NHS Scotland: Winter crisis saw highest number of deaths in over thirty years

New figures showed last year’s winter was the deadliest in more than 30 years, as the Scottish Government announced new funding to try to avert another winter crisis in NHS Scotland.

Scotland's winter death toll last year was the highest for more than 30 years. Peter Byrne/PA

The Scottish Government has announced a £50m recruitment plan for the Scottish Ambulance Service in an attempt to ward off another potential winter crisis, as it’s revealed last winter saw the highest number of deaths in over thirty years.

According to statistics published by National Records of Scotland (NRS) 24,427 deaths were registered in Scotland between December 2022 and March 2023 - 11 per cent higher than the previous winter - and the highest number of deaths since the winter of 1989/90.

During last winter’s NHS crisis, the Royal College of Emergency Medicine (RCEM) in Scotland warned there was an excess mortality of 50 deaths in Scotland every week, due to the pressure on emergency departments.

Health Secretary Michael Matheson.

Increasingly long waiting times lead to poorer outcomes for patients, causing needless deaths which would otherwise have been prevented.

Last winter - “the worst winter ever”, according to Nicola Sturgeon - Scotland’s hospitals reached 95 per cent capacity, waiting times for A&E soared and ambulances queued up outside. The severity of the situation led the then-First Minister to host weekly, televised press conferences.

According to the NRS statistics, the causes of death with the largest seasonal increases in winter 2022/23 were: dementia and Alzheimer’s disease (640 additional deaths); coronary (ischaemic) heart disease (490 additional deaths); chronic lower respiratory disease (400 additional deaths); influenza (340 additional deaths); coronavirus (Covid-19) (310 additional deaths); and ‘other circulatory system diseases’ (270 additional deaths).

“Very few deaths are directly due to cold weather (e.g. hypothermia),” the NRS report reads, and “in each full calendar year since 2019 there have been fewer than ten deaths from ‘exposure to extreme natural cold’.”

Ahead of the next winter, an extra £50m of funding is being given to the Scottish Ambulance Service (SAS) to boost staffing ahead of what health secretary Michael Matheson said would be an “extremely challenging” winter for the NHS.

Mr Matheson said the money would help the service recruit a further 317 frontline staff, with 18 new clinicians also to be taken on for a call centre hub where they can help to triage patients.

He also pledged up to £12m would be spent to expand the Hospital at Home service, which allows people to be treated at home instead of in busy hospitals.

Funding for both was announced as the Scottish Government published its winter plan for the NHS for the coming winter.

The health secretary told MSPs at Holyrood: “We’re in no doubt this winter will be extremely challenging for our health and social care system.”

But he added: “This winter plan specifically seeks to address the specific operational pressures experienced across the health and social care system over winter, with actions already under way to improve services.”

Recruitment of new staff for the Scottish Ambulance Service is “presently under way”, Mr Matheson said, adding this would “increase capacity for emergency response”.

On additional funding for the Hospital at Home service, he said the money would enable at least 380 more beds for the service this winter, “significantly increasing capacity”.

With acute care provided to patients at their home, he said the service already achieves “equivalent or better results” than hospital treatment.

The Scottish Conservative shadow health secretary, Dr Sandesh Gulhane, said: “On the same day it was revealed Scotland suffered its highest number of deaths in winter for over 30 years, sadly the SNP’s planning for this year is once again too little too late.

“Even the SNP chair of Holyrood’s health committee – Claire Haughey – has warned Michael Matheson that this is the case, yet this year’s winter plan was delivered to Parliament later than it was last year.

“With each passing week, A&E waiting times have been utterly woeful on the SNP’s watch, with more and more patients suffering intolerable delays.”

Scottish Labour’s health spokesperson, Jackie Baillie, said “statistics show that services are already in disarray” and said A&E has been in “chaos”.

“Last winter delayed discharge was the highest it has ever been and the effect of this was catastrophic,” said Ms Baillie.

“The Scottish Government failed to deliver a comprehensive winter plan, resulting in a last minute scramble to roll out additional support in January in an attempt to fix the mess.

“We cannot let history repeat itself – the health secretary must set clear targets to drive down delayed discharge and protect our NHS this winter.”

Responding to the government’s winter preparedness plan, the British Medical Association (BMA) Scotland’s Dr Iain Kennedy said “on first glance” the Scottish Government appears to be “focusing on the right areas such as recruitment and retention, social care, and hospital at home”.

However, Dr Kennedy added: “It is really just tinkering around the edges and lacks the real substance and understanding – and crucially proper investment – that we need to improve the current situation our NHS is in.

“And it is worth noting there was no mention of investment in the medical workforce at all, despite GP and secondary care doctor vacancies being worryingly high.

“The whole system approach as outlined in the plan is welcome, acknowledging that the problems are not confined to simply one area of our NHS and recognising that there are issues across the entire system – but this cannot be just about winter.

“We are in a year-round crisis with our NHS and workforce planning is abysmal. We simply do not have the staff – be that doctors, nurses or allied health professionals – to cope with the rising levels of demand and we are heading into what I expect will be our worst winter ever.

“It’s a bleak picture but we cannot sugarcoat it or we will simply lurch from winter crisis to winter crisis until the system finally breaks.”

The Royal College of Nursing’s (RCN) Scotland director, Colin Poolman, said today’s statement “will not provide much relief or hope for our hard-pressed nursing staff” working in health and care services as winter approaches.

“Scotland is in the midst of a nursing workforce crisis, with persistently high vacancy levels across the NHS and social care,” Mr Poolman said.

“There are over 5,600 vacant nursing and midwifery posts in the NHS alone.”