Scotland Emergency Department performance drops significantly to reach new record low

7 February 2023

Responding to the latest Emergency Department performance figures for Scotland for December 2022 Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said:

“December was the most challenging month the NHS in Scotland has ever faced. Staff faced increasingly difficult conditions, with huge numbers of patients facing long and dangerous waits throughout the system. We know these long waits are associated with patient harm and even patient deaths, it is increasingly distressing for staff and patients. Exit block – where patients are unable to be admitted to a bed because other patients are unable to be discharged – was the worst it has ever been, meaning the entire Emergency Care system has been gridlocked – like a traffic jam. Patients spending far longer in Emergency Departments than they should be, often in inappropriate or inadequate areas, on trolleys in corridors, in small, cramped spaces with a lack of privacy and lack of dignity.

“We welcome the gravity with which the First Minister and the Cabinet Secretary are taking the current crisis in Emergency Care. We have had constructive meetings with the Cabinet Secretary and do feel that there is recognition of the root of the issues and a political will to tackle it. We especially welcome the focus on social care and the whole system capacity. It is critical that we sort out discharges, ensuring patients who are medically fit to leave are able to return home or to the community in a timely way. We must continue to focus on this to free up beds so we can increase flow throughout hospitals and admit patients from Emergency Departments into a bed on wards.

“While these are the right initiatives, the green shoots of hope are not translating to big enough or fast enough improvements. Without significantly increasing capacity across Scotland, we will continue to borrow from tomorrow to cover today. This means cancelling elective surgery so we can admit Emergency Care patients to a bed, but at the cost of further delaying what may be serious surgery for patients who have already waited for a long time. We should not be in a position where decisions like these need to be made. It is wrong for specialties to compete for beds for their patients. What is better is to increase the number of staffed beds throughout the system, where safely possible, so we do not need to compromise on which patients are able to be treated.”

Notes to editor

The latest performance figures for December 2022 for Emergency Departments across Scotland show:

• There were 113,326 attendances at major Emergency Departments
• 58.4% of patients were seen within four-hours at major (Type 1) Emergency Departments
  • This is the lowest four-hour performance since records began and is 20.3 percentage points lower than December 2021.
  • 47,177 patients waited over four-hours in major Emergency Departments
• Average four-hour performance for 2022 was 67.1%, the lowest annual four-hour performance on record
• In December 2022, 19,131 patients waited eight-hours or more in an Emergency Department
  • This is equal to more than one in six patients waiting eight-hours or more in a major Emergency Department
  • This is the highest number of eight-hour waits since records began
• In 2022, a total of 141,197 patients waited more than eight-hours before being seen, admitted, discharged or transferred. This is more than the previous eight years combined.
• 8,658 patients waited more than 12-hours before being seen, admitted, discharged, or transferred
  • This is the highest number of 12-hour waits since records began
  • This is almost five times as many 12-hour waits as December 2021
• In 2022, a total of 55,095 patients waited more than 12-hours before being seen, admitted, discharged or transferred.