‘What would he say about his party’s stewardship of NHS England and its A&E provision?’

Scottish Conservative's newly elected Sandesh Gulhane arrives for... News  Photo - Getty Images

By stewartb

The latest overall A&E waiting times performance statistic against the 4-hour standard in Scotland is disappointing. It is less poor than the latest for NHS England but its still poorer than one would have hoped/wished for.

Intuitively, it seems to me (a non-expert in this field) that the variability in this statistic both across Scotland in any given week and between hospitals/ Boards over relatively short periods of time merits closer analysis than opposition politicians or the corporate media deploy when issuing their ‘scandal’ cries. Candidly, this variability merits closer analysis and explanation than NHS Scotland or the Scottish Government put into the public domain. From ‘rough’ inspection, it seems that substantial changes in performance can occur without always commensurate, large changes in number of attendances.

Digging into the data seemingly odd details are apparent. As an example, Monklands Hospital (NHS Lanarkshire) has recorded performances against this 4-hour standard of 91% falling to presently 61.2% over a 3 week period. The weekly attendances at A&E have risen by 142 over the same period. But the most recent number of attendances, at 1,087 for the week, is the second lowest since 14 March 2021. The performance of 61.2% against the 4-hour target has never been lower during the past 12 months, even when attendances have been higher than at present.

There must be another factor/s involved. One cause of the poorer performance at the Scotland level according to the Cabinet Secretary for Health is staff absences. But given the variability in the waiting times performance across Scotland one would want to know how A&E staff absences vary across NHS Scotland. Is there a correlation, is there good evidence of causation? What about local staff morale, staff exhaustion, local leadership?

Notably, A&E in NHS Tayside continues to deliver performances above 90% against the 4-hour target. Does it have especially low staff absence levels? Might all this variability suggest something more or different from a national system failure?

The BBC News website’s Scotland page tells us today that: ‘The Scottish government’s target of 95% of patients being admitted to the hospital, transferred or discharged within four hours has not been met since July 2020.’

According to the Nuffield Trust and its article ‘Chart of the week: The rise of over four-hour A&E waits across the UK’ published on 15 September, 2021 the last time NHS England met the 95% target was August 2014.

According to NHS England’s latest statistical commentary on A&E performance, the 95% standard – even for ‘all’ its A&E departments in England, not just its Type 1 (main) sites – was last met in July 2015.

And yet the BBC News website’s Scotland page chooses to amplify, without perspective or challenge, this from Scottish Conservative health spokesman Dr Sandesh Gulhane. He called the statistics a “shameful indictment” of Health Secretary Humza Yousaf’s stewardship of Scotland’s NHS. What would he say about his party’s stewardship of NHS England and its A&E provision?

By the way, if the BBC was to report the latest statistics for A&E in Scotland using the method it applied recently to the last NHS England performance data release – namely reporting the performance of ‘all’ sites and NOT for the Type 1 (or main) departments – the percentage for Scotland would be 75.9%!


3 thoughts on “‘What would he say about his party’s stewardship of NHS England and its A&E provision?’

  1. I suppose another factor to consider would be the nature of the cases presenting at the A&E departments. Difficult to determine what if any contribution to the figures that this might make because the level of detail required possibly breaches patient confidentiality.

    Staff absences over the past 2-3 weeks have made the biggest contribution to the drop in the figures.

    Liked by 1 person

  2. Patient X being seen in 3 hours 59 minutes will be no less happy than Y at 4 hours and 1 minute, even if Politician Z insists it is a disaster.

    Absent context it’s the old “Lies, damned lies and statistics” game – Only the facility managers have the context to the figures, their own central managers will already have enquired and accepted the explanation, yet we get lured into concern where none may be merited because of politicians and their damned lies.
    – This is not an assembled device rolling off a production line, but a real person with real fears – eg Patient Y may need a bit more of a cheery pep-talk than patient X before discharge.
    Is Gulhane seriously suggesting worried Y gets thrown out the door for the sake of data ?

    True to form, the BBC not only publish this distortion but invite the usual negative comments from their professional keyboard warriors such as McTavish (Smythe) from Banchory (Basingstoke) etc to rail against the “outrage”.
    The real McTavish of Banchory rolls his eyes at the mention of Gulhane and best summarises concerns as “mair keech”.

    Liked by 2 people

  3. I like him. Not much, but that’ll be me, not him.
    I like his “something about Mary” hair-do!
    I like his bright blue polyester suits (expect he is colour blind).
    I like his earnest, don’t knew much, but I’ll tell you anyway, waffle.
    I like the way he looks straight at camera, rather than the person talking to him.
    I like the way someone as dim as him can edge out DRossie.
    I’ll like him even more when he goes back daan saff.
    Then I’ll miss the wee nyaff.


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