The NHS is facing record accident-and-emergency (A&E) waiting times, strike actions from nurses, paramedics and doctors, as well as spiralling delayed discharge numbers due to staff shortages in care settings. This has come all before the expected surge in Covid and influenza hits Scotland this winter.
The report, entitled ‘A Fractured Service’, comes after health secretary Humza Yousaf warned this winter would be “the most challenging in the history of the NHS”.
Waiting times for A&E are at a record-high, with just under 65 per cent of patients being seen within four hours – despite Scottish Government targets of 95 per cent – and more than 50 per cent of Scots are having to wait in excess of 12 weeks for an outpatient appointment. Eight per cent have to wait more than a year.
“Longer waiting times and poor access to emergency care are causing Scots to die,” the report’s authors argue. “If the failings of the NHS are not adequately addressed, increased mortality rates will likely continue.”
Delayed discharges, where patients who could be discharged back to care settings cannot be released because of a lack of capacity in those care settings, are contributing to the increased wait times.
The report reads: “Whilst understaffed A&E units leave people waiting at the start of their hospital journey, the lack of provision in community services, namely social care, is causing a bottleneck at the end of a patient’s journey in hospital.”
Among the proposals, the report calls on UK health leaders to come together to urge the public to reduce demand on hospitals this winter – for example, by using minor injury units rather than A&E – and to plan for the coming winter on a “four nations” basis.
The report’s authors also propose the reintroduction of mask wearing on public transport, claiming it “remains one of the simplest ways to reduce the spread of Covid and flu”, and calls for carers to be given a statutory right to leave of absence to help them look after vulnerable people.
Government ministers may also need to draft in military personnel to support the ambulance service, argues the report. It also calls for the creation of “rapid support teams” made up of police, care workers and firefighters who can support elderly people in need and prevent them from going into hospital.
“Without radical action, the founding principle of the NHS – of high-quality treatment free at the point of use – is going to end, and end quickly,” argue the report’s authors.
“The NHS will be replaced with a two-tier healthcare system, in which a booming private sector caters for better off people to receive treatment more quickly.
“This will widen Scotland’s already gaping health inequalities. For those poorer families who are unable to pay, they will have to accept a second-class service.”
A Scottish Government spokesperson said: “Pandemic backlogs, Brexit-driven staff shortages, and inflation costs have all contributed to make this the most challenging winter the NHS has ever faced.
“Our £600 million winter plan will support services through this period and will see us recruit 1,000 new NHS staff, including up to 750 frontline nurses from overseas.
“Our £50m Urgent and Unscheduled Care Collaborative looks to relieve pressure on services and drive down A&E waits by offering alternatives to hospital, such as Hospital at Home; more appropriate urgent care settings and urgent scheduled appointments.
“A&E pressures are being driven by delays in discharge elsewhere in hospitals, which is why a key focus of our winter plan is on social care and actions to help alleviate delays. We have made clear to GPs our expectation that pre-bookable appointments are made available in every practice this winter, alongside same day, face-to-face and remote appointments.”
Scottish Conservative shadow health secretary Dr Sandesh Gulhane said Mr Yousaf was “missing in action”, and added: “He has completely failed to grasp the seriousness of the situation facing suffering patients and my colleagues on the frontline as winter looms large.
“Our health service is on its knees and it is time for Humza Yousaf to finally deliver the resources overwhelmed staff desperately need.”
Scottish Labour health spokesperson Jackie Baillie said: “We urgently need a response that matches the scale of the terrifying crisis tearing through our NHS. That sense of urgency is clearly missing from the health secretary.
“During the pandemic we did everything we could to protect the NHS and save lives – now the SNP Government needs to do the same.”