A&E at Edinburgh Royal Infirmary on brink as bed and staff shortage leaves patients on trolleys for hours

The emergency department at Edinburgh’s largest hospital is “bursting at the seams”, a union has warned, after reports of patients left on trolleys for hours prompted stark warnings over staff and bed shortages.

Union bosses at Edinburgh’s Royal Infirmary said that the crisis-hit A&E department is seeing admissions of three times its capacity a day.

Hundreds of patients a day are being admitted to the emergency department – which only has a capacity of 36 bays with beds – while it’s operating with minimum staff who are ‘on their knees’, insiders said.

The situation is forcing staff to line up patients on trolleys in corridors because there isn’t enough beds to move them to in A&E or other wards.

The A&E at the ERI is under strain

Almost 5,000 people attended A&E in the last week of August, making it one of the busiest weeks on record for NHS Lothian.

Unison has issued a stark warning that patients are not getting the quality of care they deserve, while staff are struggling to cope at the rammed A&E department at Little France.

It follows reports by the Evening News that staff shortages are causing waits of up to 12 hours for patients, while other sites in the Lothians have also been forced to close beds.

The crisis-hit emergency department is operating at three times capacity

The latest figures show national A&E waiting time performance has hit a record low for a fourth consecutive week, with more than a quarter of patients waiting more than four hours to be seen.

In addition to facing long waits to be seen patients at the ERI are being left on trolleys until beds become available, with reports of people crammed in along corridors.

It’s understood some are even being forced to wait by a busy nursing station at triage, if they are not well enough to be moved.

Meanwhile, the packed waiting room is often at capacity with standing room only, union staff said.

The A&E at the ERI is feeling the strain

It comes as nursing chiefs voiced fears over critical staff shortages, with figures showing nursing and midwifery vacancies at a record high, adding to the strain of pressured frontline services.

Unison said staff at the Royal Infirmary are ‘run ragged’ as many work overtime to plug the gaps despite staff morale hitting ‘rock bottom’.

It has prompted fears that the under-staffed department could see worsening shortages as the winter months loom.

Jean Harnes, organiser for the ERI at Unison said: “The emergency department at ERI is bursting at the seams. There is a shortage of staff and beds. And it’s often only standing room in the waiting room, with patients on trolleys in corridors. Staff are running about like headless chickens.

"Patients on trolleys are still being looked after, but not getting privacy or decency. Or the care they deserve. When staff can’t get patients out of the bays to get another one in, or get available beds in the wards, they have to keep them on a trolley if they are not well enough to be moved.

"Staff are doing their best but they are run ragged. I’ve only seen normal levels of new recruits for the coming months, that isn’t going to be nearly enough. The hospital A&E is as busy as I saw it when we were at peak covid-19 levels.

“Morale in A&E has hit rock bottom. Many are talking of packing it in. They are on their knees.”

In NHS Lothian, 750 nursing and midwifery posts are vacant while across Scotland a record high of 4,854 nursing and midwifery posts are not filled.

The RCN, which is calling for fair pay for nurses, has branded proposals to recruit 1,500 additional staff across the country as “woefully inadequate.”

NHS Lothian escalated staffing issues to their ‘gold command group’ in August and said they have recruited large numbers of clinical staff that will start in the next month.

But the Royal College of Nursing said current plans will fall short as work related sick leave caused by stress and other mental health issues is also on the rise.

Local politicians have added their voice to growing concerns, demanding urgent financial support for NHS Lothian.

Lothian Tory MSP Sue Webber, said: “Patients in NHS Lothian are continuing to be let down by delays and inaction.

“They are facing completely unacceptable delays with every passing week at accident and emergency departments in NHS Lothian. There’s no end in sight.

“In the face of a crisis in our NHS, all we’ve seen from the SNP is a flimsy pamphlet that they’re trying to pass off as an NHS Recovery Plan. It delivers no new funding for A&E services.

“Our heroic frontline staff in NHS Lothian are overwhelmed and crying out for real leadership.

“Patients need urgent answers as to how the Health Secretary will get on top of this situation to avoid waiting times completely spiralling out of control.”

Jacquie Campbell, Chief Officer, Acute Services, NHS Lothian said: “Our services have been experiencing unprecedented and prolonged levels of demand which is causing real challenges for both acute and community care. We apologise to anyone who has had to wait longer for care than we would like.

“Our teams are working tirelessly to ensure that we can continue to prioritise the most clinically urgent patients for example by streamlining services, introducing smarter ways of working, and managing our resources and staff to improve flexibility and support effective bed management at this crucial time. We have also been recruiting a large number of staff to our clinical services who will be starting throughout this month.

“To ensure that we can continue to prioritise the most clinically urgent patients, everyone has a part to play. If you think you need to visit A&E, but it's not life threatening, or you think you need to visit a Minor Injury Unit, call NHS 24 on 111 first, day or night.”

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