Tag: waiting times

Scotland’s Emergency Departments experience worst ever May performance

The latest data released yesterday by the Scottish Government for May 2021 show that attendances at Emergency Departments have risen significantly.

In May 2021 there were 112,563 attendances to major Emergency Departments across Scotland. This is a 12% increase compared to April 2021, a 24% increase when compared to March 2021, and a 45% increase compared to May 2020.

Following this increase, four-hour performance deteriorated, 86% of attendances to major Emergency Departments in Scotland were seen within four hours. 15,706 patients were delayed by four-hours or more in an Emergency Department, this is the highest figure since January 2020, and it is the highest figure ever recorded for the month of May. This means one in seven patients were delayed by four hours or more before being seen.

In May 2021, 393 patients spent 12 hours or more in an Emergency Department, this is double the figure for April 2021. This is the highest number of 12-hour delays for the month of May ever recorded, and it is more than double the previous highest May figure of 189 12-hour delays that was recorded in 2019.

Data also show that 1,680 patients spent eight hours or more in a major Emergency Department, this is an increase of nearly 50% compared to April 2021 and it is the highest figure ever recorded for the month of May.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said: “The data is deeply concerning and very much reflects what is happening on the ground. Departments are busier than ever, especially for the summer period with some record-breaking figures for the month of May, and it is becoming increasingly challenging.

“These figures come at a time when reports suggest Scotland has the highest covid infection rate in Europe. We are battling community admissions, elective care patients seeking treatment, as well as increasing covid patients attending our departments, all within the context of reduced bed-stock.

“Departments are filled with patients, some who may have covid, waiting to be seen. While long-stays alone can put patient safety at risk. This risk is increased as some patients could contract the disease in a busy Emergency Department.

“The College’s recent Emergency Medicine workforce census in Scotland revealed an Emergency Medicine workforce that was not adequately staffed to deliver the highest quality patient care in Emergency Departments in Scotland.

“We have shortages across the board, but particularly among consultants and senior decision-making clinicians. These shortages are currently exacerbated by the soaring covid infection rate, meaning there are a large number of absent NHS staff due to covid in Scotland.

“We are doing all we can to maintain flow and maximise patient safety, but the pressures are increasingly intense and are faced by the existing but short-staffed workforce that are facing continued burnout and exhaustion.

“The data show the growing demand for urgent and emergency care, Emergency Departments are where people turn to for treatment when there is nowhere else to go, so they must be adequately staffed with trained Emergency Medicine staff, properly funded, and equipped with enough capacity and resources to cope with severe demand.”

“We urgently need the Scottish Government to support the urgent and emergency care system to cope with these pressures.”

Two NHS Grampian hospitals have announced this week that they are at capacity as Covid cases rise.

Scotland was expected to move to level zero on 19 July, with remaining legal restrictions lifted on 9 August, but First Minister Nicola Sturgeon conceded yesterday that th planned dates are not “set in stone”.

She will be holding a media briefing at lunchtime today:

Royal College of Emergency Medicine: Winter crisis looming?

16,000 additional beds may be needed for the NHS to cope this winter

The NHS urgently needs a rapid increase in bed numbers if it is to meet potential demand this winter according to new analysis from the Royal College of Emergency Medicine.

The College’s new briefing document ‘RCEM Explains: Hospital Beds’ looks at how bed numbers have declined in the past decade, the impact of covid, and the potential number of beds needed this winter, based on previous levels of demand.

The briefing uses the ratio of emergency admissions to beds to model the numbers of beds that will likely be needed, based on the levels of demand seen each winter prior to the pandemic.

In the last five years in England this figure has fluctuated between 11.07 admissions per bed (winter 2015/16) and 12.50 (winter 2018/19). Excluding the most recent winters (both of which saw demand and capacity fall due to the pandemic), there was an average of 11.77 admissions per bed.

If the NHS is to achieve a similar ratio this winter, and there are a similar number of admissions as in the winter of 2017/18, the NHS will need just over 7,500 additional beds. If demand is similar to 2018/19, then this figure rises to 15,788 extra beds.

President of the Royal College of Emergency Medicine, Dr Katherine Henderson said: “We are currently seeing record levels of attendances at Emergency Departments and if this continues into winter – an extremely likely situation – the NHS will have too few beds to be able to cope.

“The consequences of having too few beds could be dire. If we do not have the capacity to admit patients into hospitals, then A&E waiting times will go up, patients will end up being treated in corridors – a very real threat to their safety before the pandemic, but now with the added risk of hospital acquired infection – and the elective backlog will grow further as beds earmarked for surgeries will be used for emergency patients.”

The briefing also makes clear the relationship between high bed occupancy and an increased rate of cancelled elective operations.

Dr Henderson said: “Too few beds means higher rates of occupancy, which in itself puts patient safety at risk, but it is clear that this has a huge knock-on effect on elective care. Lack of beds is one of the top reasons for cancellation of surgeries and if we do not address the shortage now, before winter, the elective recovery will fail.

“We know that access to services is an issue throughout the NHS at the moment with resources short all-round, but Emergency Departments act as the safety net for the NHS – if they cannot function properly the entire system stalls – so it is vital that the new Secretary of State does all he can to enable the NHS to expand hospital capacity. 

“The safe restoration of bed capacity to pre-pandemic levels is no easy fix though – as we’ve seen with the Nightingale initiative, capacity cannot be expanded if we do not have enough doctors, nurses, and clinicians.

“The capacity and staffing issues we face now have been over a decade in the making. Social care is still unfixed. Waiting lists are growing. Structural reconfiguration is in progress. Covid is less of an immediate threat but is unlikely to disappear. The Secretary of State has much to do, but he must start by making the beds.”

Briggs: NHS Lothian has longest outpatient waiting times in Scotland

Lothian Conservative MSP Miles Briggs said: “Every health board in Scotland has been significantly impacted by Covid-19, but none more than NHS Lothian.

“Consecutive years of chronic underfunding for NHS Lothian by SNP Ministers has meant that the health boards was the least prepared for Covid-19, with lengthening waiting times pre Covid-19.

“A recovery plan to restore performance targets will be important across Scotland, but especially for NHS Lothian and the formula for funding health boards needs urgently reviewed.

“It is time for NHS Lothian to receive their fair share of funding, so that patients in Edinburgh and the Lothian’s don’t have to suffer exceptionally long waiting times for treatments.”

https://beta.isdscotland.org/find-publications-and-data/healthcare-resources/waiting-times/nhs-waiting-times-stage-of-treatment/

Child mental health services: Coalition calls for national crusade

The Scottish Children’s Services Coalition (SCSC), an alliance of leading independent and third sector providers of children’s services, has warned of a mental health “perfect storm” for children and young people. It has also called for a “national crusade” to tackle this.

The warning comes on the back of figures from Public Health Scotland which indicate that the number of referrals to child and adolescent mental health services (CAMHS) has dropped by a staggering 55.8 per cent between quarters January and March 2020 and April and June 2020 (from 9,017 to 3,985). 1

These range from a 66.7 per cent fall in referrals for NHS Dumfries and Galloway to 7.7 per cent in NHS Orkney (full table in Notes to Editors).

It also highlights that in June 2020, 1,136 children and young people had been waiting more than a year for treatment, up from 581 on the same point last year.2

The SCSC has warned that mental health services will face an overwhelming and unprecedented pressure due to pent-up demand created by the COVID-19 lockdown, coupled with a cut in youth support services. This could potentially lead to a “lost generation” of vulnerable children and young people who are missing out on the support they vitally need.

It has called for a “national crusade”, with the Scottish Government working closely with authorities, including the third and independent sectors, and investing significantly in mental health services. The coalition has also urged that greater awareness is made of the services on offer, especially those at a community level.

The SCSC has warned that self-isolation and social distancing have had an impact on young people struggling with issues such as anxiety and depression. It has noted that even the most resilient children are going to need additional support as they navigate this transition back into whatever is the new normal, and some will need a lot of extra support.

A  report commissioned by Young Scot, YouthLink Scotland and the Scottish Youth Parliament, called Lockdown Lowdown, found almost two-fifths of young people felt moderately or extremely concerned about their own mental wellbeing.3

A spokesperson for the SCSC commented: “These latest figures are deeply troubling and point to a ‘perfect storm’ for our young people, with increased demand coupled with cuts in services.

“While referrals have dropped during lockdown and children are not accessing support, we are storing up immense problems for the future as specialist mental health services face being overwhelmed due to greatly increased demand.

“We need a ‘national crusade’ to deliver the mental health provision our young people desperately need. The Government needs to work urgently with the relevant authorities to ensure that not only is there sufficient provision available at the local community level, but that this is clearly communicated and easily accessible for young people and their parents or carers.

“It is not just the NHS, but the third sector and other independent organisations play a key role in addressing mental health services and must receive the funding they vitally need or we face a ‘lost generation’ of vulnerable children and young people.” 

Six out of ten young people waiting over 18 weeks to be seen in Lothian

The number of children and young adults waiting over 18 weeks to be seen by a mental health professional has increased to 147 out of 247 patients seen, 59.5%, In June 2020 the latest month of statistics available.

As of June 2020 there are 2,482 young people waiting to be seen in Edinburgh and the Lothians, with a record 472 waiting for over a year, 19% of total waits.

In April to June 2020 there were 825 CAMHS referrals, with 109 rejected, making a total of 706 new referrals. This is compared to 1,659 referrals in January to March 2020, with 382 referrals rejected, making a total of 1277 new referrals.

Lothian MSP, Miles Briggs, said: “These figures reinforce the mental health crisis for young people in NHS Lothian with exceptionally long waits to be seen by a mental health professional.

“Mental Health professionals in NHS Lothian work incredibly hard to support young people who are struggling with their mental health, but services are simply not being properly resourced to meet demand.

“Lockdown, Covid-19 restrictions and failures by SNP Ministers over SQA results will all have added to stresses for young people making mental health support even more important.
“SNP Ministers have presided over our health service for over 13 years and have failed to support a generation of young people.”

1 NHS Information Services Division, Child and Adolescent Mental Health Services Waiting Times in Scotland – Full report (PDF link), 1st September, Table 5, Available at: https://beta.isdscotland.org/find-publications-and-data/conditions-and-diseases/mental-health/child-and-adolescent-mental-health-services-camhs-waiting-times/  (accessed 1st September 2020).

2 Ibid., waiting times table 1b

3  Young Scot, YouthLink Scotland and the Scottish Youth Parliament, Lockdown Lockdown – what young people in Scotland are thinking about COVID-19 (PDF), 23rd April 2020. Available at: https://www.youthlinkscotland.org/media/4486/lockdown-lowdown-final-report.pdf (accessed 11th August 2020).

‘Perfect COVID storm’ for children’s mental health

  • The NHS in Scotland failed to meet a maximum 18-week waiting time target for children and young people to receive treatment from mental health services
  • More than a third are waiting more than 18 weeks for treatment.
  • All health boards bar the Island health boards failed to meet this target
  • Danger of ‘perfect storm’ of pent-up demand as lockdown eases overwhelming services

The Scottish Children’s Services Coalition (SCSC), an alliance of leading independent and third sector providers of children’s services, has warned of a “perfect storm” of a mental health crisis coupled with further cuts to some services following the Coronavirus pandemic.

It has urged the Scottish Government to invest significantly in mental health services to address this, warning of an overwhelming demand on services, and urged parents and young people to seek support if they need it.

The call comes as latest waiting time figures from Public Health Scotland, covering the period January to March 2020 (just as the lockdown came into force), show that 4,093 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period.

Of this number under two-thirds (65.1 per cent) received this treatment within the Scottish Government’s 18-week waiting time target from referral to treatment.

This was lower than the previous quarter (66.4 per cent) and significantly lower than the same period last year (73.6 per cent), meaning that just over a third are not being seen within the waiting time target.

All bar the island health boards failed to meet the Scottish Government 18-week waiting time target for children and young people to receive treatment from CAMHS. This target should be delivered for at least 90 per cent of patients.

Individual health boards failing to meet this target are: NHS Borders (89.8 per cent), NHS Fife (76.0 per cent), NHS Ayrshire & Arran (71.4 per cent), NHS Grampian (86.0 per cent), NHS Greater Glasgow & Clyde (58.8 per cent), NHS Highland (84.8 per cent), NHS Lanarkshire (57.7 per cent), NHS Lothian (54.6 per cent), NHS Tayside (65.0 per cent), NHS Dumfries & Galloway (87.2 per cent) and NHS Forth Valley (54.2 per cent).

The coalition has warned of a significant demand on services once the lockdown ends as subsequent to these figures there has been a fall in the number of children being referred for specialist help during lockdown, which could have a devastating impact on their mental health.

It warned that the absence of support from teachers and other care professionals could result in early warning signs being missed and lead to a surge in demand for services once the lockdown ends. Self-isolation and social distancing are already having an impact on young people struggling with issues such as anxiety and depression.

A recent report by Young Scot and the Scottish Youth Parliament, called Lockdown Lowdown, found almost two-fifths of young people felt moderately or extremely concerned about their own mental wellbeing: –

  https://youngscot.net/news-database/lockdownlowdown-results

And a separate report from YouthLink Scotland showed the youth-work sector was facing a mental health crisis due to projected budget cut of £20.5 million this year – https://www.youthlinkscotland.org/news/may-2020/survey-report-reveals-20m-funding-hit-for-sector-as-youth-mental-health-crisis-looms/

Although the coalition welcomes the announcement made  by the First Minister (27 February) to invest £3.8 million in developing mental health services to cope with the coronavirus pandemic, it fears that not enough will be done to safeguard the mental health of our vulnerable children.

A spokesperson of the SCSC commented: “These latest waiting time figures highlight that nearly all of Scotland’s health boards are failing to meet the Scottish Government waiting time target for treatment.

“Along with cuts in services this points to a ‘perfect storm’ of a mental health crisis as we come out of lockdown, coupled with further cuts in services.

“While referrals have dropped during lockdown and children are not accessing support, we are storing up immense problems for the future as these same under-pressure services face being overwhelmed due to a greatly increased demand.

“Children are not currently getting access to social services and are not going to school or reporting their experiences. Taking them to see the GP may currently be considered low priority.

“It is important to stress that these services are still available and the Scottish Government must look to support these young people as we come out of lockdown by investing significantly in services.”

Children’s mental health services ‘creaking at the seams’

  • The NHS in Scotland failed to meet a maximum 18-week waiting time target for children and young people to receive treatment from mental health services
  • More than a third are waiting more than 18 weeks for treatment.
  • 11 out of 14 health boards, including NHS Lothian, failed to meet the 18-week waiting time target.
  • 272 children and young people waited more than a year prior to being seen
  • Coalition calls for fundamental rethink and renewed focus on prevention and early intervention, including embedding mental health within education.

Latest waiting time figures have reinforced the call by a coalition of leading independent and third sector children and young people’s service providers for dramatically increased investment in mental health services in the budget to address the current mental health crisis.

It has also called for an urgent need for transformational change in services, focusing on prevention and early intervention in order to tackle what is one of the greatest public health challenges of our time.

The call from the Scottish Children’s Services Coalition (SCSC), which campaigns to improve services for vulnerable children and young people, comes as the latest waiting time figures from the Information Services Division, part of NHS National Services Scotland, highlight that thousands of children and young people are failing to treated within a Scottish Government waiting time target.  

With an increasing number of children and young people being identified with mental health problems they also highlight a postcode lottery for mental health treatment across the country.

Covering the quarter October to December 2019, the figures highlight that 3,884 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period.

The NHS in Scotland, including 11 of the 14 regional health boards, failed to meet the Scottish Government 18-week waiting time target for children and young people to receive treatment from CAMHS. This target should be delivered for at least 90 per cent of patients.

While 66.4 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, more than a third (33.6 per cent) are failing to be seen within this period.

Individual health boards failing to meet this target are: NHS Fife (66.1 per cent), NHS Ayrshire & Arran (89.9 per cent), NHS Grampian (80.1 per cent), NHS Greater Glasgow & Clyde (68.9 per cent), NHS Highland (75.2 per cent), NHS Lanarkshire (57.8 per cent), NHS Lothian (48.4 per cent), NHS Tayside (57.4 per cent), NHS Dumfries & Galloway (88.6 per cent), NHS Shetland and NHS Forth Valley (57.7 per cent).

The figures also indicate that 272 children and young people in the October to December quarter had been waiting for more than a year prior to being seen for treatment, an increase from 204 in the previous quarter and a considerable increase from the  same quarter of last year (108).

Mental health services are creaking at the seams due to greatly increasing demand, as evidenced by these waiting time figures. Research indicates that 10 per cent of children and young people (aged five to 16) has a clinically diagnosable mental health problem (around three in every classroom), with 50 per cent of mental health problems established by the age of 14 and 75 per cent by the age of 24.

While acknowledging the great efforts the Scottish Government is making, such as an additional £250 million of funding announced in the Programme for Government of 2018, the SCSC has called for the Scottish Government to greatly increased investment in CAMHS and for a more consistent approach to delivering these services across Scotland. 3

It has also called for a renewed focus on prevention and early intervention for those with mental health problem, reducing the need for referral to under-pressure specialist CAMHS.

This includes embedding mental health within education from an early age in order to strengthen knowledge and awareness of mental health, as well as reducing the stigma associated with mental health.

SCSC says emotion and resilience classes should be provided to all students from primary one to teach students how to work through their emotions in a healthy way and there should be a whole-school approach, with training for all staff involved in education and providing counselling support.

A spokesperson for the SCSC said: “These latest waiting time figures highlight that we desperately need increased investment in the forthcoming budget to address this situation. The simple fact is that we are continuing to fail thousands of children and young people with mental health problems, and more clearly needs to be done to address this epidemic.

“These newly released figures highlight that the NHS in Scotland, including eleven of our health boards, are failing to meet what is already a lengthy waiting time. Yet we know that three children in every classroom has a clinically diagnosable mental health problem.

“There must be a radical transformation of our mental health services, with a focus on preventing such problems arising in the first place and intervening early, especially when we know that half of all mental health problems begin before the age of 14.  This includes embedding mental health within education from an early age as well as providing training for all staff involved in education.

“With mental health and the issues associated with it representing one of the greatest public health challenges of our time, we must ensure that children and young people are able to get the care and support they need, when they need it. This includes investing in greater community support and support at school, reducing the need for referral to specialist CAMHS.”

One in three young people in the Lothians are waiting over a year for mental health support.

Miles Briggs, Scottish Conservative Lothian MSP, said: “It is deeply concerning that we are now in a situation where over a third of young people referred for mental health support in NHS Lothian are having to wait over a year.

“SNP Ministers have allowed us to reach crisis point by not properly managing NHS Lothian’s workforce and must take responsibility for neglecting to take action over the mental health crisis amongst young people.

“These figures show just how urgently we need an additional 40 whole time equivalent mental health professionals in NHS Lothian.”

Concern over alcohol and drug treatment waiting times

Scottish Conservative Health Spokesperson, Miles Briggs, has raised concerns about waiting times for Alcohol and Drug Partnerships (ADPs) in Lothian, with patients waiting for alcohol and drug treatments having to wait longer than anywhere else in Scotland. Continue reading Concern over alcohol and drug treatment waiting times

Health: Tories call for greater use of private sector to cut waiting times

The amount spend by NHS Lothian on private treatment for inpatients has reduced significantly over the last five years. Inpatient (IP/DC) private spend has dropped from £15,751,689 in 2014/15 to just £1,339,216 in 2018/19. Continue reading Health: Tories call for greater use of private sector to cut waiting times

NHS to receive a further £32 million to reduce waiting times

The NHS will receive a further £32 million to help reduce waiting times.

The investment is in addition to £70 million funding announced by the Health Secretary in April and brings the amount being spent on the Waiting Times Improvement Plan for 2019-20 to £102 million. The £102 million is part of the £850 million set aside to support the delivery of the plan over a three-year period.  Continue reading NHS to receive a further £32 million to reduce waiting times

Alcohol and Drug Partnership waiting times must improve, says Briggs

Lothian MSP Miles Briggs has raised concerns with SNP Ministers about waiting times for Alcohol and Drug Partnerships in Lothian, following latest ISD figures for the quarter ending 31st March 2019. Continue reading Alcohol and Drug Partnership waiting times must improve, says Briggs