Lower standards ‘used to deal with A&E crisis’

Toby Harris. Picture: Greg Macvean
Toby Harris. Picture: Greg Macvean
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THE Scottish Government has today been accused of responding to a crisis in accident and emergency departments by lowering standards, after health bosses were given 18 months to hit a far lower target than they had previously been expected to achieve.

The Evening News revealed yesterday that the number of patients waiting half a day or longer in A&Es was at unprecedented levels in Lothian, with claims that the emergency department at the Royal Infirmary had been “in meltdown” as recently as last week.

The Government expects 98 per cent of patients to be admitted, discharged or transferred after arriving at emergency 
departments within four hours, but after NHS Lothian fell short by 12 per cent in December, a new goal of 95 per cent has been introduced across Scotland.

And regional NHS chiefs have been told that they have until September 2014 to hit the “first milestone”, following dismal statistics which showed that only four of the country’s 14 health boards – NHS Tayside and tiny NHS services in the Western Isles, Orkney and Shetland – achieved 98 per cent in December.

The Government insisted that hitting the new HEAT target, which is used in a number of areas in the NHS to track and improve performance, was “a minimum” expectation and that it still expected health boards to work towards the 98 per cent standard, which remains in place.

But Tory health spokesman Jackson Carlaw said the move amounted to an admission of failure, and accused Holyrood of bringing in a lower target “by the back door”.

He added: “Amid all the announcements about recycled money and new IT systems, this was conveniently left off. Instead of lowering standards and expectations, the Scottish Government should be doing the opposite.

“The picture in casualty wards in Lothian and across Scotland is an extremely grim one, but rather than address that, the Scottish Government is bringing down the bar, and will no doubt pat itself on the back furiously if these lowly goals are achieved.”

At the Royal Infirmary, as well as emergency departments at St John’s Hospital, the Western General and Sick Kids, 17,485 people waited beyond the four-hour target between April and January.

Between April and February, 276 people were stuck in A&E for 12 hours or more, while from April to January, 1610 faced waits of eight hours or more. The current financial year is not yet complete, but both figures already dwarf the previous high recorded in a full 12-month period since records began in 2007.

The patients facing the longest waits will have been seen by doctors, but become stuck because there are no beds available in the inpatient wards they need to be sent to.

Labour MSP and Shadow Health Secretary Jackie Baillie said the poor performance in Lothian was the result of fewer staff and resources and claimed the region’s health board is “simply not fit for purpose”.

She added: “The SNP can’t keep blaming winter for these pressures. We should know it adds pressure and health boards should plan to deal with it.”

Health Secretary Alex Neil said that the vast majority of emergency patients were treated within four hours, but admitted that improvements could be made. He added: “We are working with NHS Lothian to improve unscheduled care to make sure people are seen and treated in our hospitals and as quickly as possible. Changing the system takes time, which is why – as part of an investment package of £50 million across Scotland – we will be doubling our winter planning fund to £6m this winter.”

‘I decided to go elsewhere’

‘I decided to go elsewhere’

TOBY Harris, 21, visited the ERI A&E on three occasions on Monday after falling down stairs and rupturing ligaments in his ankle – but left each time after being told to expect a wait of three-and-a-half hours.

The podiatry student at Queen Margaret University, who has represented Scotland as a sprint hurdler, said it appeared the department was in turmoil.

Toby, of Leith, said: “It was crammed each time. I wanted an X-ray as there was a lot of swelling and bruising, but I decided to go to health professionals elsewhere.

“All of the seats were full so they were bringing in wheelchairs for people to sit on. Nurses were asking people to go to their GP. I think people could have felt under pressure to leave.”

NHS Lothian said that while A&E patients were told of alternative options, it was “wholly inappropriate to suggest that any undue pressure to leave is exerted on those individuals that do require emergency care.”