Royal College of Emergency Medicine Menu Menu

RCEM Scotland: Current A&E performance trend is extremely worrying

7 December 2021

In October 2021 there were 108,279 attendances to major Emergency Departments across Scotland, the number of attendances dropped by 5,719 patients (5%) compared to the previous month, September 2021.

Despite this, data show that four-hour performance in major departments has once again reached a new record low, with 70.9% of patients being seen, transferred or discharged within four-hours – 2.5 percentage points lower than the previous month, September 2021.

In October 2021 2,533 patients spent 12-hours or more in a major Emergency Department, this is an increase of 30% compared to the previous month, September 2021, and the highest number on record.

Data also show that 8,181 patients spent eight hours or more in a major Emergency Department. This is an increase of 21% compared to the previous month, September 2021 and is also the highest number on record.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “Yet again we are reporting on the worst performance figures on record. 1 in 13 patients are now delayed by eight hours are more. This trend is extremely worrying and, most of all, dangerous for patients. Each month, the number of patients that have come to avoidable harm grows. So far in 2021, 387 excess deaths have occurred as a direct result of crowding.

“This number will continue to increase unless patient flow is prioritised this winter; this means freeing up beds where possible by ensuring that patients have timely access to social care, utilising the Discharge to Assess model, and avoiding admission when appropriate by maximising the use of Same Day Emergency Care.

“Every winter we know that the increase in demand for unscheduled care, and therefore beds, disrupts elective surgery – this is not a new phenomenon by any means.

“However, with a record number of patients awaiting surgery, ensuring that unscheduled care does not derail progress on the backlog is more crucial than ever. This requires a whole system approach and cannot be tackled in isolation. If poor patient flow in emergency departments is addressed successfully, this will go some way in mitigating the risk of further disrupting elective care.

“We are very keen to work with the Scottish government on what can be done in the short term to alleviate the immense pressures EDs are currently facing. Accompanying this, we continue to call on the Scottish government to set out a long-term workforce plan. The required expansion in capacity cannot be safely achieved without both recruiting new and retaining existing staff. At present we need an additional 130 EM consultants along with sufficient numbers of both junior and supporting staff and nurses.”

Back to top Back to top