Tag: waiting times

RCEM: Emergency care ‘in dire crisis’

Devolved governments call for more cash for NHS pay

The UK Government has been urged to increase the amount of funding available for NHS pay.

Ahead of the Autumn statement, Scottish Health Secretary Humza Yousaf and Welsh Health Minister Eluned Morgan have written to UK Health Secretary Steve Barclay to ask for additional funding to help avert strike action this winter in the NHS.

The letter reads:

“We wanted to write to you in advance of the Chancellor’s Autumn Statement on 17th November to once again make the case for additional funding for our hardworking NHS staff.

“In recent weeks the Deputy First Minister of Scotland and the Welsh Government Minister for Finance and Local Government have written to His Majesty’s Treasury to make clear the need for additional funding for public services.

“The Royal College of Nursing have announced a sweeping legal mandate for industrial action across the UK. In Scotland, they have joined several other unions representing NHS staff in gaining a legal mandate for industrial action with ballots expected to confirm a mandate in the rest of the UK.

“The risk to the NHS of industrial action this winter is profound, and we all need to do all we can to avert industrial action in any form. The NHS across the UK continues to feel the effects of the pandemic as it recovers and remobilises, and any action is likely to have catastrophic effects in all parts of the UK.    

“We are experiencing a cost of living crisis and the anger of NHS staff is entirely understandable. Sky rocketing inflation combined with high interest rates, a direct result of the havoc caused by the UK Government’s mini-budget, means that we are simply unable to come close to matching the expectations of NHS staff across the country. While the support provided by the UK Government on areas such as support for energy bills is welcome, it has not gone nearly far enough.

“Media reports suggest that the Chancellor is considering reimposing austerity on the people of the UK again, for which there is no mandate, through extensive spending cuts. That would be a disaster for our public services, including the NHS, at a time when they need more investment, not less.

“We would therefore implore you to work with us to make the case to the Chancellor in advance of his Autumn Statement for increased funding for the NHS and the devolved governments as a whole, primarily to pay our hard working NHS staff a fair pay rise in the face of the cost of living crisis this winter, and avoid what could be catastrophic industrial action in the NHS.”

Responding to the latest Emergency Department performance figures published by NHS England for October 2022, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “The crisis in Emergency Care is dire. October saw nearly 44,000 patients face a 12-hour DTA wait – we know 12-hour waits measured from decision-to-admit are just the tip of the iceberg and hides the reality.

“We know far more patients wait for 12-hours measured from their time of arrival. NHS England and the Department of Health and Social Care will still not commit to publishing this data, despite it being collected by all Trusts. We believe this is a barrier to tackling the root of the crisis.

“We know excessively long waits and dangerous crowding are associated with patient harm and increased risk of mortality. Scientific studies have shown that there is one death for every 67 patients waiting between eight and 12-hours from their time of arrival in the Emergency Department.

“The ONS continue to report worryingly high excess mortality figures and we believe that dangerous crowding, long delays, and the crisis in urgent and emergency care are contributing to a significant proportion of these excess deaths.

“We are increasingly concerned about the winter and the health system’s ability to cope. We are already at 94.3% bed occupancy for all general and acute beds and each month patients face the longest waits on record. The system is failing in its core function – the quick and effective delivery of emergency care.

“We need meaningful action now – sticking plasters like setting up tents or handover units will do nothing to resolve these long-waits and may actually cause more harm to patients. We know we need to be able to admit patients, we know ambulances need to handover patients quickly, we agree that it is vital that ambulances must return to Urgent and Emergency calls in the community – but to achieve this we must tackle the issue of poor flow in our hospitals.

“Many patients in hospital no longer meet the criteria to reside, they are occupying beds to which we could be admitting patients. Around 13,000 people are in hospital unable to be discharged. We urgently need an effective social care workforce to help with the discharge of these patients, so we can admit patients, receive patient handovers promptly, and get ambulances back out to the community.

“It is crucial that those in power understand that this is not a demand issue, attendances are not causing crowding and long waits. Crowding and long waits are a consequence of the inability to move patients through the hospital, a consequence of patients who are unable to be discharged because of severe cuts to social care.

“If you can’t discharge patients, beds are indefinitely occupied and the whole system is blocked. The government must get a grip of the social care crisis to fix flow.”

Commenting on the news that the RCN have voted in favour of strike action, Dr Adrian Boyle said: “In Emergency Medicine there is a retention crisis, particularly amongst our nursing colleagues.

“Emergency Medicine nurses are a critical part of the workforce – EM is a team sport. We know and understand that many EM staff, including nurses, are burned out, exhausted and overwhelmed.

“They are skilled, competent professionals who deliver excellent care for our patients. It is vital that our nursing colleagues feel valued and appreciated.”

The latest Emergency Department performance figures published by NHS England for October 2022 for show:

  • There were 1,399,916 attendances at major Emergency Departments
    • This represents a 7.5% increase compared with September 2022, and a 1.7% increase compared with pre-pandemic levels (October 2019)
    • There were 2,000,493 attendances at all Emergency Care facilities
  • 43,792 patients were delayed for 12-hours or more from decision to admit to admission
    • This is the highest number of 12-hour waits on record
    • It is 520% higher than the same month last year, October 2021, and it is 5932% higher than October 2019
    • There have now been 255,334 12-hour DTA stays recorded so far in 2022 – three times as many as were recorded in the 137 months prior to 2022
  • Four-hour performance at major Emergency Departments was 54.8%, this is the worst four-hour performance on record
    • This is a 7.1 percentage point decrease from October 2021, and a 19.7 percentage point decrease compared with October 2019
  • Type 1 admissions stood at 366,964 (a daily average of 11,838)
  • 26.2% of type 1 attendances were admitted, this is a one percentage point decrease from September 2022
  • 150,922patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)
    • This is the highest figure on record and is a 14.5% increase from September 2022
  • Delays to admission stood at 29.8%, this is the highest on record and a 2.8 percentage point decrease from September 2022

The latest beds data for October 2022 show:

  • Last month there were 97,350 general and acute beds available, an increase of 0.71% from September. The occupancy rate was 94.3%, 0.7 percentage points higher than September, the highest monthly figure on record
  • The occupancy rate for adult general and acute beds was 95.6%, also the highest figure on record.

The latest Hospital Episodic Statistics published by NHS Digital for September 2022 show:

  • Patients leaving the department before being seen stood at 5.2%. This is a decrease of 0.2 percentage points from August 2022, but a decrease of 0.7 percentage points from September 2021. 
  • Unplanned reattendance rate was 8.5%. This is 0.4 percentage points lower than September 2022, but 0.3 percentage points higher than September 2021.  
  • Median time in department for admitted patients was 404 minutes. This is an increase of 29% compared with September 2021 (314 minutes). For all patients, the median wait was 192 minutes. 

Staff ‘deeply worried’ about Urgent and Emergency Care crisis

Scotland records worst A&E performance once again

Responding to the latest Emergency Department performance figures for Scotland for September 2022 Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said: “The situation as we enter winter is dire. Month-on-month, more and more patients face longer and longer waits – that we know are associated with patient harm and even death.

“Emergency Medicine staff and our paramedic colleagues are doing all they can to ensure the urgent and emergency care system continues to function and patients continue to receive care. We want to thank health care workers for their hard-work and diligence at this incredibly challenging time.

“We know that patients are deeply worried about the crisis. Emergency Medicine staff are worried too, distressed that they are unable to move patients through the hospital or take in patients from ambulances to the Emergency Departments.

“The difficulty in discharging patients from hospital when they are medically fit to be discharged is causing exit block in hospitals. The lack of social care is preventing these patients from being discharged.

“This is leading to a lack of flow throughout the hospital and leading to long waits in Emergency Departments, long waits in ambulances outside Emergency Departments, and long waits for an ambulance in the community.

“The Scottish Government must get a grip of this crisis and urgently boost the social care workforce, only then will we be able to discharge patients, free up beds and reduce these long waits throughout the system.”

The latest performance figures for September 2022 for Emergency Departments across Scotland show:

  • There were 113,522 attendances at major Emergency Departments
  • 65.6% of patients were seen within four-hours
    • This is the lowest four-hour performance since records began and is 8.2 percentage points lower than September 2021.
  • 13,506 patients waited more than eight-hours before being seen, admitted, discharged, or transferred
    • This is the highest number of eight-hour waits since records began
    • It means that more than one in 10 patients were waiting eight-hours or more in a major Emergency Department.
    • Double the number of patients have waited eight hours or more in 2022 so far (January – September) than in all of 2021.
  • 5,296 patients waited more than 12-hours before being seen, admitted, discharged, or transferred
    • This is the highest number of 12-hour waits since records began
    • This is an increase of 172% compared to September 2021.

Record number of Scotland’s A&E patients wait over eight hours

Responding to the latest figures showing the Royal Infirmary of Edinburgh sees only 40.6% of A&E patients within 4 hours, Foysol Choudhury MSP said: “The figures for patients being seen at A&E within 4 hours in Edinburgh remain alarmingly low, even before the anticipated winter crisis hits.

“The Cabinet Secretary for Health has said that ‘recovery from Covid will not happen overnight’, but we are yet to see any evidence of recovery at all. The 4-hour figures for NHS Lothian last averaged above 90% in March 2021, while the figures for Edinburgh Royal last averaged above 90% in October 2020. The trend has been downwards since then.

“Hard-working NHS staff are doing their best for patients in very difficult circumstances, but they are being let down by long-running structural failures which remain unresolved by this SNP-Green government.

“The Scottish Government needs to take urgent action now to arrest two years of decline in our health service, or risk putting patient safety in jeopardy over winter.”

The Scottish Conservatives said: “This week, A&E waiting time figures showed 1506 patients waiting more than half a day in emergency departments.

“Hardworking NHS staff are being pushed beyond their limits and patients are suffering needlessly as a result of SNP inaction.”

Mr Yousaf said: “A&E departments are working under significant pressure and, in common with other healthcare systems across the UK and globally, the pandemic continues to impact performance.

“Recovery from Covid will not happen overnight, which is why we are continuing to work with boards on a number of measures to reduce pressure this winter.”

Comparison Table: NHS Boards and Scotland

Date ↓ NHS Board Attendance % within 4 hours
09-Oct-2022 NHS Ayrshire & Arran 1,818 67.2
09-Oct-2022 NHS Borders 577 60.5
09-Oct-2022 NHS Dumfries & Galloway 956 78.6
09-Oct-2022 NHS Fife 1,328 63
09-Oct-2022 NHS Forth Valley 1,145 39.7
09-Oct-2022 NHS Grampian 1,923 62.5
09-Oct-2022 NHS Greater Glasgow & Clyde 6,471 63.6
09-Oct-2022 NHS Highland 1,257 78.4
09-Oct-2022 NHS Lanarkshire 3,793 54.3
09-Oct-2022 NHS Lothian 4,488 61.7
09-Oct-2022 NHS Orkney 95 93.7
09-Oct-2022 NHS Shetland 187 92.5
09-Oct-2022 NHS Tayside 1,546 90.4
09-Oct-2022 NHS Western Isles 100 96
09-Oct-2022 NHSScotland 25,684 64.2

NHS crisis: the faces behind the waiting lists

Responding to Scottish Labour Leader Anas Sarwar raising his late constituent Anne Sinclair’s case at First Minister’s Questions this week, Foysol Choudhury MSP said: “I am grateful to Anas Sarwar for raising the case of Anne Sinclair with the First Minister.

“I raised the case with the First Minister in February and was told that the seven months of delays she had faced in her cancer diagnosis were ‘not at all acceptable’. I agreed with that assessment.

“Unfortunately Anne passed away this summer. Throughout her journey with cancer she was determined that I raise her story in the Parliament, find answers for the delays she faced, and fight so that nobody else was left in the same position. Her sons, who were in the gallery of the Scottish Parliament for FMQs today, have kindly given me permission to continue that fight on their mother’s behalf.

“Anne’s case starkly demonstrates the real people behind the numbers we hear every week in the Scottish Parliament. There are faces behind all the waiting lists, the people waiting in ambulances, and the people who cannot get the care they need. These are not just statistics, they are human beings who deserve dignity in their healthcare.

“Unfortunately Anne was let down, and her sons deserve answers and an apology for the delays in their mother’s diagnosis.

“I want to thank my office staff for pursuing what has often been an emotional case. We all want to see that Anne’s family can be assured that lessons are learned and nobody else will be left in the same position.”

The family of Anne Sinclair, 64 from Edinburgh, said: “We are happy that Foysol Choudhury MSP and Scottish Labour have continued to raise our late mother’s case at the Scottish Parliament.

“We do not wish for any other families to go through what our mum and our family have gone through. Our mum was a fighter and she would want her questions about her late diagnosis to be answered.”

Preparing the NHS for Winter

YOUSAF: ‘this winter will be one of the most challenging our NHS has ever faced’

Additional funding of £8 million for overseas nurse recruitment and increased flexibility for Health Boards to retain staff are among new measures to support the health and care system through what is anticipated to be an extremely challenging winter.

Health Secretary Humza Yousaf has outlined a number of actions for the coming months backed by more than £600 million of funding. The announcement comes on the back of the latest awful performance figures – August’s waiting times were the worst on record.

Measures to support services include:

  • recruitment of 1,000 additional staff over the course of this winter, including £8 million to recruit up to 750 nurses, midwives and allied health professionals from overseas as well as 250 support staff across acute, primary care and mental health;
  • flexibility for Health Boards to offer ‘pension recycling’, where unused employer contributions can be paid as additional salary, to support the retention of staff;
  • £45 million for the Scottish Ambulance Service to support on-going recruitment, service development and winter planning;
  • £124 million to assist health and social care partnerships expand care at home capacity;  
  • extension of the Social Care Staff Support Fund to 31 March 2023, to ensure staff receive full pay when in COVID isolation;
  • Writing to GPs to communicate the expectation that pre-bookable appointments are made available in every practice, alongside same day, face to face and remote appointments;

The first annual update has also been published on the NHS Recovery Plan which highlights significant progress made in the last year, including increasing NHS workforce to historically high levels, the success of the COVID vaccination programme, and a marked reduction in outpatient waits of over two years.

nhs-recovery-plan-2021-2026Download

Mr Yousaf said: “NHS Scotland’s staffing and funding is already at historically high levels, but as we approach the winter period it is crucial that we look to maximise, and enhance where we can, the capacity of the NHS.

“Given the scale of the escalating cost of living crisis, combined with the continued uncertainty posed by COVID and a possible resurgence of Flu, this winter will be one of the most challenging our NHS has ever faced.

“These measures will support winter resilience across our health and care system, ensuring people get the right care they need at the right time and in the most appropriate setting. We will also expand our workforce, particularly registered nurses to assist with the expected increase in workload.

“We have jointly agreed a number of overarching priorities with Cosla which will help guide our services this winter. We are on course to double our virtual capacity this year and so far have avoided or saved bed days equivalent to adding a large district general hospital.

“We have published the first update on our NHS Recovery Plan which highlights just how much progress we have made in the past year, I am determined to build on this and we will report on progress annually.  

“Our NHS and social care staff have shown remarkable resilience in the face of sustained pressure on services and I would like to thank them for their continued commitment and hard work. As we approach the Winter period their efforts will be vital in ensuring we deliver high quality care for the public.

“To help relieve pressure on services, people should continue to consider whether their condition is an emergency before going to A&E. Local GPs and pharmacies can be contacted during the day for non-critical care, NHS 24 is also available on 111 for non-emergencies.”

The Winter Resilience Overview 2022-23 is backed with more than £600 million of funding through the 2022/23 budget.

NHS Recovery Plan 2021-2026 – Progress Update

Scotland Emergency Department performance falls for the third consecutive month as Health Secretary announces winter plan

Responding to both the latest Emergency Department performance figures for Scotland for August 2022 and yesterday’s announcement by the Health Secretary of the Winter Resilience Overview 2022-23, Dr John-Paul Loughrey, Vice Chair of the Royal College of Emergency Medicine Scotland, said: “The latest Emergency Department performance figures for August show a fall in performance for the third consecutive month.

“We are heading into a very dark and grim winter. Staff are exhausted and are anxious about the months ahead, patients are deeply worried about facing long and dangerous waits for emergency care.

“The Health Secretary yesterday announced the Winter Resilience Overview 2022-23. We welcome the focus on and investment in social care, it is imperative that we bolster the social care workforce to ensure the timely discharge of patients and improve flow throughout our hospitals.

“However, the scale of patient harm occurring as a result of these extremely long waits for admission require more meaningful and urgent intervention and engagement by those empowered to make changes.

“Measures that focus on the avoidance of low acuity patients attending Emergency Departments will not work. The priority must be on increasing the available bed base and a medium- to long-term vision for increasing staff numbers across all grades with an NHS workforce plan for Scotland.

“We appreciate the challenges that the Scottish Government face and we would welcome the opportunity to discuss measures to mitigate patient harm and limit the impact of the looming winter crisis with them.”

July sees worst performance figures ever recorded in Scotland

‘this should ring alarm bells to all political and health leaders’ RCEM says

Responding to the latest Emergency Department performance figures for Scotland, Dr John-Paul Loughrey, Vice Chair of the Royal College of Emergency Medicine Scotland, said: “The latest Emergency Department performance figures for July should ring alarm bells to all political and health leaders.

“These are the worst performance figures since records began, with over 4,000 patients waiting 12-hours or more in major Emergency Departments in Scotland – equal to nearly one in every 25 patients.

“The depth and scale of this crisis is deeply concerning. Patients are already coming to harm, a consequence of long and dangerous waiting times. These data must be a call to action, especially as winter is fast approaching.

“The government must urgently expand capacity where safely possible; we know there is a shortfall of 1,000 beds in the health system in Scotland. The Scottish government and local authorities must also bolster the social care workforce. Good social care underpins an effective health service.

“Ensuring the timely discharge of patients, which relies on good social care, is crucial for freeing up beds, admitting patients and encouraging flow throughout the hospital.

“Lastly, we must see a long-term workforce plan for the NHS in Scotland. Staff have been pushed to the brink; burnout and distress are leading to health workers considering leaving the workforce.

“We must do all we can to retain staff as well as look to recruiting new staff into the health service. Without the workforce, more and more patients will face longer and longer waits and come to further harm.

“Our priority is patient safety and delivering effective care, that is only possible with a workforce that is not overwhelmed, not burnt out and not undervalued.”

The latest performance figures for July 2022 for Emergency Departments across Scotland show:

  • There were 110,494 attendances at major Emergency Departments
  • 66.5% of patients were seen within four-hours
    • This is the lowest four-hour performance since records began
    • This meant that 37,067 patients waited more than four-hours to be seen, admitted, discharged, or transferred.
  • 11,419 patients waited more than eight-hours before being seen, admitted, discharged, or transferred
    • This is the highest number of eight-hour waits since records began
    • There have been almost 20,000 more eight hour waits between January 2022 and July 2022 than in all of 2021.  
    • It means that one in 10 patients were waiting eight-hours or more in a major Emergency Department 
  • 4,271 patients waited more than 12-hours before being seen, admitted, discharged, or transferred
    • This is the highest number of 12-hour waits since records began
    • It means that nearly 1 in 25 patients waited 12-hours or more in a major Emergency Department
    • In the first seven months of 2022 there have been double the number 12-hour waits when compared to the whole of 2021
    • It is a 14% increase on the previous month, June 2022 and a 461% increase on the same month last year, July 2021

“We are seeing the sharp demise of the health service”

30,000 patients wait more than 12 hours in A&Es in England in July

Responding to the latest Emergency Department performance figures published by NHS England for July 2022, Vice President of the Royal College of Emergency Medicine, Dr Adrian Boyle said: “These performance figures are worse than we could have ever expected for a summer month.

“There were nearly 30,000 12-hour waits (measured from decision to admit to admission) in July 2022, that is more than 3.5 times the total number of 12-hour waits for the whole of 2019.

“This is only the Tip of the Iceberg as the true number of 12-hour waits, measured from time of arrival, is much higher. We urgently need transparency for the scale of the crisis, only then will everyone recognise the reality of the situation and begin to take critical action. We urge NHS England to commit to publishing this data (which is already collected by all Trusts) monthly with immediate effect.

“The crisis is escalating quickly, and health workers are seriously concerned about the quality of care being provided, especially as we exit summer and head into winter. The system is struggling to perform its central function: to deliver care safely and effectively.

“This is a whole-system problem and requires a whole-system approach. There must be total focus on promoting flow throughout the hospital and priority around our ability to provide an NHS that helps patients in an emergency.

“We must ensure patients are discharged in a timely way, so beds are freed and patients in A&Es are able to move through the system and be treated. Flow and discharge rely heavily on an effective social care service that has sufficient workforce – the government must get to grips with this.

“Across the UK we urgently need 13,000 beds to drive meaningful improvement: in Emergency Medicine in England there is a shortfall of 2,000-2,500 Consultants as well as widespread shortages of nurses, trainees, SAS doctors and junior and supporting staff.

“The social care workforce must also be bolstered, which can be achieved by giving these core workers a fair wage that respects and recognises the value of their role. Retention of all health and social care workers is vital, staff are burned out and exhausted, and some are considering their careers.

“We are seeing the sharp demise of the health service and we are seeing little to no political will to act on or acknowledge the crisis – neither of the leadership candidates seem to recognise the scale of the crisis at hand.

“Winter is looming, which will bring a wave of flu and covid and increased footfall in Emergency Departments, with the data as dire as it is today and the scale of patient harm already occurring, we dread to think how much worse things could get for patients.

In winter four-hour performance typically decreases while the number of 12-hour waits significantly increases. We may reach a point where only half of patients are seen or treated within four-hours and see an even higher number of 12-hour waits.”

The latest Emergency Department performance figures published by NHS England for June 2022 for show:

  • There were 1,385,080 attendances at major Emergency Departments
    • There were 2,163,779 total attendances at all Emergency Care facilities
  • 29,317 patients were delayed for 12 hours or more from decision to admit to admission, this is just over 3.5 times higher than the total number of 12-hour waits over the whole of 2019
    • This is the highest number of 12-hour waits on record
    • This is a one third increase compared to the previous month, June 2022, or an increase of over 7,000 12-hour waits
    • There have now been 150,014 12-hour waits (from decision to admit to admission) so far this year
  • Four-hour performance at major Emergency Departments was 57.0%, this is the worst four-hour performance on record
    • More than 2 in 5 patients were delayed by four-hours or more
  • Type 1 admissions stood at 358,284 (a daily average of 11,575
  • 136,221patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)

£10 million boost to tackle cancer waiting times in Scotland

Cancer patients are set for faster access to treatment as an additional £10 million has been allocated to help improve waiting times.

The new money, to be shared among the health boards, will boost the number of operations available, creating extra clinics, and upskilling new staff to speed up the delivery of endoscopy, radiology and chemotherapy treatment to get patients the care they need as quickly as possible.

This builds on the Scottish Government’s £114.5 million National Cancer Plan, to support patients and deliver equal access to care across the country that means anyone can access the best standard of care despite their location or background.

This extra cash is on top of the £10 million that was allocated to Health Boards last year (2020-21) to support the running of cancer services in the face of the pandemic. This delivered new healthcare staff, additional weekend clinics and operations for the areas that need it most and helped create a brand new Urological Diagnostic Hub in NHS Highland that is already showing signs of improved waiting times.

Health Secretary Humza Yousaf announced the fund while visiting NHS Forth Valley’s Breast Cancer One-Stop Clinic, which has been funded by this scheme.

This modernised service, provided  diagnostics for more than 5,000 additional breast patients from out-with NHS Forth Valley during the pandemic and continues to see and treat 80-100 new patient referrals each week from the local area. 

Mr Yousaf said: “Despite the challenges of the pandemic, NHS Scotland has consistently met the 31-day standard for starting cancer treatment with an average wait of four days once a decision to treat has been made – that’s testament to the relentless efforts of our fantastic healthcare staff across the country. However we must to more to improve our 62-day performance.

“Covid has not gone away and pressures remain, which is why we are providing health boards with a £10 million cash boost to drive down waiting times so that cancer patients can receive the best care as early as possible.”

2022-06-28-cwt-summary-finalDownload

Commenting on the Scottish Government’s announcement of £10 million funding to tackle cancer waiting times, Foysol Choudhury MSP said: “Any additional funding for cancer treatment is welcome, but the Scottish Government’s announcement of an additional £10 million to address cancer waiting lists is scarcely adequate to deal with the scale of the crisis in cancer waiting times in Scotland.

“The latest figures show that only 76.9 per cent of cancer patients are being seen within 62 days, a new record low and well short of the 95 per cent target. The Scottish Government cannot blame this entirely on the pandemic as it has not met this standard since 2012.

“Only recently, I sadly lost a constituent who contacted me about appalling delays in their cancer diagnosis and treatment. That constituent asked that I do everything in my power to ensure that nobody else goes through the same ordeal. I will continue to raise this issue until Scotland sees an improvement in outcomes, not just more hollow promises.

“Earlier this year I raised with the First Minister the fact that almost two fifths of cancers in Scotland are only being diagnosed at A&E, which is a sad indictment of the state of primary care under the SNP. But ever more are now waiting far too long for diagnostic tests and treatment for cancer.

“In spite of the heroic efforts of NHS staff, the cumulative failures in the running of the health service over the last decade are leaving patients frustrated and let down. In cases of cancer, this can mean the difference between life and death.

“I implore the Scottish Government to get a grip of this crisis. Those waiting for cancer treatment cannot afford further delay.”

There are two waiting time standards for cancer in Scotland. The 62-day standard is the time taken from receipt of urgent suspicion of cancer (USC) referral to start of first treatment for newly diagnosed primary cancers .

Patients can be urgently referred by a primary care clinician or general dental physician;  referred through a national cancer screening programme; direct referral to hospital where the signs and symptoms are consistent with the cancer diagnosed in line with the Scottish Referral Guidelines for example self-referral to A&E.

The 31-day standard is from the decision to treat to start of first treatment for newly diagnosed primary cancers, regardless of route of referral.

Latest published Cancer Waiting Times

The National Cancer Plan details how cancer services will be redesigned to benefit patients and increase resilience to future rises in COVID-19 prevalence.

New national targets to tackle long waits for planned care in Scotland

Ambitious new targets have been set out for NHS Scotland to address the impact of the pandemic on long waiting times for planned care.

Health Secretary Humza Yousaf announced NHS Scotland will aim to eradicate waits of more than two years, and then one year in most specialities by September 2024.

Mr Yousaf has asked health boards to take a focussed approach to tackle the waiting lists now that activity in the NHS is beginning to recover from the pandemic.

The targets are to treat those patients waiting longer than:

  • two year waits for outpatients in most specialities by the end of August 2022
  • eighteen months for outpatients in most specialities by the end of December 2022
  • one year for outpatients in most specialities by the end of March 2023
  • two years for inpatient / daycases in most specialties by the end of September 2022
  • eighteen months for inpatient / daycases in most specialities by the end of September 2023
  • one year for inpatient / daycases in most specialities by the end of September 2024

Mr Yousaf, who made the announcement while visiting Perth Royal Infirmary said: “We know that waiting times have grown as a result of the pandemic, which is why we now need to focus on treating these people that are waiting too long for treatment. That’s why I am announcing some of the most ambitious targets in the UK.

“From speaking to patients and clinicians across the country, I know there is a physical and mental consequence in having to wait a long period to be treated, that is why addressing long waits is a key focus of our plans for NHS recovery.”

Mr Alastair Murray, Chair of Scottish Committee for Orthopaedics and Trauma said: “Scottish orthopaedics very much welcomes the introduction of targets to address the growing number of people waiting for essential treatment. It is hoped that the targets set out will drive ongoing efforts to reduce waiting times for orthopaedic surgery in Scotland.”

The NHS will work together to reduce backlogs of care, specifically longest waiting patients, and that will mean some patients will be offered appointments outwith their local health board area to provide treatment more quickly – for example, the Golden Jubilee University National Hospital or at National Treatment Centres as they become operational over the next year.  

The approach will also build on the success of the Centre for Sustainable Delivery, which was established to drive innovation and introduce new ways of delivering care that will create additional capacity for inpatient, daycase and outpatients. 

The National Clinical Prioritisation Framework will be revised to ensure any patient waiting more than two years is prioritised and treated, as well as those who require urgent clinical care.

Funding for the new drive will come from the £1 billion allocated for the NHS Recovery Plan.

LOTHIAN LABOUR MSP: “Our NHS is in a state of year-round crisis”

Lothians list MSP Foysul Choudhury said: “The latest figures show that waiting times in NHS Lothian A&E departments are at historic highs. The last eighteen months have seen a significant drop in compliance with the Scottish Government’s target of 95% of A&E patients to be seen within four hours.

“The figures for NHS Lothian currently sit at 65% of A&E patients being seen within four hours, with the Royal Infirmary currently around 50%, one of the worst figures in the country.

“I welcome the new appointments system for the Minor Injuries Unit, but this will only have an impact on overall waiting times if the whole system – including NHS 111 – is properly staffed, resourced and able to cope with the current and future levels of demand.

“Speaking to staff from NHS Lothian, they too often feel the stress of the pressures on the NHS. They are increasingly being abused at work by patients frustrated at long waiting times, and staff absences are being kept high by repeated waves of COVID. The Scottish Government must better support NHS staff to defuse the building crisis of morale among our healthcare workers.

“Our NHS is now in a state of year-round crisis. The Scottish Government promised the Scottish people only last year that they would focus on pandemic recovery, and these latest figures only make it more disappointing that they are instead being distracted by their obsession with the constitutional question.”

Tip of the Iceberg: New report exposes real number of A&E waits

Over 1,000 patients faced a 12-hour wait in A&E every day in 2021

A new report by The Royal College of Emergency Medicine ‘Tip of the Iceberg: 12-Hour Stays in the Emergency Department’ reveals that on average 1,047 patients waited 12-hours or more from their time of arrival every day in a major Emergency Department in 2021 in England, equalling a total of 381,991 patients experiencing these 12-hour waits in 2021.

There is a total of 124 NHS Trusts in England. The College received responses from 74 NHS Trusts that were contacted. The figures above are only representative of 60% of NHS Trusts in England. The true total figure of 12-hour waits from time of arrival in major Emergency Departments in England in 2021 will be even higher.

These figures show the deep crisis facing the NHS and the Urgent and Emergency Care system. The alarming number of 12-hour waits are an indicator of the serious and dangerous levels of crowding occurring in Emergency Departments.

Crowding is unsafe, inhumane, and undignified for patients, our previous report Crowding and its Consequencesfound that patients can come to associated harm and even death.

The NHS in England currently measures 12-hour waits from decision to admit (DTA). The Decision to Admit is the decision to admit a patient to a hospital bed made by a clinician. Measuring from decision to admit is a gross underrepresentation of the reality of patient waits, as many patients will have already waited for a long period in a busy Emergency Department before this decision is made.

12-hour DTA waits have been increasing substantially, so much so that in the first four months of 2022 alone (January – April 2022) there were a total of 79,610 12-hour DTA waits; nearly as many as the cumulative total of the 11 years since data collection began (82,746 12-hour DTA waits between August 2010 – December 2021). It is evident that while the pandemic has contributed to the current situation somewhat, long waiting times have clearly been rising for over a decade.

Our recent report Beds in the NHS found that 25,000 staffed beds have been lost since 2010/11 and this has contributed to the steady increase in long waiting times in Emergency Departments since 2010/11 as detailed in Tip of the Iceberg.

Commenting on the FOI findings, Dr Adrian Boyle, Vice President of The Royal College of Emergency Medicine, said: “These figures are staggering and show the critical state of the Urgent and Emergency Care system.

“They also make clear that measuring 12-hour waits from decision to admit masks the reality facing patients and staff. Clearly, it is misleading to measure 12-hour waits in this way, and it is detrimental to staff efforts to improve A&E waiting times.

“NHS England have previously promised to make 12-hour data measured from time of arrival in the Emergency Department public and publish it alongside monthly NHS performance figures. We are still waiting for them to fulfil their promise.

“We recently wrote to Amanda Pritchard, Chief Executive of NHS England, about this, questioning why the data has not yet been published and when it will be. We have not received a response. Until it is published the NHS cannot hope to drive meaningful change and improvement in Emergency Care. Publishing this data will bring about greater accountability, and help all stakeholders understand the extent of crowding, long stays, and corridor care.

“NHS England must publish 12-hour data from time of arrival as a matter of urgency, this is the first step towards meaningfully tackling this crisis. At present, we fear that the full scale of this crisis is either being ignored or inadvertently misunderstood by the government.

“To truly tackle the problem, you must understand the scale of the task at hand. This data should facilitate better understanding of the challenges facing Urgent and Emergency Care and the wider health system and allow us to take the steps towards tackling it.

“In the short-term, the government must set out a meaningful plan for social care that includes recruitment and investment in the social care workforce and paying a wage that values and reflects significance of their role.

“In the medium-term, the government must finally commit to publishing a fully funded long-term workforce plan that recruits new staff into the health service and includes measures to retain existing staff who are burned out and questioning their careers. Then will it be possible to open the 13,000 staffed beds required to drive meaningful improvement within the health service.

“The health service is failing, and failure to act will take it deeper into crisis and inevitably lead to another ‘worst winter on record’ and further patient harm. The government can talk about phantom new hospitals all it likes, but political unwillingness to tackle the deepest health crisis in NHS history costs; the cost is both deteriorating patient health and patient lives, and an undervalued workforce struggling to deliver.”

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