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Exhausted staff continue to face severe pressures as data show a system under strain

2 February 2021

Monthly A&E data published today by the Scottish Government for December 2020 reveal continued strain on the system as staff continue to work tirelessly.

Figures show that attendances in December 2020 were 81,622 and were down by one third or 35,000 patients compared to December 2019, and down five percentage points or 4,500 patients compared to November 2020.

This is the fourth consecutive month that has seen a decrease in attendances. Despite this, performance has decreased for the seventh consecutive month.

Data show that 85% of patients were seen within four hours, this marks the worst performance since the pandemic began and is the worst performance since January 2020 (84.3%). However, four-hour performance is over three percentage points higher than December 2019, when performance was 81.6%.

The number of 12-hour waits has more than doubled on the previous month, November 2020. However, 12-hour waits are down by 40% on the same month last year, December 2019.

While 12-hour waits have been increasing steadily since April 2020, the increase from November 2020 to December 2020 represents a significant jump, the biggest in 2020.

The number of patients spending over eight hours in an A&E department before being admitted increased by 54% on the previous month, November 2020, however it is nearly 40% lower than the previous year, December 2019.

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

“The data show that staff continue to face intense pressures. They show a system under strain and once again despite the reduction in attendances, performance has decreased.

“12-hour waits have doubled, and four-hour performance has reached its lowest since January last year. But staff remain resilient and continue on despite being tired and exhausted both physically and mentally.

“Staff have been working relentlessly for 11 months now. Studies have shown many have faced psychological distress, stress and even PTSD as a result of the pandemic.

“Covid data indicates that we may have passed the peak of admissions, at least this is what we hope. But the strains on the system remain and passing the peak does not mark the end.

“The data show that fewer patients have been attending Emergency Departments throughout the pandemic, so when the pressures from Covid begin to reduce, Emergency Departments will likely see a return of their regular community patients and hospitals will urgently need to tend to the backlog of elective and non-urgent care. A whole new phase of challenging work will begin with little or no respite for the staff in our Emergency Departments.

“I am concerned about staff wellbeing and mental health. The impact of the pandemic on the mental health of frontline staff must be recognised.

“In the short term, psychological support must be provided for any health care professional who needs it. We had the clap for carers, now let’s provide actual support that tends to the mental health of frontline workers.

“Most frontline workers have seen patients die, some have known colleagues who have died, others may have been very sick themselves, but all have faced a challenge like no other and given all their energy and efforts to the care of others.

“Even before the pandemic work pressures were unsustainable for staff; now many are nearing breaking point. We entered the pandemic short of staff, so it is essential we look to the future and tackle the workforce crisis to help reduce the harsh pressures and mental strain on our existing staff. We cannot let them down.”

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