Tuesday 23 September 2025
RCEM brings together politicians and healthcare leaders to discuss the ‘Future of Emergency Care’
The Royal College of Emergency Medicine will today reveal that there were more than 800 deaths associated with long A&E waits before admission in Scotland last year.
Shockingly this is an increase of a third (202) from the 2023 figure.
The latest analysis will form part of a presentation by RCEM Scotland’s Vice President, Dr Fiona Hunter, at the College’s Future of Emergency Care event being held this afternoon (Tuesday 23 September 2025) in Edinburgh.
The event, which will be attended by RCEM Officers, clinicians, healthcare leaders, policy makers and politicians, will focus on Scotland’s Emergency Care crisis and what can be done to alleviate it.
The College will also unveil its Emergency Medicine Workforce Census 2025 and launch its manifesto ahead of the 2026 elections.
The manifesto urges all politician parties to:
- End overcrowding in Emergency Departments
- Provide Scotland with enough Emergency Medicine staff to deliver safe and sustainable care
- Resource NHS Scotland to ensure equitable care is provided throughout the emergency care system
It comes as Scotland’s Emergency Departments faced a summer of unrelenting pressure with an unacceptable number of people enduring long and dangerous waits.
Over the warmer months (1 June until 31 July 2025) one in 24 people (9,881) endured a stay of 12 hours or more from their time of arrival at an Emergency Department in Scotland.
This is 7,003 more patients than the entire year of 2018.
When looking at July alone, 4,686 people experienced this extreme wait – over 2,400 more than in the winter month of January 2022 (2,266).
Meanwhile, further analysis for the previous year (2024) reveals a record 76,510 patients waited 12 hours or more to be admitted, discharged or transferred from A&E.
That’s 20,432 more people who endured an extreme wait compared to 2023.
Of these patients, 58,906 people were waiting to be admitted to a ward for further care.
Using the Standard Mortality Ratio – a method which calculates that there will be one additional death for every 72 patients that experience an eight–12-hour wait prior to their admission – RCEM estimates that there were 818 associated excess deaths related to stays of 12-hours or longer before being admitted in 2024.
That’s the lives of 16 people lost every week.
Dr Fiona Hunter, Vice President of RCEM Scotland, said: “The fact that the deaths of more than 800 patients have been lost due to a system in crisis is a national tragedy.
“Behind this statistic are stories of heartbreak. Because these are people. Mums, dads, brothers, sisters, grandparents – their deaths shattering the lives of families and friends.
“These are patients who are sick and need further care on a ward. So they are forced to endure extreme wait times for an inpatient bed to become available for them. Often, they will be experiencing this, counting the hours they have been in ED, on a trolley in a corridor, cupboard, or simply any available floor space.
“It doesn’t have to be this way – the crisis is fixable and it comes down to patient flow in hospitals – getting people out of ED and into a ward bed and getting them out of hospital when they are well enough to go home.
“We urge all political parties to adopt the recommendations in our manifesto to give Scotland a Emergency Care system that we can be proud of once again. Because without government action, the cost will continue to be measured in lives.”
The College’s census highlights that there is a shortage of key decision makers to provide quality care to patients.
RCEM’s ‘Scotland Emergency Medicine Workforce Census 2025’ provides a comprehensive assessment of the state of the Emergency Medicine workforce, providing an insight into the working patterns of clinicians and allowing a forecast to be made around the future workforce needs of Emergency Departments in Scotland.
This is the second national Scottish census, the first having been conducted in 2021.
Responses were received from 28 major Emergency Departments, along with three Rural and Remote hospitals and found:
- There is one whole time equivalent (WTE) consultant for every 4,692 attendances. While it’s an improvement compared to RCEM’s census in 2021, (1:6,444) it’s still below RCEM’s recommended figure of 1:4,000.
- Of the 329 consultants, 38 are planning to retire in the next five years, along with 10 SAS doctors.
- There were 16 gaps in the consultant rota – the same when compared to RCEM’s last census in Scotland. Meanwhile, there were 32 in the SAS rota, up from 23, and 26 in the resident doctor rota, down from 28 compared to four years ago. Recruitment issues were highlighted among the main reasons for rota gaps.
- The average weekday consultant presence was 14 hours a day, down from 15 hours in 2021. Given RCEM’s recommendation that consultants are present at least 16 hours a day in all medium and large systems, this decline is a worrying find.
Responding to RCEM’s census, Dr Fiona Hunter said, “The College’s workforce census is a vital piece of work which reveals the true extent of workforce pressures our departments in Scotland are facing.
“While there have been some slight improvements compared to our first census in 2021, it is still abundantly clear that EDs are not adequately staffed, with senior decision makers, to deliver high quality patient care.
“Going into work, caring for patient, after patient, on a trolley in a corridor takes an immense toll. It’s no wonder they are burnout and stressed as they struggle to do the one thing they came into medicine to do, provide care.
“To futureproof our workforce, we have published a set of recommendations to the Scottish government. It must read this report and act. Because if they don’t, our Urgent and Emergency Care workforce will continue to be pushed beyond their limits, and patients will ultimately bear the brunt.”