New weekly figures from Public Health Scotland stated that only 60.4 percent of emergency patients were seen within four hours during the week ending 11 September 2022.
Scotland’s Health Secretary Humza Yousaf said the level of performance in particular sites, such as Edinburgh’s Royal Infirmary, are “just not acceptable”, even in the face of the pressures health systems are facing.
“Notwithstanding all the pressures we’re facing, [...] I want to give assurances that the government is focused on immediate improvement particularly in our most challenging sites and the reasons why we have this level of challenge of course are continued impacts and effects of the pandemic,” Yousaf said.
NHS Lothian was the third worst fairing board in Scotland, according to weekly statistics from Public Health Scotland. Only NHS Forth Valley with 38 percent of A&E patients seen in four hours and NHS Lanarkshire with 52 percent seen within four hours scored worse.
For the week ending 11 September, NHS Lothian saw 4,662 emergency department attendees. 1,848 patients waited more than four hours; 783 waited more than eight hours; and 381 waited more than 12 hours.
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In August, NHS Lothian appealed to the public to not attend emergency departments unless it is a critical emergency as “services are currently under extreme pressure.”
NHS Lothian’s Acute Medical Director, Dr Caroline Whitworth, said: "The pressure has been fairly intense for the last few weeks and months in fact, but the reason I’m speaking is because we seemed to have reached a new peak of intensity and in our emergency department in the Royal Infirmary we’ve had perhaps three times as many patients as the actual facility is designed for so that means that two thirds of patients in there are not in cubicles, they’re in trolleys and in corridors and in spaces, and that’s not a good experience for patients. It makes it really difficult for staff to look after patients safely.”
Dr Whitworth clarified that NHS Lothian is seeing a similar number of patients compared to pre-Covid, but the patients are often sicker.
“The biggest problem is we can’t get patients who need to be admitted out of the emergency department. So effectively patients are backing up in there because we don’t have inpatient beds. That’s actually probably the major source of the crowding in the emergency department,” she said.
Public Health Scotland confirmed that current emergency department attendances are similar to pre-Covid levels, but wait times have continued to increase and perform poorly.
PHS said:
“From the summer of 2021 the proportion of ED attendances being seen within four hours has dropped below 80% and has remained at this rate for a prolonged period of time.”
Comparable data from previous PHS weekly data shows a sharp increase in NHS Lothian wait times since 2019:
In September 2019, 88.5% of patients were seen within four hours
In September 2020, 88.1% of patients were seen within four hours
In September 2021, 66.3% of patients were seen within four hours
Most recently, 60.4% of patients were seen within four hours
As Health Secretary, Yousaf said he “ultimately takes responsibility upon himself.”
However, he said the issue is not unique to Scotland or to NHS Lothian:
“This is not just a Scottish problem. These are problems that health services right across the UK are facing and Scotland - although this performance is not acceptable and I’ll repeat that - we continue to outperform the rest of the UK in terms of A&E performance for like for like sites and that is because the pandemic has had that impact right across the entire country and dare I say health systems around the world.”
Public Health Scotland provides weekly updates of key statistics on attendances at Emergency Departments across Scotland. The data is based on unplanned attendances only.
Dr Tracey Gillies, Medical Director, NHS Lothian said: “Our Emergency Departments continue to be extremely busy due to sustained pressure across all aspects of the healthcare system. Increased demand for services, high volumes of patients presenting with complex and serious cases, high occupancy rates and staff absence all impact on waiting times.
“We urge anyone who thinks they need A&E, but it is not a time critical emergency, or has a minor injury, to call NHS 24 on 111 first. They can also call their GP for urgent or routine care during opening hours or visit a local pharmacist about minor illnesses and keep A&E free for those who need it most.”
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