laid out this guidance.

“The problem is poor flow throughout the hospital and exit block, this will not be resolved in the Emergency Department, it is a system-wide problem and requires system-wide solutions and collaboration.

“Boards must safely expand capacity where possible, provided doctors and nurses and other healthcare workers are available to staff the beds. Same-day emergency care can help to reduce unplanned hospital admissions, maximising the delivery of this service may alleviate some pressures.

“Discharge to assess, ensuring that patients can be discharged in a safe and timely way where they have the support they need to recover in the community, can help free up beds to increase flow throughout the hospital.

“Lastly, it is vital that adequate support and resources are given to social and community care so vulnerable patients do not face successive trips to the Emergency Department or hospital.

“Clear communication between Clinical Leads and senior Board management about the reality of ambulance handover delays; dangerous crowding; and long stays is also vital. Stating the threat these practices pose to patient safety and both reporting and escalating incidents as they occur should guide leadership to take swift action.

“It is a very difficult time, and we are preparing for a gruelling winter. The past five months of performance figures suggest that more deterioration is set to come. In Emergency Medicine we must continue to work towards collaborative solutions and work with other departments, specialties, and management.

“But we continue to call on the Scottish government to set out a long-term workforce plan. In Emergency Medicine (EM) in Scotland there is a vital need to both recruit new and retain existing staff, we need at least 113 EM consultants along with sufficient numbers of both junior and supporting staff and nurses.”
Today’s statistics revealed the worst weekly and monthly A&E statistics since records began.

The statistics show that only 65.6% of attendances at A&E services in NHS Lothian were seen and resulted in a subsequent admission, transfer or discharge within 4 hours for the week ending on the 24th of October. 

This is lower than the previous record low of 66.3% recorded in week ending 12th September. Furthermore, 508 patients in NHS Lothian waited more than 8 hours, with 240 not being seen for 12 hours.
  
Scottish Labour MSP Foysol Choudhury said: “A&E services in the Lothians are in crisis, with the situation rapidly deteriorating with every passing week.’’
  
“Hard-pressed frontline staff have been sounding the alarm for months, but the Health Secretary has spectacularly failed to take action. Patients in the Lothians are being put in danger thanks to the SNP’s catastrophic failure to support A&E services. 

‘’The Health Secretary is without a workable plan, so we have a health service in freefall. Action must be taken now. Our NHS deserves better’’

Drinks spiking: MSP calls for co-operation to keep women safe

Lothians list MSP Foysol Choudhury has called for co-operation to keep women safe following reports of drinks spiking incidents in Edinburgh.

The Labour MSP said: “Many constituents have been in touch regarding the recent reported spiking incidents in Edinburgh. The council has implemented a number of measures to ensure women’s safety, particularly during the night-time economy. 

“This includes a  a network of 193 interconnected CCTV cameras in locations that have been identified as real or emerging hotspots for antisocial or other behaviour that can compromise safety. 

“A network of an additional 13 mobile CCTV cameras are also deployed on a weekly basis to ensure safety in public places. All permanent and mobile CCTV cameras are monitored 24-hours, 7 days per week.

“They are also interlinked and connected with Shop Watch, Pub Watch and Police radio, so as soon as an incident or concern arises, an immediate coordinated response is triggered. 

“This response can involve Police officers,  and/or Street Assist , whose responsibility is to support people who are identified as being potentially vulnerable.

“The Edinburgh Community Safety Partnership provides Transport Marshalls for our busiest taxi ranks located on Lothian Road, the High Street, and Leith Street, who make sure that passengers are safe while waiting for and upon entering a black cab, on Fridays and Saturdays from 10pm to 4.30am.

“Currently licenced premises are required to perform more checks in terms of collecting more visitor information than ever before. 

“I intend to monitor the situation in the City and look to ask questions in Parliament.”

Police Scotland said: “We are aware of posts circulating on social media about spiking incidents involving injections in Scotland.Officers are carrying out enquiries, and a small number of reports from the Edinburgh, Dundee and Glasgow areas are being investigated.

“These do not appear to be linked.We take all reports seriously and we would encourage anyone who believes they have been a victim of spiking in any form to contact Police via 101.”