NHS Scotland crisis: Estimated 64 patients die each month due to 'dangerously long waiting times'

Top medics have warned NHS Scotland still remains “in the depths of crisis”, amid analysis showing an estimated 64 patients die each month due to “dangerously long waiting times”.

Dr John-Paul Loughrey, vice-president of the Royal College of Emergency Medicine (RCEM) Scotland, said the college was “extremely concerned about our patients and their safety, and for the welfare of staff who are struggling”, as the latest data revealed “a system that is not functioning as it should”.

Dr Alan Robertson, chair of the BMA’s Scottish Consultants Committee, separately said the Scottish Government’s claims that NHS staffing levels are at a record high was “not just demoralising, but incredibly insulting” to staff who were “depleted, exhausted and facing burnout”.

According to the latest Public Health Scotland (PHS) data, just 65.3 per cent of the 97,659 patient attendances at Scottish emergency departments in January were seen within the Scottish Government’s target of four hours. This is the third lowest four-hour performance since records began.

According to the latest Public Health Scotland data, just 65.3 per cent of the 97,659 patient attendances at Scottish emergency departments in January were seen within the Scottish Government’s target of four hours.

Added to this, 13.4 per cent (13,055) of patients waited more than eight hours before being seen, admitted, discharged or transferred, while 6.5 per cent (6,318) of patients waited more than 12 hours.

Dr Loughrey said: “The monthly data makes clear we are still in the depths of crisis. While it is true that the data for January 2023 show improvements when compared with December 2022, December was the worst month on record.

“We are relieved that we have mitigated against a repetition of December, but we remain extremely concerned about our patients and their safety, and for the welfare of staff who are struggling.

“January saw continued high numbers of extremely long waits; the third highest number of 12-hour waits on record, while the weekly data from February also shows that we cannot let up in our requirement for substantial improvement.”

Dr Loughrey has called on the winner of the SNP leadership election to make “tackling the crisis in emergency care as well as the crisis in the wider health and social care system a priority”.

“In 2022, a total of 55,095 patients waited 12 hours or more in an emergency department in Scotland,” he said. “Analysis by the RCEM shows that consequently, in 2022, there were an estimated 765 patient deaths associated with these dangerously long waiting times – equal to an estimated average of 64 each month.

“This is entirely unacceptable and a marker of a system that is not functioning as it should.”

Delayed discharges, which continue to cause immense pressure in Scotland’s hospitals, appear just as bad as during December.

At the January 2023 census point for the PHS’s latest figures, there were 1,833 people delayed. This is similar to the December 2022 census point when 1,838 people were delayed.

In January 2023, there were 56,826 days spent in hospital by people whose discharge was delayed. This is an increase of 8 per cent compared with the number of delayed days in January 2022 (52,678).

Dr Loughrey said: “To tackle this, in Scotland we urgently need a restoration of the acute bed base. That means opening an additional 1,000 staffed acute beds where safely possible.

“There are also significant shortfalls of staff in Scotland. The emergency medicine workforce needs at least 100 more consultants, as well as senior decision makers, ACPs/ANPs/physician associates, junior doctors and vital nurses.

“We welcomed the expansion of emergency medicine medical training places in Scotland by ten, but this expansion is considerably short of what is required and there has yet to be any commitment to maintain this each year.”

Official workforce statistics show there has been a 5 per cent increase in vacant NHS posts from the last quarter. Dr Alan Robertson, chair of the BMA’s Scottish Consultants Committee, said the organisation’s own research suggested a “substantial” number of vacancies were not included in official figures.

“The real figure is therefore likely to be much higher than this,” said Dr Robertson. “In fact, we believe it to be more than double.

“Once again, I am sure we will hear that NHS staffing levels are at a record high. But saying this to staff on the ground who are depleted, exhausted and facing burnout is not just demoralising, but incredibly insulting.

“Staff are working flat out, doing absolutely everything they can to cope with rising demand, which is spiralling rapidly out of control. But I cannot be any clearer when I say just because there are more people on the payroll than before, does not mean there is enough.

“The consultant workforce has been stretched to its limit over the past few years and staff shortages are affecting the ability of doctors to deliver the high-quality patient care they strive for.

“I’ll say it again for anyone who still doesn’t understand: we don’t have enough doctors in Scotland to effectively staff our NHS and deliver all that is being asked of us.”

Health Secretary Humza Yousaf said: “We are doing everything we can to support the health service through the remainder of the most challenging winter in its history and, while A&E performance has improved since the start of the year, pressure on services remain high. We will continue to see fluctuations in figures from week to week and month to month, but we remain determined to improve A&E performance.

“There continues to be pressure across our health and social care system that is impacting on performance. We are increasing NSH 24 staffing to help cope with increased demand and are providing up to £8m to boards to help alleviate pressure from delayed discharge.

“As part of our nationwide approach, patients who no longer need to be in hospital are being urgently reassessed and those clinically safe to be discharged will be safely moved home or to an interim placement in a care home – freeing up beds for those most in need.

“I would like to thank all NHS staff for their continued exceptional efforts in the face of sustained pressure.”