Dire state of A&E should be top of the Scottish Election agenda as record numbers experience long waits
As thousands of patients each month in Scotland are forced to wait more than half a day in Emergency Departments (ED) before being discharged, transferred or admitted, whoever forms the next Scottish Government must make this healthcare crisis an emergency. That’s the key message from the Royal College of Emergency Medicine following the publication of new ED performance data from Public Health Scotland.
A total of 7,967 patients, or one in 13, people who attended a major (type 1) ED in Scotland in February waited 12 or more hours before being admitted, discharged or transferred.
That’s an unacceptable proportion – and the worst of any February on record. In February 2025, the figure stood 1,895 lower, which was already dangerously high.
Less than a decade ago, in February 2019, just 344 patients waited that long across the entire month, despite more people attending EDs.
Dr Fiona Hunter, RCEM Vice President for Scotland, said: “Long waits in EDs are dangerous for patients and, for the sickest patients who require admission into a ward, are associated with increased risk of death.
“The state of our departments is utterly dire. This winter has left our members, and the departments they work in, on their knees. We are crying out for help.”
Driving this breakdown in patient flow are inefficiencies and blockages throughout the system. One of the greatest causes is delayed discharges.
PHS’s new data showed that in February, a daily average of 1,984 patients were occupying hospital beds despite being medically fit to leave.
Dr Hunter continued: “If the ‘back door’ blockages in our hospital, causing patients to be stuck in beds they do not need, it would ease pressure across the system – particularly in ED.
“Addressing the elephant in the room, next month’s elections: we call on all political parties to bring patient flow to the top of the agenda.
“We need whoever forms the next Scottish Government to tackle delayed discharge, end ED overcrowding and help us make the abhorrent practice of corridor care a thing of the past.”
Latest figures also showed that, for February 2026:
16,041 (one in six patients) waited eight or more hours to be admitted, discharged or transferred in a major ED
The proportion of patients waiting less than the target of four hours stood at 62.4%, far lower than the 95% system target
105,647 people attended ED, a slight increase compared to last February, but a reduction compared to February 2019, when patient flow was substantially better.
The RCN says the practice must end urgently, as testimony from members shows its damaging effects
Corridor care has become such a permanent fixture in NHS hospitals that nursing staff are in danger of “losing all hope”, with collapsing care standards devastating morale, according to new testimony from nursing staff.
The Royal College of Nursing is reiterating its call for urgent, fully funded action plans to eradicate the practice, including investment in beds, the nursing workforce, community services and social care.
Nursing staff say the lack of action by governments has left them feeling “ashamed”, “angry”, and “embarrassed” about the unsafe, undignified care they are forced to deliver to patients.
The RCN is aware of a worsening picture this week as hospitals declare critical incidents and is encouraging members to raise any concerns about patient or staff safety. Read on to find out how we can offer practical support.
Our members report shocking examples of a patient being left in a chair for four days, while another patient died after choking undetected in a corridor.
Nursing staff have also resorted to holding up sheets to protect patient dignity when performing intimate procedures, with a corridor in one hospital so tightly packed that an elderly patient was left to eat next to someone vomiting.
One nurse in the south of England said: “We would not treat animals like this in a veterinary practice, so why in a hospital?”
Another, working in an NHS board in Scotland, told us: “It’s very stressful and distressing at times. There’s a sense of frustration and hopelessness.”
A mental health nurse in Wales said corridor care is a “regular occurrence”, with staff having to increase monitoring because unsecured corridors contain objects and fittings that raise the risk of self‑harm and suicide.
A nurse in Northern Ireland said: “I’ve had resuscitation attempts in the waiting room and corridor due to no capacity. It is inhuman and undignified.”
Practical support for nursing staff
If corridor care is happening at your workplace, it’s important to raise your concerns. Find out more in our raising concerns toolkit and get information on RCN support available from member support services.
We believe this latest testimony shows the unacceptable practice of corridor care is spreading beyond emergency departments, including acute assessment units, respiratory wards, surgical wards and elderly care wards.
Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “This new testimony from nursing staff reveals once again the devastating human consequences of corridor care, with patients forced to endure conditions which have no place in our NHS.”
As a result of our pressure, the Westminster government committed to publishing data on incidences of corridor care in England in February 2025, but so far has failed to do so.
The HSSIB – the patient safety investigation body for England – released a report in January 2026 on the widespread and normalised nature of corridor care, highlighting that some trusts are reportedly installing call bells and plug sockets in corridors.
As many as two in 10 (18%) UK adults have witnessed NHS care in non-clinical spaces such as a corridor in the last six months, according to new YouGov public polling. Further RCN analysis shows that when looking at only those who accessed care, the figure is more than one in three (37%).
The polling also shows the public want faster action on the issue, with seven in 10 (69%) of respondents in England saying Health Secretary Wes Streeting’s pledge to eradicate the practice by the end of parliament is “too slow”.
“The fact remains that there can be no safe, dignified care delivered in a corridor, store room or dining room, but that has become the norm,” Nicola added.
“It’s taking a terrible toll on staff, but ministers mustn’t allow them to lose hope. Decisive action can restore care standards and stop staff morale collapsing past the point of no return.
“Now is the time for ministers to stop dragging their feet and publish the data, alongside announcing a fully funded action plan and timeline for eradication.”
We want to thank our members who have raised their voices on corridor care to show why this issue matters and why it demands urgent action.
RCEM: Nurses’ corridor care testimonies ‘distressing, damning’
NURSE: ‘CONDITIONS ARE A TYPE OF TORTURE’
The Royal College of Emergency Medicine (RCEM) has described new testimony from nurses about the state of corridor care across the UK as ‘distressing, damning and exactly what we see every single day in our departments’.
And the College says this reinforces the need to address this crisis.
More than 430 nurses described the conditions they are working in and what patients are enduring in a survey conducted by the Royal College of Nursing (RCN), that has been published today (15 January 2026).
Just some examples shared include how a nurse witnessed a patient left in a chair for four days, a patient dying after choking undetected in a corridor and nurses holding up sheets to try and protect the dignity of a patient while they underwent an intimate procedure.
One nurse went as far as saying the conditions are “a type of torture”.
Their accounts were gathered between 2 January and 9 January 2026, revealing nursing staff are treating patients in cold corridors, dining rooms, staff kitchens and offices.
The experiences of nurses build on and updates the RCN’s report published this week last year, titled ‘On the frontline of the UK’s corridor care crisis’.
Dr Ian Higginson, President of the Royal College of Emergency Medicine said: “This work by the Royal College of Nursing makes for incredibly tough reading. It’s distressing, damning and exactly what we see every single day in our departments.
“These deeply personal testimonies aren’t just stories – it’s the daily reality for patients and their nurses, who work alongside our members and their colleagues in Emergency Departments.
“Last year, when RCN released their first report on corridor care, we said that it must represent a watershed moment for the government, a line in the sand. Yet, 365 days on, the nurses voices show our patients are still in corridors, and there is no credible plan to get them out.
“So called ‘corridor care’ takes an immense toll on patients, who will be facing long waits in these conditions. And it takes an immense toll on our clinicians who are trying their upmost best to deliver quality care in these conditions.
“Our patients are being forced to endure these conditions, often for hours, if not days, because hospitals are full to bursting. We can’t move patients out of our departments, and into wards, because there are no available beds for them.
“Those beds are often taken up by patients who have experienced delays in their care, and who no longer need to be in hospital, but can’t leave, because of the lack of social care options.”
The new report also contains public polling which found:
As many as two in ten (18%) UK adults have witnessed care being delivered in a corridor or other non-clinical spaces in the last six months.
88% of respondents across the UK said tackling unsafe care is an urgent priority
Meanwhile in England, 69% said Wes Streeting’s pledge to end corridor care by the end of parliament is too slow.
Dr Higginson said: “Nurses have given their verdict loud and clear. So too have our members, and the public – they all want the crisis in EDs tackled with urgency.
“The Health Secretary said this week the government is ‘determined to consign corridor care to the history books’ and has committed to ending corridor care by the end of 2029. We welcome this. This problem can’t be solved quickly. It has been years in the making. But we do need a credible plan that starts now.
“We look forward to working with the government, and healthcare leaders, to implement meaningful solutions, many of which lie outside the walls of our EDs.”
It comes after the All-Party Parliamentary Group (APPG) on Emergency Care last year published a report, compiled by the Royal College of Emergency Medicine, on corridor care. It found almost one in five patients in EDs were being cared for in trolleys or chairs in corridors in England during summer.
The 2026-27 Budget will support a stronger NHS, with a record £22.5 billion for health and social care, expand cost of living support and invest in Scotland’s infrastructure.
Published alongside the latest multi-year Scottish Spending Review, Infrastructure Strategy and Infrastructure Delivery Pipeline, the draft Budget invests almost £68 billion including direct support for families and household budgets.
The 2026-27 Budget includes:
a cost of living package to: help families with funding to trial a programme of activities in a range of primary schools between 3-6pm; a Summer of Sport – free children’s sporting activities, including lessons on how to swim for every primary school child in the country; and a breakfast club for every primary school by August 2027
continued investment in Scotland’s existing cost of living measures, including free prescriptions, free eye examinations, removal of peak rail fares on Scotrail, free tuition fees for young Scots, free school meals for thousands of children, including all pupils in P1 to P5, and free bus travel for under-22s and over-60s
funding to increase Scottish Child Payment to £28.20 per week and investment to allow the introduction of a premium payment of £40 per week for eligible children under 12 months from 2027-28, bolstering efforts to drive down child poverty
extra funding to keep more children out of poverty from funds initially set aside to mitigate the UK Government’s two-child cap, including £50 million of whole family support and a further £49 million for measures to be announced in the Child Poverty Delivery Plan in March
tax choices which increase the Basic and Intermediate rate income tax thresholds to put more money in the pockets of low and middle income earners, maintain current income tax rates and bands, and provide a competitive non-domestic rates relief package worth an estimated £864 million, including measures for pubs, restaurants and retailers
a record £22.5 billion for health and social care, including a record £17.6 billion for NHS boards and resources to begin the national rollout of walk-in GP clinics, making it easier to access same-day appointments
an almost £15.7 billion record settlement for local government to support the services communities rely on including social care and education
significant extra funding for universities and colleges, with colleges seeing a combined increase of £70 million in resource and capital funding, equivalent to a 10% uplift, targeted support to help retrain workers in the oil and gas sector and ongoing commitment to Scotland’s apprenticeships, which this year will provide more than 31,000 Scots with a pathway to sustainable, well-paid jobs
over £5 billion to tackle the climate emergency, reduce carbon emissions and increase resilience as well as backing regenerative and sustainable skills in food and farming
£4.3 billion transport funding including investment in railways, the renewal of the ferry fleet, removal of peak season fares for residents of Orkney and Shetland on Northern Isles ferries and nearly £200 million for the dualling of the A9
record investment in new affordable homes
Ms Robison said:“This Budget delivers for families across the country, for a stronger NHS, and for a more prosperous future.
“It will fund landmark policies to continue efforts to eradicate child poverty – investing in a brighter future for Scotland and the children growing up here.
“Almost £68 billion is being invested in 2026-27 and almost £200 billion through the Scottish Spending Review and Infrastructure Investment Pipeline, demonstrating the scale of our ambition for our nation.”
Other measures include:
from April 2027, an Air Departure Tax (ADT) will come into force and the framework offered by the new ADT will be used to introduce a private jet supplement
the introduction by April 2028 of two new council tax bands for the most expensive properties in Scotland, those worth more than £1 million, on an up-to-date valuation
support for high-growth firms to attract private investment and connect entrepreneurs
£200 million for the Scottish National Investment Bank – delivering on the commitment to invest £1 billion in the Bank by the end of the parliamentary term
record funding for police and fire services and an additional £10 million investment in community justice services
a £20 million increase in the culture budget, recognising Scotland is richer because of its world-famous culture and creative sector
support for the creation of a diverse and sustainable supply chain for offshore wind, to boost the economy.
Responding to today’s proposed Scottish Budget, Poverty Alliance Policy & Campaigns Manager Ruth Boyle said: “People in Scotland want a just and compassionate society – but too many feel the system is rigged against them.
“There was some good news today – but we can do much more to make sure that every child in Scotland gets the investment they need for a decent life and a better future.
“Ensuring that every child in primary school gets a healthy breakfast is an excellent investment, because no child should go to school hungry.
“Increasing the Scottish Child Payment to £40 for eligible households with a baby under 1 is welcome and will help families at a time when they face increased costs. However, this must be a first step towards boosting that payment to £40 for every eligible child in the country.
“That is the kind of fundamental investment the Government needs to make if they are serious about meeting the 2030 child poverty targets.
“With Scotland not on track to meet those legally binding targets, we need all political parties to set out their plans to invest in country where no child lives in poverty. Our children can’t wait any longer.
“We can make that kind of investment in Scotland – and there is support for it. In among the Budget documents is new polling from YouGov showing that 54% of people in Scotland believe that Government should redistribute income from the better-off to those who are less well off. Just 29% disagree.
“The Scottish Government must raise revenue to invest in our shared national priorities, like tackling child poverty and reducing the cost of living. It’s right that the Government has turned to those with the biggest assets to contribute more with a tax on private jets and increased council tax for the highest value homes.
“This has to be the start of long-promised, fundamental reform of council tax so that our local councils can provide the services that all of us need, and that are a vital lifeline for so many households in poverty.
“The Poverty Alliance will continue to call for the measures we need to provide a Minimum Income Guarantee that no-one will fall under – including increasing wages, investing in strong public services, and providing a social security system that gives everyone in Scotland a secure foundation to build a better future.
“Today’s budget has some positive steps towards that ambition – but we need to go further and faster if we are to build a Scotland free from poverty.”
Commenting on today’s draft Scottish Budget, Mary Glasgow, Chief Executive of Children First, Scotland’s national children’s charity, said: “It’s hugely positive to see child poverty being made a top priority in today’s budget.
“The significant funding boost to whole family support and extra resources for third sector organisations will provide a lifeline to families who need help most, right across Scotland.
“But we can’t afford to slow down. Scotland’s legal target to eradicate child poverty demands bold, accelerated action. Life is tougher than ever for many children and families and at Children First we witness this first-hand every day.
“That’s why we urgently need a National Front Door that offers a simple accessible way for families to get the help they need when they need it.”
Children First’s manifesto for the 2026 Holyrood elections calls on the next Scottish Government to deliver a comprehensive offer of whole family support to tackle child poverty and give every family the emotional, practical and financial support they need.
Trussell’s Cara Hilton said: ‘While we welcome the @scotgov‘s £40 SCP rate for babies under 1, we continue to call for an increase to £40 a week for all.
‘Our @TrussellUK data shows food parcels for families with children aged 12-16 in Scotland rose by 7% over the past 5 years. #ScotBudget‘.
Responding to the Scottish Budget and Scottish Spending Review, Anna Fowlie, Scottish Council for Voluntary Organisations (SCVO) Chief Executive, said: “Too often and for too long, voluntary organisations that provide vital services to people and communities across Scotland are treated as the poor relation to mainstream public services.
“They have had to contend with budget cuts, short-term funding cycles, late payments, incoherent decision-making, poor communication, inadequate grant management, and more.
“Reform of the voluntary sector funding landscape is long overdue. The Scottish Spending Review is welcome, giving the Government the long-term outlook to make progress on its commitment to deliver improvements, including multi-year funding for Scotland’s voluntary organisations.
“Welcome too is the Scottish Government’s commitment to multi-year funding for sections of the voluntary sector—this shows, again, what is possible.
“Today we had hoped for more than a recommitment to the ‘first step’ announced last February—the Scottish Government’s ‘Fairer Funding’ pilot.
“We know the benefits of multi-year funding: better staffing, stability, and future planning for the services people and communities rely on. The Government’s own research confirms this.
“Multi-year funding alone, however, will not provide the sustainable funding environment the voluntary sector so desperately needs, funding that is flexible, sustainable, and accessible.
“We need to see real progress and recognition of SCVO’s Fair Funding asks beyond multi-year funding. Wider reforms are, unfortunately, now unlikely to be seen before the next parliamentary term.
“In the meantime it is essential that in the weeks following the Scottish Budget the Scottish Government support local authorities and voluntary organisations by meeting their commitments to timely notifications and payments.
“We look forward to further engagement on both Fair Funding and charity regulation in the next parliamentary term.”
Shelter Scotland Director, Alison Watson said:“Social housing delivery in Scotland remains too slow, too little and too late for the more than 10,000 children homeless tonight. Today’s budget doesn’t do enough to change these facts.
“Shona Robison’s budget was an opportunity for Ministers to put their money where their mouth is. On the face of it an additional £34 million for social housing, compared to the most recent budget, is a step in the right direction – but it is not enough.
“The extra money will only deliver 36,000 affordable homes by 2030 – more than 26,000 short of where they say they would need to be to deliver their promise of 110,000 affordable homes by 2032.
“The new Parliament will need a new approach and new money to deliver the social homes needed to reduce homelessness. Homes that the government promised, that academics say we need but for which there is still no credible plan to deliver.
“We must be honest about the real costs of failure. Failing to build the social homes we need means rising homelessness, rising child poverty, rising costs for councils, health boards and the taxpayer.”
Responding to the Scottish Government’s Budget, Debbie Horne, Scotland Policy and Public Affairs Manager at Independent Age said: “It is disappointing to see nothing new in this Budget to adequately respond to the growing number of older people in poverty.
“One in six pensioners now live in poverty across Scotland, a total of 160,000 older people, and we must see more action to support them.
“We want the Scottish Government to set out a clear, targeted strategy to bring down the alarming number of older people in poverty, increase access to the vital Discretionary Housing Payments that can help older renters meet shortfalls in rent, and increase the social security support available to those on a low income in later life.
“With pensioner poverty at its highest level in nearly 20 years, and likely to continue to rise as our population ages, it’s vital all political parties include measures to bring down the levels of poverty in later life in their manifestos’ ahead of May’s Holyrood elections. In a compassionate and wealthy society, we should all be able to live a financially secure, dignified later life.”
Responding to the Scottish Government’s Budget statement which slashed the 40% discount on business rates bills for pubs at the same time as a rates revaluation will lead to higher bills from 1 April, Stuart McMahon, Director of pubgoers group CAMRA Scotland said: “Pubgoers and publicans simply won’t stand for a Budget which will force more of our locals to go to the wall by landing them with bills they simply can’t afford.
“I fear that slashing the 40% discount on business rates bills for pubs to just 15% at the same time as these bills are increasing will be absolutely disastrous.
“Transitional reliefs may sound good but if this Budget still means higher business rates bills than pubs are paying now then this will be the straw that breaks the camel’s back for many hard-pressed licensees.
“Pubs need permanently lower business rates bills so that they can survive, thrive and play their part as vital community hubs.”
The Scottish Government’s budget announcement of further funding for the college sector, which includes a combined increase of £70 million in resource and capital funding, received a qualified welcome. Principal of Edinburgh College, Audrey Cumberford said: “While this is a welcome step in the right direction for college funding, there is still more that needs to be done.
“This increase will help to undo some of the damage done by years of real terms cuts, but more is needed if we are to ensure the future sustainability of our sector.
“There is now a clear consensus across the political spectrum for better funding for colleges.
“I would urge parties to continue to work together to make sure we unleash the true potential of our sector so we can continue to drive economic growth and improve the lives of Scots across the country.”
Responding to the Scottish government’s 2026-27 budget, announced today by Finance Secretary Shona Robison, RCEM Vice President for Scotland Dr Fiona Hunter said: “Scottish Emergency Departments are in the midst of a crisis born of political apathy towards tackling the difficult problems of social care capacity, delayed discharges and the overall issue of hospital flow.
“Today’s budget indicates once again that the Scottish government understands what the issues are. £2.3bn extra for social care, an uplift in frontline NHS spending, specific targeted action on delayed discharge and local engagement – these are all measures we warmly welcome from the government.
“As well as this, our members will be pleased to hear about improvements to training, retention and working conditions.
“However, we’ve been here before. Time after time the reality in our A&Es has got worse, not better, despite claims from the government that the NHS has been on ‘the path to recovery’ in recent years.
“We are seeing more and more patients waiting alone on trolleys in hospital corridors for hours on end, getting sicker and being put at risk of harm.
“This has happened because exit block has not been tackled, despite promises to the contrary from the government.
“The devil will be in the detail and I will reserve judgement for when myself, and the members I represent, see improvements in our Emergency Departments.
“We look forward to continued engagement with the government on how it seeks to tackle hospital flow, and await further information on how the Health Secretary will take today’s promises and turn them into action and, ultimately, improvements for our patients.”
Jonathan Carr-West, Chief Executive, LGIU, said: “This Budget offers some short-term stability for councils, but it ducks the bigger questions about how local government is funded.
There is still no meaningful move towards multi-year settlements, which councils overwhelmingly say they need in order to plan sustainably. Our annual State of Local Government Finance in Scotland research, launched last week, reinforces this.
Incentivising a council tax freeze risks further undermining local fiscal autonomy, while adult social care remains the single biggest pressure on council finances without clear, dedicated funding.
Housing investment is welcome, but spreading it across the country without enabling local flexibility limits its capacity to tackle the areas of greatest need.
Overall, this is a Budget that manages immediate pressures but avoids the structural reform required to put local government finance on a sustainable footing.”
The Existing Homes Alliance (EHA) is a coalition of over 20 housing, environmental, fuel poverty, consumer and industry organisations calling for urgent action to transform Scotland’s existing housing stock.
Lori McElroy, Chair of the Existing Homes Alliance said:“While we welcome the ongoing support to help homeowners, landlords and tenants to make their homes warmer, healthier and more affordable to heat, this remains a drop in the ocean when we have over 800,000 households living in fuel poverty and 44% of Scotland’s homes falling below Energy Performance Certificate band C.
“Scotland has excellent fuel poverty and energy efficiency programmes such as Warmer Homes Scotland, Area-based Schemes and the Social Housing Net Zero Heat Fund, as well as generous grants through the Home Energy Scotland Grant and Loan Scheme, but the gap between what is needed and what is currently being delivered is wide.
“This Budget, as it stands, is a missed opportunity to significantly scale up these programmes which would reduce fuel poverty, improve public health by tackling damp and mould, and prepare the workforce and supply chains needed to deliver our climate change targets – supporting thousands of jobs and economic opportunities across Scotland.”
Joanne Smith, Policy and Public Affairs Manager for NSPCC Scotland, said: “For children to thrive, it’s vital that they have the best start in life, and so we are heartened by the Scottish Government’s commitment to increase the Child Payment for under ones. But we are disappointed that young families now will not reap those benefits, with it starting in more than a year’s time.
“We also welcome the Scottish Government’s renewed investment in the whole family support fund and its work to continue to deliver the Promise. But it is so important that in this it recognises the fundamental need for support for very young children, just like the Scottish Child Payment does, so that families get the help they need right from the start.”
Scotland’s Chief Constable Jo Farrell has responded to the Scottish Government’s tax and spending plans for 2026 to 2027.
Chief Constable Farrell said: “I recognise a £90m cash-terms uplift to revenue funding and an improved capital allocation for policing against a challenging public finance picture.
“I set out the funding requirements for policing in evidence during the Criminal Justice Committee’s pre-budget scrutiny work.
“Police Scotland will continue to engage with the Scottish Police Authority and the Scottish Government to understand the full implications of the budget and develop our planning for the year ahead.
“My focus continues to be on prioritising our frontline to deliver safer communities, less crime, and supported victims as part of our vision for policing.”
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.”
Politicians must show they’re serious about tackling the crisis in Scottish A&Es, as new analysis from the Royal College of Emergency Medicine suggests that we are heading towards yet another winter of chaos.
The latest performance data for Scottish Emergency Departments, released yesterday (7 October) by Public Health Scotland for August 2025, showed that 5,556 people waited 12 hours or more to be admitted, transferred or discharged from major EDs.
That’s roughly one in every 22 patients and the highest number who experienced this wait for the month of August since records began in 2007.
The data, for major EDs in Scotland, also showed that in August 2025:
More than one in 10 (14,208) patients waited eight hours or more to be discharged, transferred or admitted – the worst August on record.
1,964 beds per day in Scotland were being occupied by people who are deemed healthy enough to be discharged, an increase of 36 on the previous month.
The proportion of patients being seen within the target of four hours fell again, from 65.8% in August 2024 to 64.7% this year.
Dr Jayne McLaren, RCEM Scotland Vice Chair, said: “These figures should send shivers down the spines of politicians who have yet to publish a tangible plan on how we will tackle the winter months ahead.
“I am dreading winter – and I know many of our members and colleagues feel the same.
“The numbers are for August when, traditionally, doctors and other ED staff would get some respite with less pressure on the system. We have had no such break – summer has been relentless
“Thousands of people, who have come to us because they are seriously hurt or sick, are being forced to endure hours and hours on trolleys and in corridors through no fault of their own. It’s a shocking consequence of a system that is near capacity.
“Unless the Government takes immediate action by putting forward detailed plans on how to tackle the issue, people will continue to bear the brunt of the crisis in Urgent and Emergency Care. This is serious.”
These figures come after RCEM’s recent analysis which showed there were more than 800 deaths associated with long A&E waits before admission in Scotland last year.
Visual representation if the data and longer-term trends are available on the RCEM Website.
800 EXCESS DEATHS ASSOCIATED TO LONG A&E WAITS IN SCOTLAND LAST YEAR
The Royal College of Emergency Medicine will today reveal that there were more than 800 deaths associated with long A&E waits before admission in Scotland last year.
Shockingly this is an increase of a third (202) from the 2023 figure.
The latest analysis will form part of a presentation by RCEM Scotland’s Vice President, Dr Fiona Hunter, at the College’s Future of Emergency Care event being held this afternoon (Tuesday 23 September 2025) in Edinburgh.
The event, which will be attended by RCEM Officers, clinicians, healthcare leaders, policy makers and politicians, will focus on Scotland’s Emergency Care crisis and what can be done to alleviate it.
Provide Scotland with enough Emergency Medicine staff to deliver safe and sustainable care
Resource NHS Scotland to ensure equitable care is provided throughout the emergency care system
It comes as Scotland’s Emergency Departments faced a summer of unrelenting pressure with an unacceptable number of people enduring long and dangerous waits.
Over the warmer months (1 June until 31 July 2025) one in 24 people (9,881) endured a stay of 12 hours or more from their time of arrival at an Emergency Department in Scotland.
This is 7,003 more patients than the entire year of 2018.
When looking at July alone, 4,686 people experienced this extreme wait – over 2,400 more than in the winter month of January 2022 (2,266).
Meanwhile, further analysis for the previous year (2024) reveals a record 76,510 patients waited 12 hours or more to be admitted, discharged or transferred from A&E.
That’s 20,432 more people who endured an extreme wait compared to 2023.
Of these patients, 58,906 people were waiting to be admitted to a ward for further care.
Using the Standard Mortality Ratio – a method which calculates that there will be one additional death for every 72 patients that experience an eight–12-hour wait prior to their admission – RCEM estimates that there were 818 associated excess deaths related to stays of 12-hours or longer before being admitted in 2024.
That’s equivalent to 16 people losing their lives every week.
Dr Fiona Hunter, Vice President of RCEM Scotland, said: “The fact that the deaths of more than 800 patients have been lost due to a system in crisis is a national tragedy.
“Behind this statistic are stories of heartbreak. Because these are people. Mums, dads, brothers, sisters, grandparents – their deaths shattering the lives of families and friends.
“These are patients who are sick and need further care on a ward. So they are forced to endure extreme wait times for an inpatient bed to become available for them. Often, they will be experiencing this, counting the hours they have been in ED, on a trolley in a corridor, cupboard, or simply any available floor space.
“It doesn’t have to be this way – the crisis is fixable and it comes down to patient flow in hospitals – getting people out of ED and into a ward bed and getting them out of hospital when they are well enough to go home.
“We urge all political parties to adopt the recommendations in our manifesto to give Scotland a Emergency Care system that we can be proud of once again. Because without government action, the cost will continue to be measured in lives.”
The College’s census highlights that there is a shortage of key decision makers to provide quality care to patients.
RCEM’s ‘Scotland Emergency Medicine Workforce Census 2025’ provides a comprehensive assessment of the state of the Emergency Medicine workforce, providing an insight into the working patterns of clinicians and allowing a forecast to be made around the future workforce needs of Emergency Departments in Scotland.
This is the second national Scottish census, the first having been conducted in 2021.
Responses were received from 28 major Emergency Departments, along with three Rural and Remote hospitals and found:
There is one whole time equivalent (WTE) consultant for every 4,692 attendances. While it’s an improvement compared to RCEM’s census in 2021, (1:6,444) it’s still below RCEM’s recommended figure of 1:4,000.
Of the 329 consultants, 38 are planning to retire in the next five years, along with 10 SAS doctors.
There were 16 gaps in the consultant rota – the same when compared to RCEM’s last census in Scotland. Meanwhile, there were 32 in the SAS rota, up from 23, and 26 in the resident doctor rota, down from 28 compared to four years ago. Recruitment issues were highlighted among the main reasons for rota gaps.
The average weekday consultant presence was 14 hours a day, down from 15 hours in 2021. Given RCEM’s recommendation that consultants are present at least 16 hours a day in all medium and large systems, this decline is a worrying find.
Responding to RCEM’s census, Dr Fiona Hunter said, “The College’s workforce census is a vital piece of work which reveals the true extent of workforce pressures our departments in Scotland are facing.
“While there have been some slight improvements compared to our first census in 2021, it is still abundantly clear that EDs are not adequately staffed, with senior decision makers, to deliver high quality patient care.
“Going into work, caring for patient, after patient, on a trolley in a corridor takes an immense toll. It’s no wonder they are burnout and stressed as they struggle to do the one thing they came into medicine to do, provide care.
“To futureproof our workforce, we have published a set of recommendations to the Scottish government. It must read this report and act. Because if they don’t, our Urgent and Emergency Care workforce will continue to be pushed beyond their limits, and patients will ultimately bear the brunt.”
Unacceptable numbers of people are still being exposed to extreme long waits in Scotland’s Accident &Emergency departments, new analysis by the Royal College of Emergency Medicine shows.
The data reveals for major EDs in Scotland in June 2025:
There were 119,383 attendances at major EDs, a 5% decrease from the previous month of May 2025.
69.7% of patients were seen within four hours (78,857) which is a decrease of 1.1 percentage points on May 2025 but up 1.6 percentage points on June 2024.
Those experiencing long waits also increased with more than one in every 10 patients (10.8%) attending waiting more than eight hours.
And almost one in every 20 patients (4.35%) had to endure a stay of 12 hours or more before they were treated, admitted or discharged.
Responding to the latest data RCEM Vice President for Scotland Dr Fiona Hunter said: “These figures clearly evidence that the issues in our Emergency Departments are not caused by too many people attending.
“In June the number of people coming to our departments fell, but yet performance across every measure worsened when compared to the previous month.
“Most worrying is, that despite fewer attendances, thousands of our patients are still enduing extremely long waits. And we know that those who do are more likely to be the most unwell, often with multiple and complex needs. A fact that is unacceptable, and dangerous.
“The crisis in A&E is something our communities are deeply worried about. Politicians should respond to those concerns now and address these issues. Otherwise in a few short months we will be staring down the barrel of another awful winter where patient safety will again be put a risk.”
Graphic representations of today’s data, as well as the long-term trends, are available on the RCEM Website.
Bothmust be political priorities, says Royal College of Emergency Medicine
Accident and Emergency
Following the Scottish Health Minister stating he is ‘determined’ to cut elective waiting times the Royal College of Emergency Medicine has warned this cannot be the Government’s only focus.
New data detailing A&E performance in Scotland reveals that long waiting times in the country’s Emergency Departments and the issue of delayed discharges – where people remain in hospital wards despite being well enough to leave – remain significant issues.
117,827 people visited a major A&E Department (Type 1) in Scotland.
Of these, almost one in three (32.9%) waited four hours or more to been treated, admitted or discharged; more than one in every 10 people (10.3%) waited eight hours or more, and 4.2% waited 12 hours or longer.
Each day an average of 1,854 beds were occupied by people who were considered well enough to not need to be in hospital – this is the second highest for any April since guidelines changed in 2016.
Longer waits are now far more common than they were seven years ago. In April 2018, fewer than one in every 50 patients (1.3%) would have endured a wait of more than eight hours, with 12-hour plus waits being extremely rare (0.3%).
The concerning data comes just a day after Health Secretary Neil Gray MSP said he was ‘determined’ to reduce long waits for elective care pledging £106m to fund an extra 150,000 appointments and procedures this year.
But the Minister made no reference to addressing long stays in Emergency Departments.
Responding, Dr Fiona Hunter, RCEM Vice President Scotland, said: “The Scottish Government is clearly focusing on improving health care with £200m pledged to support the NHS.
“But while reducing waits for elective care is important – it is not a panacea, and will not address the very serious issues happening elsewhere in the system.
“Issues that I, and my members, see every day such as patients stranded in corridors for hours, and a lack of available ward beds.
“The Government must make addressing these a political priority too.
“We have to be able to get people out of ambulances and into out department as quickly as we can, to be able to find patients a ward bed when they need one and then get them home again as soon as they don’t.
“Without this flow through the hospital these dangerous and degrading long ED stays will go on, and patients will continue to be put at risk.”
Graphic visualisations of the data compiled by RCEM can be found here.
RCEM: ‘The public has recognised tackling A&E waiting times is a priority – it’s time the government did the same’
The British public are deeply unhappy with the National Health Service – just 1 in 5 people (21%) in 2024 said they were satisfied with the way the NHS runs. That’s according to analysis of the latest British Social Attitudes survey (BSA) published today by the Nuffield Trust and The King’s Fund. Satisfaction has plummeted by 39 percentage points since the months before the pandemic.
6 in 10 people (59%) said they were ‘very’ or ‘quite’ dissatisfied with the NHS in 2024, a sharp rise from 52% in 2023. This is the highest level of dissatisfaction with the health service since the survey began in 1983. The survey, carried out by the National Centre for Social Research (NatCen) in September and October 2024, is seen as a gold-standard measure of public attitudes in Britain.[3]
The Nuffield Trust and The King’s Fund say that just 12% of people were satisfied with A&E waiting times and 23% with GP waiting times. People are unhappy about waiting times even if they are satisfied with the NHS overall, regardless of age, political affiliation or nation.
NHS staffing and spending are also worrying the public. Only 11% agreed that “there are enough staff in the NHS these days”. While a strong majority (69%) said the government spends too little or far too little on the NHS, only 14% agreed that “The NHS spends the money it has efficiently”.
If forced to choose, the public would narrowly opt for increasing taxes and raising NHS spending (46%) over keeping them the same (41%). Only 8% would prefer tax reductions and lower NHS spending.
Despite low satisfaction with services, there remains strong majority support for the founding principles of the NHS: that it should “definitely or probably” be free at the point of use (90%), available to everyone (77%), and funded from general taxation (80%). However, the percentage of people saying that the NHS should “definitely” be available to everyone has decreased from 67% in 2023 to 56% in 2024.
There is a divide between generations, with satisfaction lower and falling in younger age groups. While the proportion of people who were satisfied rose slightly between 2023 and 2024 for those aged 65+ from 25% to 27%, among those under 65 it fell significantly from 24% to 19%.
A significantly higher proportion of people in Wales (72%) were dissatisfied with the NHS compared to 59% in England and 60% in Scotland (the difference between England and Scotland is not statistically significant).
Public views of A&E services have worsened dramatically, with satisfaction falling from 31% to just 19%, and dissatisfaction rising from 37% to 52%. These are the worst figures on record by a large margin and make A&E the service with the lowest satisfaction levels for the first time.
Satisfaction with GP services continued to fall, mirroring the trend over the last few years, with 31% of members of the British public satisfied with GP services, compared with 34% in 2023.
Satisfaction with NHS dentistry has continued to collapse. As recently as 2019 this was at 60%, but it has now fallen to a record low of 20%. Dissatisfaction levels (55%) are the highest for any NHS service asked about.
Inpatient and outpatient hospital care remains the part of the NHS with the highest levels of satisfaction, with 32% satisfied and only 28% dissatisfied.
Satisfaction with social care remains worryingly low. In 2024, only 13% of respondents said they were ‘very’ or ‘quite’ satisfied with social care. 53% of respondents were ‘very’ or ‘quite’ dissatisfied.
For the first time, people who support the Reform party have been included as a separate category in the analysis instead of being part of the ‘other parties’ group, to reflect the party’s increased share of the election vote. Supporters of the Reform party were less likely to be satisfied with the NHS (13%) than supporters of the other main parties. They are also less likely to believe in the founding principles of the NHS.
Report author Bea Taylor, Fellow at The Nuffield Trust said:“Just five years after the British public were called on to “Protect the NHS” at the start of the pandemic, these findings reveal just how dismayed they are about the state of the NHS today. We found that every group in Britain is dissatisfied with access to vital services such as A&E and GP appointments.
“The government says the NHS is broken, and the public agree. But support for the core principles of the NHS – free at the point of use, available to all and funded by taxation – endures despite the collapse in satisfaction. Harnessing this support and fixing the foundations of the NHS must be central to the government’s forthcoming reform programme.”
Dan Wellings, Senior Fellow at The King’s Fund said:“The latest results lay bare the extent of the problems faced by the NHS and the size of the challenge for the government. While the results are sobering, they should not be surprising. For too many people the NHS has become difficult to access: how can you be satisfied with a service you can’t get into?
“In 2010, seven out of ten people were satisfied with the NHS – it is now down to only one in five. The scale of the decline over the last few years has been dramatic. The results show that people do not want a different funding model, but they do want the NHS to start working for them again and they want it to have the staff and the money it needs to ensure that happens. The public are also clear that the NHS needs to get better at spending the money it does get more efficiently.
“The government’s focus on bringing down hospital waiting lists may address one area of the public’s concerns, but this year’s BSA shows that all areas are flashing red, particularly A&E. Voters are impatient for change, and Ministers will need to demonstrate rapid improvement, but that should not come at the cost of the bigger, whole-system reforms that are needed to create a truly sustainable health service. These results will form the baseline from which the new Labour government’s reform plans to ‘fix’ the NHS will be judged.”
In an accompanying foreword to the report, Nuffield Trust and King’s Fund Chief Executives Thea Stein and Sarah Woolnough say: “The government now finds itself walking a fine line between meeting public demands for rapid improvements on waiting times and avoiding the pitfall of throwing more money – of which there is virtually none – at a system in need of deeper reform.”
The Chief Executives argue that ministers will need to meet public demand for improving A&E, GP appointments and dental care, but they should not lose sight of the much bigger prize of longer-term, sustainable reform focused around shifting care from hospital and moving the NHS from a sickness to a health service.
Politicians must make addressing the Emergency Care crisis a political priority as new research reveals that public satisfaction in A&E services has reached an all-time low.
That’s the call from The Royal College of Emergency Medicine (RCEM) and comes as the findings of the latest British Social Attitudes survey (BSA) Public satisfaction with the NHS and social care in 2024 have been published today (2 April 2025) showing satisfaction with A&E services has plummeted.
The survey, carried out by the National Centre for Social Research (NatCen) from 16 September to 27 October 2024 for The King’s Fund and the Nuffield Trust, asked 2,945 people across England, Scotland and Wales, for their thoughts on the NHS and adult social care services.
It also questioned 933 people about their satisfaction with specific NHS services, as well as their views on NHS priorities, principles and funding.
The research – which has been carried out every year since 1983 – found:
More than half (52%) of respondents were dissatisfied with NHS A&E services – the highest on record – up 15% from 37% in 2023. Those who were satisfied stood at 19% – a fall from 31% the previous year.
69% of people were very or quite dissatisfied with the length of time it took to be seen in A&E
The most important priorities cited by respondents for the NHS included ‘improving waiting times in A&E (49%), which was considered the second most important – behind access to GPs but ahead of elective care waiting lists.
RCEM President, Dr Adrian Boyle, said: “This annual survey is a barometer of public feeling and people – voters – have given their verdict loudly and clearly.
“The public aren’t daft and can see what is happening in our Emergency Departments. I worry that this situation stops people attending when they should.
“But it is hardly surprising when the message from the Westminster government is that the health service is broken. If that is their assessment, they must get on with the job of fixing it. And it is fixable.
“The public has stated that, behind GPs, the service they most want prioritised is A&E, but we only ever hear about what has been done to improve elective waiting times.
“The public has identified A&E as a priority. It is time the government did the same.”
The survey also revealed:
In 2024, just one in five British adults (21%) were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs. This is the lowest level of satisfaction recorded since the survey began.
Only 13% of respondents said they were ‘very’ or ‘quite’ satisfied with social care (the same figure as 2023). 53% of respondents were ‘very’ or ‘quite’ dissatisfied
Satisfaction with GP services continued to fall, mirroring the trend over the last few years. 31% of respondents said they were satisfied with GP services, compared with 34% in 2023
62% were very or quite dissatisfied with the length of time it takes to get a GP appointment, and 65% for the length of time it takes to get hospital care.
Most (44%) believe the government is spending too little money on the NHS
More than 75% continue to support the founding principles of the NHS, with little sign of change compared to the previous year. However, the proportion ‘definitely’ agreeing that it should be available to everyone fell significantly from 67% to 56%.
The BSA follows a survey by Ipsos Mori conducted in February 2025 which revealed that almost 80% of people polled would avoid attending an A&E because they were worried about ending up waiting for hours on a trolley in a corridor.
The Royal College of Emergency Medicine has asked ‘where are the tangible plans for Emergency Care?’ after Scotland’s A&Es experienced the worst February on record for performance.
The figures, released yesterday (1 April 2025) by Public Health Scotland comes just a day after the Scottish government revealed its ‘operational improvement plan’ which RCEM says ‘missed the mark’ in tackling extreme and dangerous long stays in A&Es.
The new PHS data shows that in A&Es in Scotland in February, 6,072 patients waited 12 hours or longer before being admitted, discharged or transferred.
They also reveal just how much long waits have increased since the 2010s.
Since February 2018, for example, the number of people waiting four hours or more in major EDs has increased by 3.4 times (10,979 to 37,274) eight hours or more by 13 times (1,023 to 13,638) and 12 hours or more by almost 35 times (174 to 6,072).
Patients are often experiencing these extreme long stays on trolleys in corridors due to the lack of available in-patient beds.
People in these beds are often stuck in hospital, despite being well enough to be discharged, because there is no appropriate social care support.
So called ‘delayed discharges’ meant there was an average of 1,986 patients in hospital each day, waiting to be discharged, even though they are well enough to leave. This is the highest number for the month of February since 2016, when guidelines changes.
Responding to the data, Dr Fiona Hunter, Vice President of RCEM Scotland said: “Scotland’s Health Secretary has said he is ‘encouraged’ by a weekly improvement to the four-hour target for admission, treatment or discharge – but our members and their colleagues certainly don’t feel encouraged when you look at the bigger picture.
“Across the board – four, eight and 12 hour waits – were the worst on record for the month of February.
“This should sound alarm bells to politicians and galvanise them to act before A&Es delve into an even deeper crisis.
“This data comes hot on the heels of the government’s NHS improvement plan, which did little to reassure burnout Emergency Medicine clinicians that they won’t be treating patients, who have endured a stay on trolley in a corridor for 12 hours or more, in the weeks, months and years to come.
“It was a golden opportunity, and it missed the mark.
“It’s left us asking, where are the tangible plans for Emergency Care?
“Time is ticking for the government to act and #ResuscitateEmergencyCare.”
