Tag: hospital

Delayed Discharge: ‘The current approach has failed’

Significant Change Needed, says new report

NHS Scotland spent £440m last year on beds for patients who were unable to get out of hospital despite being ready to be discharged, according to a new report by Scotland’s public spending watchdogs.

The report from the Audit Scotland and the Accounts Commission said one in nine hospital beds were occupied because of delayed discharges in the 12 months to April 2025.

It said the Scottish government must set out a plan to tackle the problem.

Delays in discharging patients from hospital affect people’s physical and mental health, and make it harder to admit others to hospital. Delayed discharges are a symptom of wider pressures across health and social care in Scotland.

The joint report by the Auditor General for Scotland and the Accounts Commission warns this has a significant effect, despite impacting only around three per cent of hospital patients. People medically ready to leave spent 720,000 unnecessary days in hospital in 2024/25. Whilst the full financial impact is unknown, the cost to the NHS in hospital days alone is an estimated £440 million a year.

The causes are complex, including rising demand for health and social care services, financial pressures, long-standing recruitment and retention problems across Scotland and for some, not having a Power of Attorney in place.

Reducing delayed discharges is a priority for the Scottish Government and their partners in health and social care, with significant activity underway to tackle this. But a lack of evaluation of initiatives across the country means it is difficult to measure what is having the greatest impact and whether these initiatives represent value for the money and time spent.

Stephen Boyle, Auditor General for Scotland, said: “Delayed discharges from hospital have far-reaching impacts on people’s health and well-being. The Scottish Government, health bodies, councils and other partner organisations agree on the need for major changes and are actively trying to reduce delayed discharges.

“Now they must improve how they collect, analyse and use data to evaluate the initiatives underway to tackle the problem. Without this, it’s impossible to understand the impacts and costs of delayed discharges and whether the initiatives across Scotland are improving lives, services and delivering value for money.”

Malcolm Bell, Member of the Accounts Commission said: “Significant change is critical across our health and social care services, shifting towards preventative care, greater use of technology and ongoing investment in the workforce. Without this, the care and support individuals need to leave hospital won’t always be available.

“The Scottish Government and COSLA’s joint health and social care service renewal framework is an opportunity for progress to be made with health and social care reform. But IJBs and social care need to be at the centre of planning and decision-making on service renewal, and it’s not clear how the framework will address the challenges faced by social care.”

‘The current approach has failed’

In response to the joint report into delayed discharges by the Auditor General for Scotland and Accounts Commission, Dr Fiona Hunter, RCEM Vice President for Scotland, said: “This report lays bare the scale of delayed discharge, and the impact it has on our health and social care system and the people it serves.  

“720,000 days’ worth of unnecessary hospital stays in the 2024/25 financial year. That’s almost 2,000 years – an almost inconceivable amount of wasted resources which, if exit block had been addressed, could be used to help the patients lining the corridors of Emergency Departments day in, day out.  

“The knock-on effect delayed discharge has on EDs cannot be overstated.  

“Every hospital bed occupied by someone who does not need it, but cannot leave through no fault of their own, adds pressure to EDs which are receiving more patients than they can move on.  

“And these unnecessary stays in a hospital bed puts patients at greater risk of hospital-born infection, and can lead to deconditioning, stripping them of their independence. 

“This is something RCEM has been raising the alarm about for years now, and while the government has acknowledged the issue and taken some steps to address it – the total breakdown in hospital flow outlined in this report shows that the current approach has failed.  

“Things cannot go on like this and I hope the government, health service and local authorities heed the recommendations set out by the Auditor General for Scotland. 

“Improvements to data gathering and discharge planning, among the other recommendations, would be a step towards the system-wide approach we have long said is needed to fix Emergency Care.”  

RCEM said earlier this week that The Scottish government must prioritise tackling delayed discharges and overcrowding in Emergency Departments (EDs) or risk the entire system collapsing under the strain of an incredibly difficult winter. 

Th message from the Royal College of Emergency Medicine (RCEM), followed the release of ED performance figures on Tuesday (6 January) by Public Health Scotland (PHS) for November 2025.  

One in 15 patients (8,065) waited 12 or more hours in a type-1 ED before being admitted, transferred or discharged in that month alone, the worst figures for a November since records began in 2007.  

Further, the new data found that:  

  • It was the worst November on record for eight-hour waits, which stood at 17,259, or 14.5% of patients attending a major ED 
  • Only 63% of patients seen within four hours at type-1 EDs, a far cry from the government target of 95%  
  • Compared to November 2018, waits of four or more hours were four times higher, eight-hour waits were 14 times higher, and 12-hour waits were 39 times higher 
  • Meanwhile, the number of people attending ED was only 5.5% higher in November 2025 compared to November 2018 

Dr Fiona Hunter, RCEM Vice President for Scotland, said: “This is yet another month of predictable broken records for Emergency Medicine performance in Scotland.  

“The Scottish government continues to shout about improvements to NHS waiting lists. We, of course, welcome these but a lack of political will to put the same emphasis on addressing delayed discharges means our departments are at risk of total derailment.  

“We are now in the depths of winter. Patients are arriving into EDs only to find that there isn’t the space to treat them safely, let alone quickly.  

“Very sick and injured people are lining corridors, crammed into whatever space we can find, because of exit block and a complete breakdown in flow out of hospitals. 

“With warnings of storms, snow and freezing temperatures, the situation is likely to get a lot worse before it gets better.  

“It’s unacceptable that this has been allowed to happen, but it’s not too late to act. We call on the government to support health boards so they can make the improvements needed to tackle delayed discharges and improve patient flow.”

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RCEM: Scottish government must act now to avoid a “truly ugly winter”

12-hour waits in EDs joint worst on record for October

The Scottish government must take urgent action on overcrowding and delayed discharges, or Emergency Departments (EDs) in Scotland will be completely swamped – and patients will be the ones who suffer. 

ED performance figures, released today (2 December 2025) by Public Health Scotland (PHS) for October 2025, showed that one in 16 (7,362) patients waited 12 or more hours before being admitted, transferred or discharged in that month.  

That is the same proportion as last October, which was the worst since records began in 2007 for 12-hour waits.  

The figures also showed:  

  • 16,659 patients, or 14.1% of all attendances, waited eight or more hours, the worst of any October on record, and an increase of 1,211 on last year 
  • Only 62.8% of patients were seen within four hours at major (Type-1) Emergency Departments, which is the worst four-hour performance for any October since records began and far below the target of 95% 
  • There was an average of 1,981 beds each day occupied by patients medically fit to be discharged 

These figures come shortly after the publication of the Scottish government’s winter plan, in which it pledged £20m to tackle delayed discharges across the devolved nation.  

Dr Fiona Hunter, RCEM Vice President for Scotland, said: “The figures for October demonstrate the unacceptable pressures our departments are under, and just how bad things are as we go into winter. 

“Now, seasonal pressures such as flu are beginning to hit EDs and the system is starting to crack under pressure,which means patients and staff are suffering. And we are only in the early stages of winter so it will likely become even worse for patients if nothing changes. 

“As our hospitals deal with the inevitable strains and stresses on vital resources that the colder weather brings we’ll once again see the consequences of the failure to properly tackle the issues EDs face; overcrowding, long delays and avoidable deaths. 

“The number of patients experiencing the longest waits is utterly unacceptable and something must change. Clinicians, through no fault of their own, are struggling to provide our patients with the care they deserve and need. 

“Last month, we welcomed the government’s £20 million funding announcement to boost social care capacity this winter, and its accompanying plan for the health service to tackle the cold months.  

“This showed that the government understood the issue. But we need that understanding to translate into further meaningful short and long-term action. Urgent action is needed to ensure that health boards can make the improvements that are needed to improve patient flow and tackle delayed discharges.   

“Our EDs will only get through the coldest months if the government steps in – or we all need to brace ourselves for a truly ugly winter.”  

Graphs of the data can be found on the RCEM website.

#ResuscitateEmergencyCare

Nigerian hospital reports surge in child ops thanks to KidsOR charity

A hospital Operating Room for children in the capital of Nigeria, which was newly installed in August 2019 thanks to a Scottish-based charity, has managed to increase the number of paediatric operations carried out by more than two-thirds in just a year.

From July 2018 to July the following year, 229 operations on children at the National Hospital in Abuja were carried out. Then, thanks to Kids Operating Room, a new Operating Room was installed in August 2019. This new Operating Room has enabled the surgical team in Abuja to undertake 381 operations from September 2019 to September last year – a staggering rise of more than 66 per cent.

Commenting on the difference that the new Operating Room has made, Dr Olubunmi Majekodunmi, the hospital’s Chief Paediatric Surgeon, said: “Having a KidsOR Operating Room has made surgeries far more effective. We have paediatric-sized instruments and do not have to struggle with larger ones meant for adult surgeries.

“As for the children, they move into an Operating Room filled with beautiful wallpapers and exciting toys and are so engaged that they do not even realise when they are put under anaesthesia. But, most importantly, our backlog of patients which used to involve a waiting list of a year or sometimes more, has been cleared.

“The relief on the faces of parents when they realise that their kids can have surgeries within a few days – enough time for pre-operative preparation – is priceless. Thank you KidsOR for such a tremendous gift!”

Rosemary Mugwe, Africa Director at KidsOR, said: “The Surgical Team at National Hospital were carrying out fantastic work before KidsOR came on board; however, they lacked specialist paediatric equipment to provide safe, quality surgery.

“We were happy to provide the tools – metaphorically and literally – to give them even greater capacity to help the children of Abuja. And we are delighted to learn of the large increase in the number of operations being carried out meaning that children do not have to wait for life saving or life changing surgery.”

The charity’s research also revealed that the percentage of wound infections decreased from 1.3 per cent to 0.29 per cent during the year after the new Operating Room was installed. This figure represents the percentage of surgical cases in which the patient developed a surgical infection and is another quality of surgery measure.

KidsOR is a Scottish global health charity with bases in Edinburgh, Dundee and Nairobi with an ambition to provide all children around the world with access to safe surgery.

The charity also funds training of surgeons and anaesthesia providers and works with National Ministries of Health to develop sustainable healthcare services.

Lift Off for NHS Lothian’s new helipad at New Sick Kids

NHS Lothian and the HELP Appeal are today (12 April) celebrating an important milestone as the new helipad located at the Royal Hospital for Children and Young People and the Department of Clinical Neuroscience (RHCYP/DCN) officially opens.

The helipad, located above the fourth floor of the RHCYP/DCN will serve both the Royal Infirmary of Edinburgh and the RHCYP/DCN giving direct access to child and adult emergency departments, as well as all other clinical departments based on site.

Hospital helipads play a critical role in trauma care by helping to minimise the time it takes to transfer critically ill patients. Without them, patient treatment can be delayed, which can have a devastating impact on survival rates.

Dr Jon McCormack, Clinical Lead for Paediatric Major Trauma, NHS Lothian explained that having access to a helipad plays an important role in optimising patient flow pathways for both planned and emergency transfers.

He said, “The helipad will provide access to hospital services 24 hours a day, seven days a week, with three trained helideck responders being available to ensure safe landing and departure. This will help to enhance patient care by facilitating a seamless transition of patients from the air ambulance to in-patient services.”

The helipad was part funded through the HELP Appeal, which aims to ensure that patients who sustain life threatening critical injuries or illnesses are able to be flown directly by air ambulance to a Major Trauma Centre or key A&E hospital, where all the specialist clinical skills and medical equipment are immediately available, improving their chances of survival and recovery.

The HELP Appeal is the only charity in the country funding hospital helipads.

Robert Bertram, Chief Executive of the HELP Appeal said, “The amazing RHCYP, DCN and the Royal Infirmary of Edinburgh treat some of the most seriously ill in Scotland. This lifesaving helipad will dramatically speed up the time it takes to transfer these patients from helicopter to hospital anytime of the day or night, giving them the best chance of survival and recovery.

“We had no hesitation in providing the £700,000 needed to ensure the hospitals had a state-of-the-art helipad – a crucial element in their emergency care offering – as it will save many lives.

“With brand new helipads opening in Applecross and Campbeltown, and the helipad opening in Edinburgh today, we are so pleased that the HELP Appeal is making a positive impact in emergency care across Scotland. We look forward to helping many more hospitals secure helipads in the future.”

Jim Crombie, Deputy Chief Executive, NHS Lothian said, “We are incredibly grateful for the support of the HELP Appeal in part-funding our new helipad.

“It really will make a positive difference to our patients and will no doubt save many lives not just here in Lothian, but across Scotland.”

Play time at children’s hospitals

Get Well Gamers donation

Young patients undergoing treatment at the Royal Hospital for Sick Children (RHSC), the CAHMS Inpatient Unit at the Royal Hospital in Edinburgh and the Children’s Ward at St John’s Hospital in Livingston have received a host of special gifts to help fill the hours spent in hospital.

Get-Well Gamers, a charity dedicated to bringing electronic entertainment to children’s hospitals for the benefit of entertainment and pain relief, has donated a number of gaming consoles and games to the West Lothian ward, including Xbox 360s, PlayStation 3s and Nintendo Wiis.

Originally donated to the charity from Microsoft, the consoles have now been redistributed to children’s hospitals across the UK.

Jordan McDonald, Play Specialist at St John’s, said: “Our brand new Xbox has already been well used. Four boys who were at the ward for theatre used the console to play FIFA together, with one little boy even saying it was the best day of his life! This sort of reaction from children is truly priceless – we can’t thank Get-Well Gamers and the Sick Kids Friends Foundation enough their generosity in making these distractions possible.”

James Stewart, Director of Get-Well Gamers UK, said: “We’re delighted to have been able to donate to St John’s Hospital and the Royal Hospital for Sick Children. Play Specialists do fantastic work and have next to no budget for video games and consoles. 

“Having access to electronic entertainment is of great benefit to children in hospital. It helps them with pain management, encourages socialising with other children and alleviates boredom. We’re very grateful to The Sick Kids Foundation for making this donation possible.”

The Sick Kids Friends Foundation (SKFF), which is responsible for funding the best facilities, equipment, distractions, emotional support, training and research in the RHSC and its surrounding facilities, has worked closely with gamers over the last six years to raise money for these extra comforts.

The charity’s Sick Kids Save Point – now the biggest video gaming marathon in the UK – has raised £72,000 to date and continues to champion gaming as a welcome distraction for sick kids spending hours on hospital wards.

Rachel McKenzie, head of fundraising at the Sick Kids Friends Foundation, said: “Get-Well Gamers’ donations have already made a fantastic difference to the children’s hospital experience.

“We’re always looking for people to help support the work of the Foundation and make life a little easier for our young patients. I would encourage any gaming fanatics keen to do something different for the cause to sign up to our 24 hour Sick Kids Save Point gaming marathon taking place later this year.”

Sick Kids Save Point event takes place from 9 until 11 October, 2015. For more information visit www.sickkidssavepoint.com.

For more information on Get-Well Gamers visit www.getwellgamers.org.uk.

 

A week on Ward 72: new exhibition at Western General

Edinburgh SketcherLOCAL arts and disability organisation, Artlink, is pleased to present an exhibition of drawings by Mark Kirkham – ‘The Edinburgh Sketcher’- documenting his observations as an artist-in-residence at the Royal Victoria Building at the Western General on Ward 72. The exhibition also shows Mark’s perspective – as a parent – of time spent in Edinburgh’s Royal Hospital for Sick Children.

Mark is an Edinburgh-based illustrator who produces an almost daily sketch blog of life in and around Scotland’s beautiful capital; an online sketchbook of scribbles and observations of daily life.

Impressed with his work,  Artlink invited Mark in to become an artist in residence in the care of the elderly wards, documenting situations and stories from patients and staff on the ward. These observational drawings begin to explore how we communicate different healthcare experiences and contribute to a growing body of work which explores the positive relationship between the arts and healthcare in supporting recovery.

Mark said: “I would like to thank all the staff and patients for making me feel so welcome during my week on Ward 72. I drifted in and out, sketched from the corners of the room and tried to stay out of the way of the busy staff’. In the patients rooms it was a different experience, I was in their personal space and was welcomed in and given time and an insight into their lives. Through our chats and my drawing we connected and shared our individual stories and discussed what brings people into hospital.”

Over many years Artlink has worked with patients and staff to encourage their involvement in cultural and arts activity throughout NHS Lothian. We realise that this work not only creates positive involvement, we also know that it supports better communication and contributes positively to recovery. We are delighted with the response to Mark’s drawings so far.

Kirsten Smith, senior charge nurse, said: “It was great having Mark on the wards it was a positive experience for staff and patients. The patients were happy to talk about something else other than their illness and other routine matters for a while. Mark through his sketches has captured the person not the patient, you really see a person that is valued and respected and their story.”

A patient from North Berwick added: “I really enjoyed meeting Mark he came across as a very intelligent and interesting young man who obviously loves to draw. I liked his drawings and the amount of detail he has put, he’s captured North Berwick beautifully although he’s aged me by one year as i’m 90 not 91 but I am in my 91st year so I will let him off. I’ve showed it to some friends and they really like it too. I ended up being in hospital for three months and it was lovely to chat to Mark about other things and for someone from outside to come in to the ward.”

“I’m pretty sure we both benefited, I know how long days can be when in hospital and to have a friendly visit, which some of these patients aren’t lucky enough to have daily, it can be a great lift emotionally – which hopefully leads to a lift physically too,” said Mark.

SickKids

The other part of the exhibition features Mark’s observations at the Sick Kids Hospital.

In 2011, Mark’s wife gave birth to twins, James and Zoe. James has Haemophilia A and consequently the family have had several visits to Edinburgh’s Sick Children’s Hospital. Whilst there, Mark continued to draw and most of the sketches shown here were made during the time James was in hospital. For Mark, drawing was a welcome distraction from all the things he was powerless to help with, and they have become a visual diary of a most terrifying, depressing and uplifting and amazing time in their lives, something that is being replayed many times over in a hospital ward right now.

We all have different ways in which we document our experiences. Some of us – like Mark – will draw, others write, and many of us will take pictures and now more often than not we will share these on Facebook or Twitter. In essence the arts are a tool of communication, both in terms of what we can make sense of and what we can’t. The arts can give us a new perspective on our experiences and provide new opportunities for understanding. Over many years Artlink have worked with patients and staff to encourage their involvement in cultural and arts activity throughout NHS Lothian. We realise that this work not only creates positive involvement, we also know that it supports better communication and contributes positively to recovery.

‘The twins were born on 9th March 2011 at just past 10pm at the Simpsons Memorial ward at Edinburgh’s Royal Infirmary. James arrived first weighing 4lb 15.5oz with his sister Zoe (5lb 5oz) following close behind”, said Mark. “We discovered James had Haemophilia A early, thankfully, when a routine heel prick on the maternity ward failed to stop bleeding. A genetic disorder which impairs the body’s ability to control blood clotting, Haemophilia A can cause even minor injuries to result in a severe bleed, either externally or internally. Such a bleed can last much longer and frequently require medication to stop.”

The Edinburgh Sketcher exhibition can be viewed from 1 August –November 2014 at

The Western General Gallery

Link Corridor between Alexander Donald building and Anne Ferguson Building

Western General Hospital, Crewe Road South.

You can see more examples of Mark’s work at www.edinburghsketcher.com

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Arts and disability organisation Artlink celebrate their thirtieth anniversary this year. For more information about Artlink visit www.artlinkedinburgh.co.uk