Festive A&E figures

An increase in flu cases and patients with complex care needs have contributed to significant pressure on Scotland’s A&E departments over the Christmas period, as clinicians focus on delivering the best treatment for patients.

During the week between Christmas and Hogmanay, many of the cases treated in Scotland's emergency departments required complex assessment which often takes longer, such as establishing the correct diagnosis of flu type, and which is essential to ensure effective and safe infection control measures.

The Christmas week is traditionally a challenging time for Scotland’s health service. The Scottish Ambulance Service reported an almost 40% increase in the number of calls on Hogmanay alone, and NHS 24 received more than 45,000 calls in the four days over Christmas -  almost double the number of calls in the same period last year.

Flu rates in Scotland doubled in December with the most recent figures from Health Protection Scotland showing around 46 Scots in every 100,000 were suffering from the virus, comparing to 22 in every 100,000 for the same week in 2016.

All eligible groups are being encouraged to get the flu vaccine which has proved to be a good match for this year’s most common strains.

Dr Dan Beckett, Scottish representative of the Society for Acute Medicine said:

“Falls and slips as a result of the icy weather and public holidays have put pressure on hospitals and A&E departments, however flu has had a significant additional impact on most acute medical units this winter.

“We are seeing numbers of patients requiring admission to hospital at a scale we haven’t seen for several years and patients who are frail, or have other medical conditions, are requiring several days in hospital before they are able to be discharged.  Hospital teams are ensuring that patients with flu are either cared for in single rooms or in wards with other patients with the same type of flu to avoid cross-contamination and reduce spread however this results in extra cleaning and administration. This keeps care and safety at the forefront, but it can mean that treatment can take longer than normal in A&E and Assessment units. While we do not want any delay to patient treatment, ensuring that patients with flu are admitted to, and cared for in the right place must always come first - the clinical needs of our patients is paramount.

“Overall clinicians in Acute Medical Units across Scotland are working incredibly hard, with fantastic teamwork, to deliver high quality care to our patients despite exceptional pressures."

Health Secretary Shona Robison said:

“During my visits to hospitals I’ve been struck time and time again by the dedication and sheer hard work of staff throughout this busy winter. I’d like to thank them for their work in supporting any patient or family experiencing a delay to their treatment, and to thank patients themselves for their patience and understanding.

“Scotland’s accident and emergency departments are continuing to outperform those across the rest of the UK - and indeed it is to the great credit of NHS staff that even at the height of these exceptional winter pressures, almost eight out of ten people who attended A&E were admitted, transferred or discharged within the four hour target.

“I’ve heard an overwhelming number of reports from clinicians about how flu and respiratory illness, combined with other winter pressures and exceptional and sustained levels of demand, is changing the way they are treating patients arriving at A&E. It is crucial that patients with complex care needs and flu receive the right care, not simply the fastest.

“It will take some time for services to recover from the pressures being felt this winter and for the spikes in flu levels to subside - however we are working to provide support to Boards wherever they might need it, alongside the £22.4 million investment the Scottish Government has already made available for winter contingencies. to ensure demand is appropriately managed.”

Background

78.0% of people attending Emergency Departments were seen and subsequently admitted, transferred or discharged within 4 hours. See: http://www.isdscotland.org/Health-Topics/Emergency-Care/Publications/index.asp#2081

Statistics on instances of flu in Scotland are published weekly by Health Protection Scotland: http://www.hps.scot.nhs.uk/resp/resourcedetail.aspx?id=3410