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RCEM Scotland: performance deteriorates further as four-hour target falls to record low

7 September 2021

The latest Emergency Department performance figures for Scotland published by the Scottish Government today for July 2021 show that performance has deteriorated once again with four-hour performance reaching its lowest since records began, and the number of patients delayed in major Emergency Departments continues to rise steeply.

In July 2021 there were 114,392 attendances to major Emergency Departments across Scotland. This is a three per cent decrease compared to June 2021, an 18% increase when compared to July 2020.

Four-hour performance reached its lowest since records began, having deteriorated for the third consecutive month. 79.5% of attendances to major Emergency Departments in Scotland were seen within four hours. 23,493 patients were delayed by four-hours or more in a major Emergency Department, this is the highest figure since records began. This is equal to more than one in five patients delayed by four hours or more in a major Emergency Department. The number of patients delayed by four-hours or more reached its highest ever figure having increased for the fifth consecutive month.

In July 2021, 755 patients spent 12-hours or more in a major Emergency Department, this is the highest figure since February 2020. This is nearly a 50% increase on the previous month, June 2021. It is a 3,000% increase compared to July 2020 and it is a 200% increase compared to July 2019. The number of patients delayed by 12-hours or more increased for its third consecutive month.

Data also show that 3,477 patients spent eight hours or more in a major Emergency Department. This is the second highest figure since records began. It is an increase of 50% compared to the previous month, June 2021. It is an increase of over 1,000% compared to July 2020, and it is an increase of 200% compared to July 2019. The number of patients delayed by eight-hours or more increased for its third consecutive month.

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

“These figures show an ongoing deterioration in performance. Current pressures are equal to or worse than normal winter pressures – but these figures are for July. Among staff there is serious concern and low morale, winter is fast approaching and quite simply there is low confidence that our hospitals and staff are going to be able to cope.

“The number of patients delayed in Emergency Departments has risen steeply for three consecutive months, the pressures on this trajectory could lead the health service into a crisis.

“It is unacceptable that patients are delayed for so long, in one Emergency Department a patient was delayed by 48 hours – these are dangerously long waits that are likely to adversely affect patient outcomes. We have a duty to keep patients safe and treat them quickly and effectively. The current challenges are hindering our ability to achieve that, and for both patients and staff alike it is incredibly difficult.

“The entire health service is under severe strain. Our primary care colleagues are facing record demand, the elective care waiting lists continue to grow, all departments and specialties are facing these unprecedented challenges. Yet, while demand is high, the numbers of patients are not the challenge – the challenges stem from capacity issues, across-the-board workforce shortages, and the limitations and deterioration of hospitals and equipment – resourcing has not met demand for some time.

“It would be irresponsible to look on these consistently decreasing monthly performance figures and not recognise the potentially looming crisis fast approaching this winter. Now is the time for an appropriate response. We need the Scottish Government to take action, to develop and communicate a joined-up plan on how the health service is going to manage ongoing demand and prepare the workforce, hospitals and Emergency Departments for the upcoming winter.”

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