PATIENTS in Scottish A&E departments are being treated in “inhumane” conditions, doctors leaders are warning MSPs as the NHS continues on an emergency footing.
Senior medics, nursing chiefs and trade union bosses are stepping up their concerns over pressures on the service as it heads towards what is expected to be its worst ever winter.
Ahead of giving evidence to Holyrood’s health committee this morning, Dr John Thomson, vice president of the Royal College of Emergency Medicine, said in a written submission that A&E demand had increased while the number of beds had fallen over the last decade.
“This has led to patients often waiting on a trolley for hours for an available bed and having to receive care in a corridor. This reality is inhumane and unacceptable and can cause significant distress to both patients and staff,” he said.
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Thomson added that currently A&Es (EDs) are experiencing record breaking levels of demand. He said performance data published for August 2021 revealed that 75.4% of patients waited more than four hours to be admitted transferred or discharged in major departments – the worst performance on record.
He added that “even more alarming” is that 5460 patients were delayed by eight hours or more and 1410 patients by 12 hours or more and said that from January to August 2021 in Scotland there have been 231 excess deaths directly caused by a long wait due a crowded A&E.
The senior medic also warned in his submission that because of the strains the treatment of patients paused earlier in the pandemic and due to go ahead may have to be put on hold again.
“The recovery of the elective backlog should be a priority, but it cannot be considered in isolation. If unscheduled care cannot cope this winter, elective care will once again have to be paused,” he said.
But the earlier pausing of treatments was itself contributing to the current situation, with people, who operations had been halted previously in the pandemic, now turning up at A&E as their conditions deteriorated.
Dr Colin Poolman, interim director of the Royal College of Nursing (RCN) in Scotland, last week said Scotland was short of thousands of nurses. He will also appear at Holyrood’s health committee today to give evidence to their inquiry on winter preparedness.
Ahead of his appearance his written submission also raised significant fears for the coming months.
“RCN Scotland members are braced for an incredibly challenging winter,” he said.
“This year, seasonal infections such as the flu and norovirus will be met with the combination of staff burnout following the pandemic, a workforce crisis (including record high nursing vacancies), rising Covid cases, built up demand from services being paused and attempts to remobilise services in order to reduce a backlog in elective procedures.”
He added: “To prepare the NHS and wider health and care services for this winter, steps need to be taken to ensure Scotland has the nursing workforce needed to maintain services and clinical care. This has to start with a focus on retaining existing staff and being honest with members of the public about what services can be delivered, but longer term, transparent and fully costed workforce planning is needed,”
Last week Health Secretary Humza Yousaf issued guidance for emergency departments that would also see them refer patients to GPs or pharmacies in a bid to reduce record waiting times.
It follows another week where A&E waiting time performance had fallen to a record low, with 30.4% of patients not seen within the four-hour target.
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Nicola Sturgeon was last week asked about the RCN figures and pressures on the NHS by Scottish Labour leader Anas Sarwar at First Minister’s Questions.
She said she takes “personal responsibility for everything that the Government is responsible for, every single day”.
She added that she recognised that the “NHS is working under extreme pressure right now.” and paid tribute to its staff.
But she added that nursing and midwifery staffing in Scotland “is currently at a record high”.
She added research published by the Royal College of Emergency Medicine appeared to use research findings from England from four years ago to make extrapolations from Scotland-only data now.
On warnings from Thomson, the First Minister said: “We absolutely recognise the challenge, but we are listening to those on the front line in coming up with the best and the right solutions.”
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