Scotland records worst ever A&E 12-hour waits in December

The record delays emerged as the latest set of weekly statistics for Scotland’s emergency departments (EDs) show that performance against the four-hour waiting time target is continuing to improve, after hitting an all-time low of just 55 per cent in the run up to Christmas.

By the week ending January 29, 70.3% of people attending an ED in Scotland were seen, treated, and subsequently admitted to a hospital bed, transferred or discharged within four hours.

Performance against the four-hour A&E target has improved over recent weeks but remains far short of the 95 per cent target which was last achieved in 2020 - when attendances fell sharply (Image: PHS)

This is the highest level since the end of April last year, although it still remains far short of the 95% target and 851 patients spent over 12 hours in EDs.

The number of people seeking help at emergency departments by the final week in January - at around 22,400 - is also much lower than it was in November and December, when around 25-26,000 people a week were attending.

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A separate monthly report for December, covering all A&E departments - not just the larger EDs - shows that a record 8,658 people spent over 12 hours waiting, compared to the previous high in October of 7,015.

Most of these delays were caused by shortages of available beds on wards, resulting in lengthy trolley waits in A&E for patients who were sick and requiring admission.

Previous research has found a clear link between patients spending too long in A&E prior to admission and an increased risk of death during the subsequent 30 days.

Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine (RCEM) Scotland, said december had been "the most challenging month the NHS in Scotland has ever faced".

He said: "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."

Dr Loughrey said the RCEM had held "constructive meetings" with the Cabinet Secretary, including in relation to social care and the need to tackle delayed discharge.  

He added: "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.”

The number of patients exceeding 4, 8 and 12-hours in A&E has falling recently but remains well above pre-pandemic levels (Image: PHS)

Conservative health spokesman Dr Sandesh Gulhane said the December A&E figures were “catastrophic”.

Dr Gulhane, a Glasgow-based GP, said: “They indicate more than 250 patients needlessly died due to excess waits in Scotland’s emergency wards in December, using Royal College of Emergency Medicine (RCEM) methodology.”

Health Secretary Humza Yousaf said the figures “highlight the scale of the challenge our boards faced at the height of winter”.

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The Scottish Government announced funding of £8 million at the beginning of January to temporarily buy up an extra 300 interim care home beds in an attempt to move patients out of hospital sooner once they were ready to be discharged.

During December, according to a Public Health Scotland (PHS) update, an average of 1,878 hospital beds were occupied each day by patients well enough to leave.

Typically these patients had spent an extra 28 days longer in hospital than necessary prior to discharge, mainly due to a lack of social care.

Mr Yousaf said: “We will continue to see fluctuations in figures over winter; however, weekly performance over four hours is the best we have seen in eight months.”

It comes as a separate PHS report revealed that the number of elective operations which took place during December - 15,444 - was the lowest since July last year, and down 21% on November activity.

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Prior to the pandemic, in 2019, NHS Scotland was carrying out around 25,670 elective procedures a month on average.

The Scottish Government’s five-year NHS recovery plan wants to see elective activity exceed pre-Covid levels by 20% by 2025/26, partly through the creation of national treatment centres (NTCs).

Today, NHS Highland said it has filled 80% of the 208 new posts created for its NTC - an elective hub focusing on joint and eye procedures, due to open in April.

The purpose-built treatment centre in Inverness - which was originally scheduled to be operational from late 2021 - will take over delivery of eye care services from Raigmore hospital.

NHS Highland said it is continuing to seek applicants for porter, catering and security roles.