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Despite reduced attendances, Emergency Departments in Scotland face pressures with capacity and flow

6 April 2021

The latest monthly A&E data published by the Scottish Government for February 2021 show the lowest total attendances at A&E services in Scotland since April 2020.

In February 2021 there were 80,423 attendances at A&E services in Scotland; this represents a decrease of 6.2% when compared to January 2021 and 25% decrease when compared to February 2020. 1,786 of those attendances waited eight hours or more and 483 patients waited 12 hours or more to be admitted.

The data also show that 84.9% attendances at major emergency departments were seen and discharged within four hours. This is a marginal increase of 0.1 percentage points compared to January 2021.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said:

“February saw a significant decrease in attendances and is the lowest since April 2020. Despite this, our Emergency Departments continue to face issues with exit block, patient flow and capacity. This may be due, in part, to higher acuity patients staying in the hospital longer elsewhere in the system but it has an impact on Emergency Departments.

“At present, as attendances are beginning to pick up, we are struggling to move patients through the system and some hospitals are beginning to face pressures with ambulance stacking and handover delays.

“Our main concern is that as we begin to see the level of demand increase and the return of our community patients, we will also begin to see a return to the way things were before, with crowding and corridor care becoming daily practices – which are a huge risk for patient safety.

“Patient safety is paramount, especially with covid still present in the community, so we must not let crowding and corridor care return to our Emergency Departments. We must collaborate on a system-wide approach to prevent this.

“With that being said, it is clear that we have significantly fewer people coming to our Emergency Departments, so we are also worried that there are people in the community who need urgent and emergency care but are not coming forward. If you have a serious injury or are in a serious condition you must seek out the medical care you need by calling 999 or attending A&E.

“We would also encourage patients with less serious conditions to consult NHS 24, where they will be directed to the appropriate care for them, and only attend Emergency Departments if their condition or injury is severe.

“In our hospitals, we must do all that we can to increase capacity, in line with appropriate infection prevention control measures, to prepare for a potential return to pre-covid demand for A&E services. An increase in capacity will help to manage demand and promote flow through our hospitals.

“We have a window of opportunity to avoid returning to our old ways, we must seize it and keep our patients and their safety at the forefront of our minds, ensuring the delivery of care is quick, efficient and effective.”

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