RCEM Scotland: Huge increases in extreme A&E waits ‘dangerous and shameful’

More than TEN TIMES as many people waited over 12 hours in Scottish A&Es in August 2023 than in August 2019 – an increase branded ‘dangerous and shameful’ by the Royal College of Emergency Medicine.

The figure has been calculated using data published yesterday (3 October 2023) by Public Health Scotland and reveals how many people visited a major Emergency Department in Scotland in August 2023.

When compared with August 2019 (pre-pandemic) they show the number of people waiting:  

  • more than four hours is up from 14,372 to 39,147 
  • more than eight-hours is up from 1,395 to 10,793
  • more than 12-hours is up from 352 to 3,847.

The data for August 2023 shows:

  • 116,673 people visited a major Emergency Department in Scotland – almost 6,000 more than the previous month (110,854).
  • 67.90% of patients were seen within four-hours at major Emergency Departments.
    • This is a decrease of 1.7% from the previous month.
  • 37,415 patients waited more than four-hours in major Emergency Departments, which is a 9.8% increase from the previous month and an 5.3% decrease from August 2022.
  • 10,793 (9%) patients waited eight-hours or more in an Emergency Department
    • This is an increase of 2% from the previous month. But a 1.9% decrease compared with August 2022.
  • 3,847 (3%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred
    • This figure has increased 0.9% from the previous month, but decreased by 1% compared with August 2022.
  • There were 1,797 beds occupied due to delayed discharges, the most for any August on record. 

Visualisations for the data are available here.

Responding to the figures, Dr John-Paul Loughrey, RCEM Vice President for Scotland, said: “When you compare figures month-on-month you only get a snapshot of what is happening, but when you take a longer view it reveals the bigger, much more concerning picture.

“To think that in just three years we have seen the percentage of people experiencing extreme waits increasing so significantly is shocking.

“But worse than that it is shameful, and it is dangerous. We know long waits increase the risk of people dying.

“The system is stretched to beyond capacity. Nobody wants to be in this situation – not patients and certainly not clinicians. And this should not be blamed on the pandemic – it is symptomatic of a much wider issue.

“In the short term, we need decisive and urgent action from the Scottish Government to avert what is looking like an inevitable winter A&E crisis, but we also need and effective long-term strategy to reverse this unacceptable situation.”  

Social care crisis must be addressed, says Royal College of Emergency Medicine

Commenting on the latest Urgent and Emergency Care Daily Situation Report 2021-22 that shows nearly one third of patients who were in hospital for 21 days or more were fit for discharge, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “These data reflect the deepening social care crisis.

“We currently have the highest number of long stay patients (21 days or more) since winter 2017-18. Last week, on average, 6,500 beds were occupied by patients who are fit for discharge, and only one in 10 of these patients were able to be discharged daily (on average). All these patients will want to return home and to their communities, but they are unable to because there isn’t the support to aid them upon their discharge.

“There must be a system-wide effort and focus on discharging patients, but such effort will only translate to meaningful action if the government address and take urgent steps to resource social care. Freeing up these beds would help alleviate system pressures, particularly those on Emergency Departments, and promote vital flow throughout the hospital.”

The latest Urgent and Emergency Care Daily Situation Report 2021-22 for the week 10 – 16 January 2022 show:

  • As a daily average 17,541 patients stayed in hospital for 21 days or more
  • As a daily average 6,495 of these long-stay patients were fit for discharge, this is equal to nearly one in three
  • On average only 656 patients were discharged daily, equal to just one in 10