Tag: waiting times

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.

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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.”

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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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Mental health emergency as child referrals increase by more than 22%

Over 1,300 children waiting more than a year for treatment

The Scottish Children’s Services Coalition (SCSC), an alliance of leading providers of specialist children’s services, has warned of a mental health emergency and called for greatly increased investment as the impacts of the Covid-19 pandemic on the young become clearer.

It notes that the mental health of children and young people is set to further worsen given the cost-of-living crisis, as more people are driven into poverty.

The SCSC has also warned of the devastating impact of cuts in public services on those with mental health issues, as outlined in the Scottish Government’s Resource Spending Review, with an estimated £3.5 billion spending shortfall by 2026/27.

The call comes as new figures published by Public Health Scotland yesterday (7th June 2022), indicate that over the quarter covering January to March 2022, 9,672 children and young people were referred to specialist child and adolescent mental health services (CAMHS) for treatment.

This includes issues such as anxiety and depression and represents a staggering 22.4% increase in numbers from the same quarter of the previous year when the equivalent figure was 7,902.

With already under-resourced and overstretched services facing overwhelming pressure due to increased demand, the SCSC has raised concerns over a potential “lost generation” of vulnerable children and young people whose mental health is being impacted by Covid-19. 

Even before the pandemic, cases of poor mental health were at unprecedented levels with services in crisis, and there are a growing number of vulnerable children who cannot access adequate support. The pandemic and cost-of-living crisis has exacerbated this, with more children and young people driven into poverty, with the resulting impact on their mental health. This has led to unprecedented demand and backlogs, with services struggling to keep up.

In total, 5, 016 children and young people started treatment at CAMHS during the period January to March 2022, an increase of 7.7% from the previous quarter (4,659). Just over a quarter (26.8%) were not seen within the Scottish Government’s maximum waiting time for the NHS of 18 weeks from referral to treatment (to be met by at least 90% of patients). 

A total of 1,322 children and young people had been waiting over a year for treatment at the end of March 2022.

In addition to increased investment in specialist CAMHS, the SCSC has called for greater workforce planning and a renewed focus on expanded prevention and early intervention services, reducing the need for referral to costly specialist mental health services. It has also called for greater partnership working between the public, private and third sectors as well as greater awareness of the services on offer, especially those at a community level.

A spokesperson for the SCSC commented: “We have been warning for some time that we are facing a potential lost generation of vulnerable children and young people, whose mental health is being impacted even further by the Covid-19 pandemic and the cost-of-living crisis.

“Adding to this are cuts in public services, which will impact especially on local government and the third sector, responsible for many of the preventative and early intervention services supporting those with mental health problems.

“Faced by such a devastating series of factors, there must be a radical transformation of our mental health services, investing in specialist services and with a renewed focus on preventing such problems arising in the first place through intervening early.

“This is a crisis we can overcome, but as the country comes to terms with the biggest hit to its mental health in generations, it will require a similar energy and commitment to that demonstrated for Covid-19 if we are to achieve this and prevent many young people giving up on their futures.”

Reshaping unscheduled care services

People needing urgent and unplanned hospital care will benefit from a new national improvement programme aimed at reducing waiting times.

The Urgent and Unscheduled Care Collaborative will see health boards adopt a number of measures to reduce A&E waiting times and improve patient experience, including offering alternatives to hospital–based treatment.

People will also be offered scheduled urgent appointments to avoid long waits in A&E. The programme will also determine how the discharge process can be simplified to ensure patients don’t face unnecessary delays in leaving hospital. Health boards will share more than £50 million of funding this year (2022-23) to support this national integrated approach with work already underway in some areas.

Earlier this week the Scottish Government’s Resource Spending Review was published, setting out priorities for the next five years, including investment and 2reform of health and social care services.

Health Secretary Humza Yousaf said: “It is absolutely crucial we ensure people are receiving the right care at the right time and in the right place. That’s why I’m pleased to confirm today’s £50 million investment to help achieve our national urgent and unscheduled care priorities. 

“Our twin approach of investment and reform in urgent and unscheduled care will help boards see people who need urgent attention more quickly. For many, A&E may not be the best place for their healthcare needs and our £50 million improvement programme will offer patients alternative routes to urgent care.

“Last year 4,500 patients received care from a Hospital at Home service – without this these patients would have experienced an acute hospital stay, we are determined to build on this success.”

Royal College: Urgent and Emergency Care ‘in dire crisis’

RCEM urges action to address failing A & E system

The latest monthly Emergency Department (Major EDs) performance figures for Scotland for February 2022 show:

  • There were 95,692 attendances
  • Four-hour performance was 71.7%, 1.9% lower than the previous month, January 2022, and the second lowest on record
  • 27,087 patients were delayed by four hours or more, this is means more than one in four patients were delayed by four hours or more
  • 6,248 patients were delayed by eight hours or more
  • 2,230 patients were delayed by 12 hours or more, this represents the highest proportion of attendances experiencing 12 hour waits since records began

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The crisis in Urgent and Emergency Care is dire. The health system in Scotland is ceasing to function as it should. Patients are at risk of severe harm and staff are facing stress, distress, burnout and moral injury on a daily basis.

“This is unsustainable and dangerous. The first step to tackling this crisis is opening 1,000 beds that are desperately needed across the system and recruiting senior decision makers in Emergency Medicine. In addition, the crisis in social care, which is resulting in the most vulnerable patients residing in hospital for extremely long periods of time before being discharged means that the system is unable to cope.

“This patient safety crisis must be a priority for the Scottish Government, and they must take meaningful action now before more patients come to severe harm.”

Weekly Scottish Emergency Department waiting times are ‘worst on record’

Serious concerns for patient safety

The latest weekly update (w/e 20 March 2022) of Emergency Department activity and waiting time statistics show:

  • There were 25,506 attendances in week ending 20 March 2022
  • Four-hour performance was 66.2%, the lowest on record
  • 8,610 patients were delayed by four hours or more, this is the highest on record and means one third of all patients were waiting for four hours or more in an Emergency Department
  • 2,615 patients were delayed by eight hours or more, this is the highest on record and means more than one in 10 patients were waiting for eight hours or more in an Emergency Department
  • 1,015 patients were delayed by 12 hours or more, this is the highest on record and means one in 25 patients were waiting for 12 hours or more in an Emergency Department

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “Each week the Urgent and Emergency Care crisis worsens.

“Scotland’s Emergency Care system is failing patients who are coming to harm, and failing staff who are overworked, exhausted, and burned out but are left to cover the widespread shortcomings of the health system. Shortages of beds, shortages of staff, the social care crisis; existing staff do all they can to keep patients safe in these exceptionally challenging circumstances.

“It is an untenable and unsustainable situation. This week saw the highest number of long waits on record yet again. Data show that there is one excess death for every 82 patients delayed for more than six hours.

“This week 2,615 patients were delayed by eight hours or more, from this we can estimate that over 30 patients in this week alone could have come to associated harm or death as a result of their delay to admission.

“The significance of this appalling harm must not go unnoticed and must be met immediately with effective and meaningful action. The Scottish Government must understand the severity and extent of harm befalling our patients, and see that existing staff facing moral injury, going above and beyond, running on goodwill and adrenaline is not reasonable or acceptable.

“This can no longer be the sole answer to the biggest patient safety crisis in Emergency Care for a generation. This must not continue.”