Action needed as A&E waiting times slide

At the end of last month the NHS Information Services Division published its latest figures on waiting times at A&E departments across Scotland.

Under targets introduced by the previous Labour led Scottish Executive, 98% of patients attending A&E should be assessed and either discharged, redirected or admitted within four hours of arrival.

The latest figures made disappointing reading for people in the NHS Lothian area with the Edinburgh Royal Infirmary performing poorest against the four-hour standard.  In March this year, one in five patients attending the ERI waited over four hours.

These figures are further evidence, if it was needed, of the serious capacity issues at the ERI.  In the last 12 months we’ve seen some of the worst compliance rates since the 4 hour target was introduced.

Dedicated hospital staff are working flat out to cope with demand but as the College of Emergency Medicine has warned, A&E departments are facing unsustainable workloads.

To make matters worse, the ERI could soon be taking on additional patients from St John’s due to staff shortages.  I raised this issue last week during question time in Parliament (see above video at 7 mins 40 secs) and was disappointed by the Health Secretary Alex Neil’s response.

Firstly, he noted the recruitment by NHS Lothian of additional nurses and consultants to work at St John’s while glossing over the fact that a disappointing response to adverts for specialist doctors and GPs has left an estimated 100 hour/week shortfall in staffing.

Secondly, he went on to try and blame the previous Scottish Executive (including a personal dig at me) for the lack of space at the ERI when the contract to build the hospital was signed off before the Scottish Parliament even existed.   While the Cabinet Secretary rightly points out problems with the initial design, his focus should be on finding solutions, not laying blame.

The A&E waiting figures for NHS Lothian are part of an emerging picture across the country where patients are being left for longer in our emergency departments. Unfortunately, the Scottish Government’s response has been to lower the target rather than increase capacity.

Earlier this year, the Scottish Government introduced a new target of 95% compliance with the four-hour target.   While the Cabinet Secretary states that 98% remains the standard, the lower target has led to accusations of moving the goal posts.

Rather than focussing on the needs of patients, this tells you in a nutshell what’s happening to our NHS under the SNP.

Going to hospital in an emergency is distressing enough for patients and while they appreciate the pressure being placed on staff they still expect to be treated quickly and efficiently.   These figures must be a wake-up call to the Scottish Government that it needs to act to address the capacity issues the underpin the slide in A&E waiting times.

On Friday MSP’s had the chance to air these issues with NHS Lothian Health Board representatives.    The need to recruit new specialist staff for A&E was seen as a key priority alongside developing more beds in the ERI and new ways to support people who are ending up in A&E when care at home or in a care home environment would be more appropriate.  I’ve blogged about these issues in recent weeks as these alternatives need new investment too before any hospitals or care homes are closed.