Public Health Scotland’s latest report for A&E activity and waiting times for the month ending 31 March 2022 does not make pleasant reading for NHS (Scotland).
The data published is for unplanned attendances only and does not include recall/returned planned data. Whilst the Covid pandemic resulted in significant reductions in attendances at A&E Services in Scotland in Spring 2020 and Winter 2021, since Spring of 2021, the attendance numbers at A&E have been returning to pre-Covid levels.
In March 2022 there were 130,188 A&E attendances in Scotland. 71.6% of them were seen within four hours; 11,017 (8.7%) spent more than eight hours in A&E; and 4,128 (3.3%) spent more than 12 hours in A&E.
For some reason, there does not seem to be a figure for those patients who spent between four and eight hours in A&E. On the above figures, it appears that this group accounts for 16.4% of attendees representing 29,356 patients.
These figures are ones to be compared against the national standard for A&E attendances set in 2007 at 95% of all patients to be seen within a period of four hours and either admitted, discharged or transferred from A&E within that period. This standard was set with an expectation of moving towards a 98% rate.
When comparing different months, it is of note that in August 2019 attendance at A&E was 152,514 with 90.6% of patients seen within four hours; November 2019 was 141,973 with 85.5% seen within four hours; and June 2021 with 136,888 with 81.5% seen within four hours.
When considering such statistics, on any view, March 2022 represents a dramatic decrease in A&E performance without any real explanation from Public Health Scotland as to why that is the case. No doubt, Covid will be cited as a reason. However, when one looks at the above figures which clearly were during the worst of Covid, it cannot be the only reason.
On any view, these figures are concerning. They will serve to erode patient confidence. One cannot put a figure on that. We are likely to see a drop in A&E attendance figures as people simply shy away from the prospect of having to wait up to 12 hours in A&E. Many conditions, some life threatening, will go undetected and untreated which, on a worst-case scenario, could lead to avoidable deaths.
We clearly need to see a dramatic improvement on NHS A&E activity and one which is sustained over the coming months. As we move into Winter 2022, no doubt, waiting times will increase. Firstly, we need a clear explanation as to what has caused this recent deterioration in performance with a plan in place to address the issues. Otherwise, many people face several hours of waiting in A&E or, worse still, will avoid going at all with whatever consequences that may entail.
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