ACCIDENT and emergency staff in Scotland are "fire-fighting" as hospitals run short of beds, according to a top consultant.

 

There are reports of A&Es being overwhelmed around the country, with as many as 58 patients lying on trolleys waiting for space on the wards in one large West of Scotland department.

Major health boards such as Greater Glasgow and Clyde, Lothian and Grampian have cancelled planned operations to make more space for emergency cases.

Some people have had to wait more than 12 hours in casualty to be admitted and others have been directed away from their nearest hospital because it was too busy.

Martin McKechnie, chair of the College of Emergency Medicine Scotland and an A&E consultant, said: "I was on last night and all weekend and we were fire-fighting because of over-crowded departments. Everyone was working their socks off, including the ward doctors who were coming down to help. But there was just nowhere for the patients to go.

"We are struggling our best to deliver quality care, as far as I am aware no harm has come because of the heroic deeds of staff nurses in particular. The public need to understand this is not the fault of NHS staff, it is not the fault of ward staff."

Some Scottish hospitals have seen an increase in patient numbers of 10 or 11per cent this festive period, according to Dr McKechnie, while for others it is around 1 per cent.

"There is year on year increasing attendance and what is the real problem is the exit block," he said. "The issue is the flow of the poorly elderly out of A&E departments onto wards, because there is not enough space on the wards as patients are not being discharged."

Mr McKechnie said on Monday night he was working in a medium-sized Scottish hospital and there were 20 patients waiting to be seen in A&E, 17 patients on trolleys queuing for ward beds and 10 cubicles to accommodate everyone. Not one of those queuing for treatment had come to A&E inappropriately, he added.

On Sunday night, he said, a major A&E in the West of Scotland had 58 patients waiting on trolleys for medical beds.

In a statement NHS Greater Glasgow and Clyde said: "Over the past few days we have experienced intense pressures on our emergency departments.

"Despite the best efforts of staff right across our acute hospitals system and from colleagues in the community many patients have had to wait far longer than we would want them to before either discharging them after treatment or admitting them to inpatient wards."

NHS GGC said they had postponed 44 procedures and had asked GPs to send patients to alternative hospitals within the health board area, to reduce the pressure on the busiest.

NHS Grampian announced Aberdeen Royal Infirmary was very busy early yesterday(tue) and said some planned procedures had been postponed. NHS Lothian also described hospitals as "very busy" and said they had deferred some operations. NHS Ayrshire and Arran said it had been extremely busy at the weekend with five people waiting more than 12 hours to be admitted to wards at Ayr Hospital and NHS Lanarkshire also said they were experiencing a high level of emergency admissions.

The growing elderly population, with more frail patients requiring hospital beds, is thought to be one of the main reasons for the pressures. Difficulty discharging elderly patients who need care set up in the community also means there is less space on wards.

In England the College of Emergency Medicine has highlighted record patient numbers this winter.

The Herald's campaign NHS: Time for Action is calling for a review of capacity to ensure the right resources are in the right place at the right time to cope with the growing elderly population.

Dr McKechnie expressed concern that the closure of GP surgeries for four days over Christmas and New Year and the reduction in social care services over the festive period has had an impact on the number of frail elderly patients arriving or remaining in hospital.

Dr Alan McDevitt, chair of the British Medical Association's Scottish GP Committee, said: "Action is required to ensure that there are enough staff and resources across the NHS to meet rising demand, particularly during winter months, including urgently addressing the high number of vacancies across the medical profession."

Shona Robison, Scottish Health Secretary, said: "We know the winter months can be challenging for our health boards, in particular A&E services. One key to addressing the challenge is tackling delayed discharge, which frees up capacity across the NHS.

"That is exactly why we've made over £28m available to support boards experiencing an increase in demand over the winter and ensured local plans are in place across Scotland, supported by this extra investment.

"This investment is enabling the creation of an extra 200 intermediate care beds across Scotland, expanding community capacity substantially. That means fewer people unnecessarily delayed in hospital, freeing up beds and easing the pressure on A&E."