A&E waits worsen again
ONE in 20 patients spent more than 12 hours in Scotland’s A&E departments in October, as performance against key targets sank to a record low.
The statistics from Public Health Scotland show a rise in extreme waits, despite the number of people attending A&E services actually falling by around 2,000 compared to September.
During October, just 67.6 per cent of people visiting an A&E – ranging from major emergency departments to minor injury units – were seen, treated and subsequently admitted, transferred or discharged within four hours. The target is 95%.
Of the 129,611 people who attended A&E, 6,814 spent more than 12 hours there, mainly due to a lack of available hospital beds for admission.
The A&E performance – which is the worst on record in Scotland – coincided with a further deterioration in delayed discharge.
During October, an average of 1,898 hospital beds each day were occupied by a patient fit for discharge but unable to leave, typically due to a lack of social care.
This is equivalent to around 14% of the acute beds in NHS Scotland, with patients affected by delayed discharge remaining in hospital on average for 23 days longer than necessary.
The Royal College of Emergency Medicine has warned long delays are harming or killing more than 30 patients a week.
A key factor is a lack of social care places, leading to the delayed discharge of patients medically fit enough to leave hospital.
This creates an overall shortage of beds, making it harder to advance patients through A&E.
Opposition parties have called for Scottish Health Secretary Humza Yousaf to go.
Dr Sandesh Gulhane, a GP and Scottish Conservative health spokesman, said Mr Yousaf had “lost the trust of shattered patients and staff”.
He added: “Enough is enough. We can’t go on like this. Nicola Sturgeon must act without further delay and sack Humza Yousaf now.”
Scottish Labour deputy leader Jackie Baillie said the NHS crisis was “getting worse instead of better”, adding:”thousands of people have been left stranded in A&E for more than 12 hours and spiralling rates of delayed discharge will make this bad picture even worse.”
Mr Yousaf said Flow Navigation Centres – a network of virtual triage control rooms – were succeeding in reducing pressure by re-directing people away from A&E to other services, such as pharmacies, or scheduling in-person, phone or video appointments, where appropriate, to avoid unnecessary long waits.
However, clinicians have repeatedly stressed that the major obstacle for A&E is not demand from attendances – which remain below pre-pandemic levels – but bottlenecks in getting people out of A&E and into beds.
Roughly a quarter of people who arrive at A&E require admission, data shows.
Mr Yousaf added: “A number of factors are driving up A&E waits, including the level of delayed discharge, which is why we are working with health boards to ensure people leave hospital without delay, freeing up vital beds for those who need them most.
“We will continue to see fluctuations in figures over winter, despite this, I am clear that A&E performance is not where it needs to be.”
Meanwhile, ministers have been warned of a worsening crisis in nursing, as the latest workforce figures revealed that nursing vacancies have jumped by nearly 10% in a year – from 5595.5 in September 2021 to 6142.5 by the end of September this year.
The Royal College of Nursing in Scotland is currently balloting its members over an average pay offer of 7.5% , with the prospect of strikes if the sub-inflation uplift is rejected.
Colin Poolman, director of RCN Scotland, said: “Scotland’s nursing workforce crisis is at the heart of the challenges facing our health and social care services.
“Many of the hospital capacity problems are a result of a lack of health and social care resources within our communities.
“For example, district nursing teams are key to providing care for people at home, preventing admission to hospital and supporting those who are in hospital to return home safely and quickly.”