NHS Scotland crisis: Patients 'are not safe in Scotland's A&Es' as health secretary defends winter planning

Patient safety is at risk “every single day”, with patients in desperate need of intensive care waiting hours in accident-and-emergency departments across Scotland, the deputy chair of British Medical Association Scotland has said.

The harrowing description of the scenes in hospitals came as health secretary Humza Yousaf admitted patients were receiving care he would not want to receive himself as the NHS continues to battle intense winter pressures.

Dr Lailah Peel, deputy chair of the Scottish arm of the British Medical Association (BMA), told the BBC’s Sunday Show the crisis was “years in the making”. She blamed a creaking social care system and increased delayed discharges.

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The comments come after details of a January 2021 briefing from the Royal College of Emergency Medicine (RCEM) and the College of Paramedics to the health secretary warned of an unacceptable situation in Scotland’s hospitals.

Humza Yousaf admitted patients are not receiving the care he would personally want to receive in the NHS in Scotland.Humza Yousaf admitted patients are not receiving the care he would personally want to receive in the NHS in Scotland.
Humza Yousaf admitted patients are not receiving the care he would personally want to receive in the NHS in Scotland.

Reported in the Sunday Times, the briefing also specified the actions needed to avoid a similar situation during the current winter crisis, warning an increase of at least 1,000 new beds was needed as well as more doctors and nurses.

Dr Peel said it was the case patients were “absolutely” dying in hospitals in Scotland due to the ongoing crisis in the health service. "There’s no shadow of a doubt that that is happening,” she told the BBC.

Dr Peel added: “Every healthcare worker in Scotland right now will be able to tell you a story about a patient that has suffered because of the crisis at the moment, whether that be stuck in hospitals because we’ve got to remember that although the issues are happening in A&E very acutely, that’s not where the biggest problem lies.

“The biggest problem is the fact that patients aren’t getting discharged out of hospital in a timely fashion, for a big part because of the social care issues, and patients are ending up in hospital for longer, acquiring infections in hospital, all sorts of complications at every step of the hospital journey, not to mention the huge rise in the waiting lists that we’re seeing as well.”

The clinician, who works in accident and emergency and prior to the interview with the BBC had been on shift in a small hospital, described the situation in Scotland’s A&Es as “just absolutely brutal”. She said “it is painful to think about the future because we can’t see this improving any time soon.”

Dr Peel said colleagues were leaving the service or not turning up “because they are just broken”. She described harrowing scenes of patients in dire need of intensive care waiting in A&E rooms for hours due to the issues facing the NHS.

“Patient safety is at risk every single day in our A&Es across Scotland at the moment,” she said. “We suffer a lot of moral injury because you literally cannot give the care that you want to give to patients.

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"It is absolutely heart-breaking because as a doctor you know what you want to achieve, you know what you want to do for the patient in their hour of need and you just can’t because you’ve got so many more patients that you’re trying to deal with. You can’t get them up to the areas where they need to be.

"Patients who need to be in intensive care of high-dependency units are sitting in our A&E departments for hours waiting. It is just not safe by any shape of the imagination.”

The BMA Scotland deputy chair said she appreciated the challenges faced by Government, but said ministers must grasp the problem of delayed discharges which, she said, was “causing the problem”, rather than increased levels of flu, Covid and unnecessary A&E attendances.

In an interview also with the BBC, Mr Yousaf admitted patient care was often not at a level he would be personally happy to receive.

He said: “They are working under the most unprecedented pressure of their entire careers and I think, frankly, of the entire NHS’s existence. People are not getting the level of care I would want them, or indeed I would want for myself or a family member in many instances.

"That is of course not a situation we want to see within the Government. It is why we are doing everything we possibly can and leaving no stone unturned.”

However, Mr Yousaf defended his Government’s resilience planning ahead of this winter and maintained he did not believe drafting in the army was the correct decision – a move that has been called for by Scottish Labour.

"Yes, we planned for this winter as soon as the last winter was over,” he said. “We got right into meetings with local health boards, with our social care colleagues and everybody else.

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"There are some things we just could not have been able to have foreseen; the high levels of inflation caused by the reckless mini-budget, for example, the impact that that has had on social care.

"Although we will do our best to prepare for high levels of flu, Strep A and other viral infections, of course there is a limit to what the Government is going to be able to do to mitigate some of those challenges.

"This is an unprecedented crisis, I don’t use that word lightly. But it is something that all governments are facing, not just in these islands, but many in Europe and right across the world.”

Mr Yousaf has faced demands to draft in the army to help the NHS deal with the winter pressures, similar to the forces’ use during the Covid pandemic, but the health secretary warned this was not “the panacea to us now”.

"The vast majority of army nurses and doctors are working in wards right now,” he said. “The reservists are working in wards up and down the country already. There’s not this magic pool of nurses and doctors that we can just count on to bring in and to assist.

"One of the biggest issues, if not the biggest issue we are still facing, is that high level of delayed discharge. It’s not that we don’t have some interim beds available, what we’re doing and working on is trying to get every single one of those filled at local level where we can, so drafting in the army I don’t think is going to help with that. We’ll keep it under review, but it is not the panacea.”

Scottish Conservative health spokesman Dr Sandesh Gulhane, however, said Mr Yousaf should be sacked immediately, stressing his “dire forward planning has exposed how out his depth he is as health secretary”.

Dr Gulhane said: “Humza Yousaf is still in denial about how he completely failed to support Scotland’s NHS ahead of the worst winter in living memory that overwhelmed staff and suffering patients are continuing to endure.

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“He was repeatedly warned a year ago that a winter crisis was looming, but he totally failed to act. His flimsy NHS recovery plan, which is now well over a year old, is simply not fit for purpose and his winter planning came too little, too late.”

Amid “utterly terrifying” comments from NHS staff, Dr Gulhane, who has been working as a GP during the Holyrood recess, said he had “seen first-hand over the festive period how patients are suffering”.

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