8 September 2021
Data for June 2021 show that 83.5% of patients were seen within the four-hour target in major Emergency Departments across Scotland, a decrease of 2.6 percentage points compared May 2021, the previous month. This represents the worst performance since the start of the pandemic and the second worst performance since records began.
There were 118,269 attendances to major departments across Scotland in June 2021. This represents an increase of 5% or 5,686 patients compared to the previous month, May 2021. The number of patients who experienced long waits has also increased; in June 2021, 2,396 patients waited eight hours or more, and 532 patients waited twelve hours or more. These figures are almost double what we’d expect for this time of year and are closer to numbers experienced in the winter months.
Dr John Thomson, Vice President (Scotland) of RCEM said: “As a specialty, we have become accustomed to anticipating crowding and long waits in our departments during the colder months, however, the data published today demonstrate that pressures are now a year-round reality. The figures show the extraordinary number of long waits we are experiencing in our departments. While covid infections and hospitalisations are below what they were in the peak of the pandemic, patients are attending Emergency Departments once again in high volumes. We can no longer speak of trying winters when our summers are now just as tough.
“The pressure of the pandemic is still a reality, and departments are facing high numbers of long waits in the face of a reduced bed stock due to infection prevention and control measures. As a result, admitting patients into a hospital bed in a timely manner has become frequently unachievable. This in unsafe and can often be a stressful experience for not only patients but staff too.
“At the heart of this is a system that is under resourced and understaffed, the consequences of which have only been further exacerbated by the pandemic. Since the first wave, there has been a decrease of over 400 available staffed beds in the system in Scotland. Even once capacity is restored the College has estimated that Scotland would still need an additional 640 staffed beds to achieve safe bed occupancy rates.
“An expansion in bed numbers would require an increase in workforce in order to staff the beds. The Royal College of Emergency Medicine’s National Scottish Board has recently published its first ever Workforce Census Report which delves into this matter and offers an in-depth examination into the state of our Emergency Medicine workforce. It reveals that there is currently a shortfall of over 100 consultants in Scotland. The report also presents a comprehensive breakdown of staff mix, working patterns, and workforce gaps, as well as a look towards the future implications of current trends. Any plans to redesign the Urgent and Emergency Care system must consider these findings the state of the workforce.
“Tackling crowding and poor patient flow by addressing the current lack of resource and capacity across the entire Health and Social Care system must be a priority. Emergency Departments cannot address these problems alone, it requires joint working with Scottish Government, Health Boards, Local Authorities, Primary Care, Integrated Joint Boards and the Third Sector.”