‘Shocking and shameful’

51,400 older people endured dangerous 12 hour waits in Scotland’s A&Es last year

Extreme long waits in Emergency Departments across Scotland are a political responsibility that can no longer be ignored as more than 51,400 older patients endured stays of 12 hours or more last year – the worst on record.  

New analysis from the Royal College of Emergency (RCEM) reveals in major EDs, one in every eight patients (51,423) aged 60 or over waited more than 12 hours to be transferred, admitted or discharged in 2024.  

That’s 14,407 more patients than the year before (2023). 

And is over 16 times more people than in 2019 when just 3,135 older people endured waits of this length.    

The figures, obtained by RCEM via Freedom of Information requests to Public Health Scotland, also reveal that, concerningly, the older a patient is the longer they are likely to wait in A&E. 

People aged 70-79 have a 12% chance of waiting 12 hours or more – almost 16 times higher than it was in 2019.  

Meanwhile, people aged 80-89 have a 16% chance of enduring extreme waits, and the likelihood rises to 19% for those aged 90 and above.  

Compare that to patients aged 18-29, whose average likelihood of experiencing a 12-hour wait last year was just 2.2%. 

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Older patients often arrive to the Emergency Department with more complicated or multiple health issues.  

This, when combined with the inability to admit them onto a ward due to the lack of available in-patient beds, means older people can become stuck in Emergency Departments – enduring extreme long waits, often on trolleys in corridors.  

And when patients do finally get admitted, they often find themselves stranded in hospital, unable to go home when they are well enough to leave, frequently due to a lack of available social care support.  

Public Health Scotland recently revealed that in 2024/25, there was a record 720,119 days spent in hospital by patients whose discharge was delayed – 474,153 of which were experienced by people aged 75 or over. This accounted for two out of every three (66%) delayed discharge bed days. 

Dr Fiona Hunter, Vice President of RCEM Scotland, said, “This data is both shocking and shameful, and it is abundantly clear that older people are bearing the brunt of a system in crisis.  

“Hundreds of thousands of dearly loved people – great-grandparents, grandmas, grandads, parents – forced to experience extreme long stays in our Emergency Departments every year mainly because we don’t have enough in-patient beds to admit them to when they need one.  

“Often enduring these waits on trolleys in areas that aren’t designed to deliver care in – corridors or even cupboards. 

“It’s a failure of the system. It’s unacceptable, it’s dangerous and it’s putting lives at risk.  

“Enough is enough. The government can’t ignore the ongoing crisis our Emergency Departments – the workforce and patients – continue to face day in, day out.  

“We all deserve an Urgent and Emergency Care system that works as it should and not letting people, our most vulnerable, down when they need it most.” 

Dr Bob Caslake, Chair of the BGS Scotland Council, said, “This report highlights the urgent attention that is needed across the health and social care system to allow older people to access the care they need at the time they need it.

“The current waiting times faced by older people in Emergency Departments are unacceptable, and reducing these delays is a matter of equity, dignity, and patient safety.” 

Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said, “It is disappointing that this information is not routinely collected, analysed and published and it is unacceptable to see so many older people waiting hours — sometimes days — in A&E wards for the care they need.

“These older people are often living with frailty, dementia, and multiple other health conditions. They deserve to be treated with dignity and compassion.

“Long waits for care are neither dignified nor compassionate and can also lead to serious harm. This is not the standard of care we should accept for our parents, grandparents, or neighbours.

“With the numbers of older people in Scotland in need of care expected to increase dramatically, we urgently need a system that prioritises timely treatment and supports frontline staff in delivering the respect and care our older population deserves.” 

The figures come after the Royal College of Emergency Medicine published a report earlier this year looking at the care older people, aged 75 and over, receive in Emergency Departments across the UK.   

Titled ‘Care of Older People 2023-24’, the research found there was insufficient screening for three common conditions which primarily affect this age group, including delirium and for general frailty. 

RCEM also released analysis in February which found the number of people experiencing stays of longer than 12hrs in Scotland’s ED last year was a staggering 99 times higher than 2011 when records began. 

CHI in Local Government: Improving Outcomes through Partnership

CHI in Local Government Project brings together key partners to deliver better outcomes for citizens

A new project exploring the use of the Community Health Index (CHI) number in Scottish Local Government has been awarded £590,000 funding from the Scottish Government.

The ‘CHI in Local Government’ project, led by COSLA, the Digital Office for Scottish Local Government, and Public Health Scotland, seeks to improve information sharing across health, social work, and social care services.

The Community Health Index (CHI) System, which has underpinned NHS Scotland’s digital infrastructure for over 40 years, provides a unique patient number used across the health service. It supports everything from immunisation and screening programmes to primary and secondary care delivery.

The CHI In Local Government project aims to use the CHI number to improve the quality of the data services hold, allow services across health, social work, and social care to better match data, and ultimately deliver better outcomes for our citizens.

Accessing health, social work, and social care services all too often requires people to repeat their information. Using the CHI number as a common identifier across health, social work, and social care will reduce this duplication and improve integration of services. To deliver the highest standard of care, it is essential that our workforce have access to the right information at the right time.

The aims of the CHI in Local Government project align clearly with the ambitions set out in the joint COSLA and Scottish Government Digital strategy, Care in the Digital Age, and Data strategy, Greater Access, Better Insight, Improved Outcomes.

Both strategies emphasise the importance of robust information governance and seamless data sharing across health and social care.

Councillor Paul Kelly, COSLA Health and Social Care Spokesperson, said: “I am delighted that the CHI in Local Government project has received funding to progress to the Discovery phase.

“By using CHI more widely across our Councils we can improve data matching and, crucially, reduce the amount of times people accessing our services have to repeat their information.

“I look forward to continuing to champion this work as it progresses and ultimately delivers better outcomes for our citizens.”


Tom Arthur, Minister for Social Care and Mental Wellbeing, said: “In line with the priorities recently set out in the Health and Social Care Service Renewal Framework, I am pleased to support this project.

“Using CHI numbers in social care means people will get a better level of service. By allowing information to be shared safely and confidentially between professionals, we can reduce duplication of work, and the time staff have to spend on administrative tasks.

“It will further embed the integration of health and social care and help in preparations for the health and social care online app, launching in Lanarkshire later this year.”

Martyn Wallace, Chief Digital Officer, Digital Office for Scottish Local Government, said: “I am thrilled with this significant investment as we continue to work closely with our public sector partners to enhance our digital services for citizens.

“By utilising the Community Health Index (CHI), we will streamline access to services, reduce the need for individuals to repeat their information, and ensure timely delivery of care.

“This initiative will also promote better integration of health and social care services, support other collaborative digital projects like the new Health & Social Care App, and ultimately improve outcomes for our citizens.”

Scott Heald, Director of Data and Digital Innovation, Public Health Scotland said: “Our vision at Public Health Scotland (PHS) is focused on ensuring communities can flourish across Scotland.

“We bring together data and intelligence to shape decisions affecting health and care. This work to adopt the Community Health Index (CHI) in Scottish Local Government will make a huge contribution towards how we can work with partners to maximise the benefits of digital and data in ways that will empower individuals and communities.

“PHS already collects and analyses data from across the domains of health and social care, much of which Is sourced directly from Local Government systems.

“The opportunity to integrate the CHI into those underlying systems will lead to faster, more efficient, and accurate production of whole-system data on health and social care services and provide insights on outcomes for individuals across Scotland.”

Update on measles in Scotland – ensure everyone in your family is fully protected

Cases of Measles are on the rise across the world, so we encourage everyone to make sure you have received two doses of the measles, mumps and rubella (MMR) vaccine. Dr Sam Ghebrehewet, Head of Vaccination and Immunisation at PHS, explains more:

As measles cases continue to increase across the world, including in England where outbreaks continue, Public Health Scotland (PHS) is continuing to encourage the public to take up the offer of the Measles, Mumps and Rubella (MMR) vaccine. Having two doses of the MMR vaccine is the best way to be fully protected against measles.

As of 9 July, there have been 27 cases of laboratory confirmed measles in Scotland in 2025.

Measles can be a very serious condition, causing pneumonia and encephalitis (inflammation of the brain) and can affect people of any age if they have not been vaccinated. 

The MMR vaccine protects against measles with the first dose offered to children between 12-13 months, and the second dose offered at 3 years 4 months. If it’s missed at these times, it can be given at any age.  

Uptake of MMR has declined across all UK nations in recent years and there remains a risk of infection in those who are not vaccinated or not fully vaccinated for their age.

Health care workers should also have two doses of MMR and are advised to speak to with their employer or occupational health department if they haven’t been fully vaccinated.  

Dr Sam Ghebrehewet, Head of Vaccination and Immunisation at PHS said: “Measles is highly infectious and can lead to serious and potentially life-threatening complications for some people. 

“We’ve seen a modest decline in vaccination rates in Scotland over the last decade which is a concern as measles can spread quickly in communities where vaccination rates are low.

“That’s why we’re encouraging anyone who hasn’t had two doses of the free MMR vaccine, as well as parents and carers of children who have missed a dose, to visit the NHS Inform website and find out how to arrange an appointment in their local health board area.

“We would also encourage those who are planning to travel anytime soon to ensure that you and your children are up to date with all your vaccinations before leaving the country.”

For more information on the history of measles, read our blog Measles – a clear and continuing threat.

More information on measles, including what to do if you think someone in your family has symptoms, can be found on Measles | NHS inform.

Further information on how to check you / your child is fully protected can be found on MMR against measles | NHS inform.

Health protection teams and other health professionals can find the latest measles public health guidance here: Guidance for professionals – Measles and find the latest campaign assets here.

Updates on case numbers are published on our data and surveillance page every Thursday.

https://publichealthscotland.scot/news/2025/july/update-on-measles-in-scotland-ensure-everyone-in-your-family-is-fully-protected

Consultation: Shaping our Strategy and the future of Scotland’s health

PUBLIC HEALTH SCOTLAND

Stakeholders across Scotland are invited to support the development of Public Health Scotland’s new strategy for 2025-2035. 

As Scotland’s national public health body, we work to protect, improve, and sustain the health of Scotland’s people. We provide leadership for population health protection and improvement, supply trusted and evidence-informed advice, curate Scotland’s health data, and collaborate across all sectors turning policy into action.  

Our vision remains simple but ambitious: a Scotland where everybody thrives. Within the next ten years, our aim is to boost average life expectancy by at least a year and reduce inequalities in life expectancy. 

Scotland’s Population Health and Service Renewal Frameworks provide the ambition and direction for how Scotland will achieve this, through the core principles of preventing ill health, improving access and strengthening service quality. 

Our strategy will define our role: what we will do and how we will lead and work with partners to deliver these plans for Scotland’s health. 

We invite stakeholders from across Scotland to contribute their views to shape our strategy and to help us understand how we can achieve these goals in collaboration with partners.  

We will proactively contact and engage with a diverse range of stakeholders based on Shaping our Strategy, however we would also like to hear from other individuals and organisations.  

To support this process, several questions are provided. The closing date for submissions is Friday 29 August 2025. Feedback should be emailed to phs.strategicdevelopment@phs.scot. 

These submissions will inform our strategy which we will publish later this year. 

Find more information, including how to submit a consultation response, by viewing Shaping our Strategy.

Go to the Scottish Government’s Population Health and Service Renewal Frameworks 

Read a blog from Paul Johnston, Chief Executive of Public Health Scotland, where he discusses the new Frameworks 

RCEM: ‘Evidence to address delayed discharges continues to mount’

The issue of people who are well enough to leave being stranded in hospital wards and occupying increasingly scarce inpatient beds must be addressed if Emergency Care in Scotland is to improve.  

That’s the response of the Royal College of Emergency Medicine Scotland as new data reveals that May 2025 was the second worst May on record for so called ‘delayed discharges’. 

Published today (1 July 2025) the figures from Public Health Scotland, which detail A&E performance, show a daily average of 1,852 beds were occupied by people who were considered to no longer need inpatient care – the second highest for any May since guideline changes in 2016.  

And when compared to the previous month (April 2025) – it’s an improvement of just two beds.  

If patients cannot be discharged, this affects the flow of people through the hospital – and people end up stranded in A&E, often waiting extreme hours on a trolley in a corridor, for a ward bed to become available.  

 Covering May 2025, the figures reveal that: 

  • 125,779 people visited a major A&E Department (Type 1) in Scotland. A 6.7% increase compared to April.  
  • Of these, one in three patients (40,261) waited four hours or more to be treated, admitted or discharged (32%).  
  • Meanwhile, just fewer than one in 10 patients (12,672) waited eight hours or more in major EDs – the second highest number for the month of May.  
  • And 4,863 patients waited 12 hours or more – the equivalent to one in every 26 patients. Which is a slight improvement on the previous month when 5,139 patients endured this wait.  

The figures come just a week after  Public Health Scotland released data revealing there were 720,119 days spent in hospital by people whose discharge was delayed during the year 2024/5 – the highest annual figure reported since guidelines changed in 2016.  

Of the total number of delayed discharge bed days, 73% were due to health and social care and patient and family related reasons (522,599).  

 

Vice President of RCEM Scotland, Dr Fiona Hunter, said: “Yet again, the evidence to address delayed discharges continues to mount. 

“As I’ve said before, and I will say it again, the situation at our hospitals’ ‘backdoor’, where we unable to discharge people, is deeply concerning and distressing for both patients and the workforce.  

“Patients when they are well enough to leave want to do just that – leave, to continue their recovery. But often they can’t because of a lack of social care. 

“Meanwhile in A&E, seriously unwell people are left waiting for that elusive ward bed to become available, watching the clock tick by and counting the hours they have spent on a trolley in a corridor.  

“This is the reality for thousands of patients every month, while Emergency Medicine clinicians try their best to treat patients in areas that weren’t designed to deliver care in. And it’s not just an issue confined to the winter months – it’s year-round.  

“So it is hard to celebrate slight improvements in extreme waiting times when every day my colleagues are struggling to admit vulnerable patients that need further care. 

“Until available inpatient bed numbers increase the crisis in our EDs will continue.” 

Graphic visualisations of the data compiled by RCEM can be found here.  

Eligible people urged to take up COVID-19 vaccination offer

COVID-19 is still here.

Older adults and people with a weakened immune system are being offered a COVID-19 vaccine.

Protection against COVID-19 reduces over time, so it’s important to get vaccinated before the offer ends on 30 June.

You’re eligible for a COVID-19 vaccine this spring if you are:

  • aged 75 years and over
  • in a care home for older adults
  • over the age of 6 months and have a weakened immune system

It’s important to take up the vaccine every time you’re offered. Even if your health condition is well managed, you’re still at increased risk.

More information:

http://nhsinform.scot/covid19vaccine

New report explores the future demand for healthcare services in Scotland

Public Health Scotland (PHS) has published a new analysis of the possible future demand for healthcare services in Scotland over the next decade.

The analysis, which focusses on unplanned NHS hospital activity and is based on historic trends and projected demographic change, offers a best estimate of future demand if current trends continue.

The report, “Projecting Future Demand for Health and Care Services in Scotland (2024-2034) – A Focus on Unplanned Inpatient Admissions to Acute Hospitals”, estimates an 11.8% rise in unplanned hospital admissions between 2024 and 2034, from approximately 586,000 to 656,000. This projected growth appears to be driven primarily by the impacts of an ageing population.

This latest report builds on the work of the Scottish Burden of Disease study, which has highlighted potential future population health challenges across a wide range of health conditions.

This projected demand for healthcare services is far from inevitable and it is being used to plan for a healthier, better future for everyone. PHS’s extensive modelling of possible future demand has helped to inform the Scottish Government’s Population Health Framework, published yesterday (17 June).

Recognising that people’s health is about more than healthcare, the framework introduces a whole-system, whole-person approach to promoting health, preventing illness and tacking health inequalities.

Dr Fatim Lakha, Consultant in Public Health Medicine at PHS, said: “Our report estimates that, by 2034, Scotland’s NHS could be managing around 1,300 additional unplanned hospital admissions each week.

“A substantial part of this rise is expected to come from people aged 65 years and over, primarily driven by Scotland’s ageing population. Meanwhile, admissions amongst children under 18 years are expected to remain at similar levels, even though the number of people in this age group is decreasing.

“It is important to note that these projections are not inevitable.  Every additional admission represents a person whose health issue might have been prevented through earlier action.

“Strengthening the building blocks of health – like secure income, fair employment, quality housing and education – offers the greatest opportunity to improve Scotland’s health and stop these projections becoming a reality.

“Reforming NHS services is also essential to managing rising demand.  But without sustained action across both prevention and service redesign, pressures on hospitals are likely to continue, even as the quality of care itself improves.”

https://twitter.com/i/status/1934988684790562885

Dr Andrew Lee, Whole-systems Lead, at PHS, said: “We celebrate the fact that more people are now living longer, thanks to advances in public health. We must also ensure that, in these additional years, they also enjoy good health and a good quality of life.

“By acting now to improve health and wellbeing across the population, we can support a better quality of life in later years, ease pressure on healthcare services, and help to build a sustainable, future-ready NHS.”

Read the PHS report 

Latest version of Ready Steady Baby! available now

The latest version of Ready, Steady, Baby! is now available.

Everyone who is pregnant and lives in Scotland will receive a free printed copy from their midwife (also available in other formats and languages). It’s also available on NHS inform.

https://nhsinform.scot/ready-steady-baby

Public Health Scotland: Make sure you’re protected against measles

Cases of measles are on the rise. It’s important everyone going on your family holiday has had two doses of the MMR vaccine before travelling.

Visit

http://nhsinform.scot/MMRagainstMeasles…

to check you and your family are fully protected.

#DontLetMeasles

Eligible? Get your Covid vacccination

Older adults and people with a weakened immune system are being offered a COVID-19 vaccine.

Protection against COVID-19 reduces over time, so it’s important to get vaccinated when offered.

For more information, visit http://nhsinform.scot/covid19vaccine #SpringTopUp