A SENIOR doctor has warned NHS Scotland that there cannot be a return to long A&E queues after the Covid-19 crisis as the “biggest threat to the mental health of emergency department staff is the fear things will go back to the way they were”.

In February, the month before emergency lockdown measures were put in place, the Scottish Government had failed for more than two years to meet its own flagship target of making sure 95 per cent of A&E patients were seen, transferred or discharged within four hours.

The latest weekly A&E waiting time figures show that 95 per cent of people were seen and treated within the four-hour target, as demand of services has reduced.

But in a letter sent to the chief execute of NHS Scotland, John Connaghan, seen by the Herald on Sunday, Dr David Chung, vice-president of the Royal College of Emergency Medicine Scotland (RCEMS), stressed that the crisis situation has “adopted new ways of working that have eliminated, for now, both crowding and many attendances that could be managed elsewhere”.

In a scathing assessment of the situation of A&Es before the pandemic, Dr Chung said that “emergency departments were crowded to unsafe levels” as “many patients attended the emergency departments because it was the only place they felt they could have their needs addressed”.

He added: “Our emergency departments had become the most convenient option for patients and other care providers.”

Dr Chung said that emphasis put on the mental wellbeing of frontline staff during the pandemic “has been viewed with some bemusement by emergency department staff” who for some time “felt that they were just to ‘get on with it’, or indeed were told, because they could cope with the ‘pressure’, they would be the area where the risk was placed” while the situation has “broken more than a few” staff.

He added: “The biggest threat to the mental health of emergency department staff is the fear things will go back to the way they were.”

Dr Chung has set out seven steps “to protect patients in a safe environment”, which will need “careful planning to prevent queues forming at any point of the patients’ journey”.

He added that the emergency footing during the pandemic has “forced many of us to ask why these measures could not be adopted before, especially as they have now been demonstrated to work so effectively”.

One suggestion to relieve pressure on emergency department staff, made by Dr Chung, is to set up mental health assessment hubs as “this group of patients are particularly disadvantaged by long waits for psychiatric assessment in emergency departments”.

Monica Lennon, Scottish Labour’s health spokesperson, said the issues raised by Dr Chung “should serve as a wake-up call” to the Scottish Government.

She said: “It’s unacceptable for anyone working in our NHS to feel ‘broken’ by excessive workloads and to be told to get on with it when they are clearly burnt out.

“For a long time, staff working in emergency departments have no longer been simply trying to survive winter pressures, they have been experiencing overcrowding in A&E all year round.

“Scottish Labour agrees that we can’t return to a ‘normal’ that was letting down patients and healthcare staff.

“Supporting the mental health and wellbeing of staff must be a priority and we agree with RCEMS that mental health assessment hubs for patients are a good idea.”

Conservative health spokesperson Miles Briggs, added: “This is an important contribution from the RCEMS and SNP ministers must listen to what emergency department staff are saying.

"It is a damning indictment of the SNP's record in running our health service that the RCEMS states that the biggest threat to emergency department staff is the fear that things will go back to as they were before the pandemic.

"SNP ministers need to do far more to support the mental health and wellbeing of all NHS staff, especially those in accident and emergency departments, and the Scottish Conservatives will continue to press ministers on this as strongly as possible."

A Scottish Government spokesperson said: “We applaud the efforts of those working in our emergency departments for their efforts during the Covid-19 pandemic. We will continue to do everything we can to support them - working with health boards and partnerships to ensure robust plans are in place to strengthen capacity and minimise the impact of Covid-19 across the health system as we move into future phases of our response.

“We agree that we need to build upon the new ways of working which have been adopted as a result of the pandemic. That is why we have brought together a group of operational and clinical leaders, including Dr Chung, to review and build upon some of this important work with the aim of minimising footfall at A&E departments and avoiding crowding in emergency departments by introducing a more scheduled approach to emergency care and ensuring people receive care closer to home. “We will continue to work with the RCEMS and other professional bodies as well as health boards, local authorities, unions and other key stakeholders so that all learning gained throughout the response to the Covid-19 pandemic is applied appropriately to ensure they operate as effectively as possible.”