BBC Scotland have headlined this one-week variation, not evidence of any trend, with a view to scaring their audience.
One-week variations are not a trend. In the last 8 weeks we’ve seen these percentages seen in 4 hours:
65, 66.3, 67.6, 65.1, 65, 66.1, 67.7, 63.5.
That’s flat, stable. Let’s see what happens in the next three weeks before we claim anything more.
The report includes these ridiculous claims from their Health Correspondent, Lisa Winters:
Doctors working in emergency medicine have issued stark warnings recently about the impact of long waits in A&E. It is simply not safe, and patients are dying as a result, they say.
Like the rest of the NHS, a major part of the problem is bed capacity in hospitals.
Too many beds are taken up with patients who don’t need hospital treatment any more but can’t get home because of pressures in social care.
https://www.bbc.co.uk/news/uk-scotland-62969233
I’ve dealt with these claims before. Here are the answers again:
There is no shortage of beds in NHS Scotland with around twice as many per head of population than NHS England: https://www.interweavetextiles.com/how-many-hospital-beds-uk/
There are over 50% more nurses, per head of population in Scotland, to treat the patients: https://www.gov.scot/publications/foi-19-00620/
In September 2022 there were typically only around around 600 in hospital compared to more than 2 000 in March 2022. https://www.travellingtabby.com/scotland-coronavirus-tracker/
There is no correlation between A&E waiting times and deaths as the ambulance prioritising system and the triage system in hospitals ensure that those at risk are cared for extremely quickly. At worst, delays result in longer waiting times only for those cases in which to do so is not life-threatening. The RCEM know this fine well.
The report, of course does not tell us that the rate in England for August was 58%.
Talking-up Scotland 
I suspect that there are figures coming out shortly for NHS England that are much worse, and that this is BBC Scotland’s early attempts to convince folk that we are all just as bad or even the worst!
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Two more opportunities for NHS Scotland related gaslighting before next NHS England data release c. 8 October. Weekly reports in Scotland are so helpful!
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I probably imagined it during Lockdown that we were exhorted to show our support for the NHS by clapping every week at specific times .
I am not imagining the tsunami of ”bad ” NHS stories that fill The Herald , The Scotsman and BBCScotlandshire each day .
Surely this is not the same NHS ? Or is it a different mainstream media ?
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For any process which has to deal with host of variables there will be ups and downs in outcomes, these Lisa Winters regurgitations only appear on the downs, so it stands to reason with the result published weekly that she will get max 26 articles a year out of this guff to justify her wages https://archive.ph/BBF0G.
Scroll to the bottom of the article and you can see the BBC kindly provided links to much the same dated 12 July, 19 April and 29 March, a copy/paste exercise only requiring fresh “wir doomed” quotes from Disaster Gulhane, Tsunami Baillie and the Tailor’s Dummy to complete.
The problem for them is that almost everyone in Scotland has some connection with the NHS, as a patient, friend, neighbour or relative, so how the service is performing will inevitably crop up in conversations – I doubt there will be many who see these articles as other than politically motivated “guff”.
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There is a problem with the balance between ‘demand’ and medical support ‘supply’ in the UK’s publicly funded emergency health services. Is anyone ‘denying’ this? Is anyone in government or in political opposition anywhere in the UK denying this?
Well probably not IF asked directly! It’s just that governments and opposition parties in SOME parts of the UK seem not to talk about this issue much. And the corporate media and the BBC tend not to pressure them to do so – not even when the Royal College of Emergency Medicine issues a damning press release on NHS England performance statistics.
The net effect is that A&E waiting times performance tends not to be politicised – rightly or wrongly. The exception – and it could hardly be more evident – is in Scotland!
As a result:
– we, the voting public across the UK, learn little or nothing about the steps being taken by the responsible governments in England, NI and Wales to address their own problems in A&E
– we see little or no holding to account those responsible governments over the extent to which the steps they are taking are proving to be effective or failing to solve the problems
– we see no debate over whether the current problems are (only) a fall out from the Covid pandemic or have origins much further back in time – end of free movement or Tory austerity or something else?
– we see no debate over whether the A&E problems are due to a whole system failure – e.g. the NHS model itself and/or the model of social care provision?
-we see no discussion of why A&E performance at any given time is so highly variable between health boards/trusts and their emergency departments – unequal investment, better A&E processes, better integration with local social care, regional health inequalities, luck?
– and no doubt other matters of importance for emergency medical services that merit debate.
But then is all the above not needless diversion? In Scotland the issue is straightforward, is it not – the problem is caused by the Scottish Government. Or so Scotland’s voting public are being told – endlessly!
On 8 September 2022 I posted this on TuS btl: it seems relevant to bore with perspective again.
The latest statistics on NHS England’s A&E waiting time performance (for August 2022) have just been published.
See https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2022-23/
We learn that 58.0% of patients were seen within 4 hours in type 1 A&E departments compared to 57.0% in July 2022, 66.2% in August 2021 and 78.3% in August 2019. So a slight improvement on the previous month! In Scotland this would have merited a ‘nearly the worst’ or ‘second worst’, scandalised statements from the corporate media, BBC Scotland and opposition politicians. Expect nothing comparable in England – hardly a ripple!
Using the figures above together those published for NHS Scotland’s equivalent A&E departments, we can offer some perspective. Based on performance against the 4 hour waiting time target:
– in August 2022: NHS England achieved 58% (reports monthly) NHS Scotland achieved between 65% to 67.6% (reports weekly)
Using a median performance of 66.3%, NHS Scotland achieved 8.3% percentage points higher i.e. a 14.3% better performance
– in July 2022: NHS England achieved 57% NHS Scotland achieved between 64.8% to 67.8%
Using a median performance of 66.3%, NHS Scotland achieved 9.3% percentage points higher i.e. a 16.3% better performance.
– in August 2021: NHS England achieved 66.2% NHS Scotland achieved between 74.3% to 78.7%
Using a median performance of 76.5%, NHS Scotland achieved 10.3% percentage points higher i.e. a 15.5% better performance.
– in August 2019: NHS England achieved 78.3% NHS Scotland achieved between 88% and 89%
Using a median performance of 88.5%, NHS Scotland achieved 10.2% percentage points higher i.e. a 13.0% better performance.
Is this BBC Scotland’s best kept secret?
Substantial and consistently better A&E performance by the health service in Scotland whose overall resourcing (just like that available to the Labour government in Cardiff struggling with NHS Wales’ performance too) is to a large extent set by the government in Westminster, the same government that ALWAYS holds ALL the powers to determine the level of resources allocated to NHS England.’
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Scotland has the best waiting times in the UK and the best staffed NHS.
The BBC and our colonial press give isolated stats unless it shows Scotland in a bad light.
Then they are promulgated repeatedly daily and highlighted in a way that figures south of the border are not.
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This is a very good visual.
https://www.facebook.com/groups/215556435841901/permalink/1186859592044909/
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Perhaps it’s a good visual! But before I could be sure, I’d need to know what statistic the author is using for NHS England’s over 12 hour waits. The officially released one is NOT equivalent to that published in NI, Scotland and Wales.
The folk waiting over 12 hours in an A&E department in England may have already waited for hours from the time they arrived at A&E reception up to the time a clinical decision was made to admit them. At the point when the decision to admit is made the NHS England clock starts again. In other words, the 12 hour wait in England is (just) a ‘trolley’ wait: a clinical decision has already been taken and the patient is (just) waiting to be taken to a ward.
Elsewhere in the UK by contrast a 12 hour wait is just that – from first check-in at A&E reception to actual admission, transfer or discharge.
The Royal College of Emergency Medicine (RCEM) in a press statement dated 12 August 2022 stated this about NHS England’s statistical reporting (with my emphasis): ‘‘.. we stand by our position that THE 12-HOUR DATA MEASURED FROM DECISION TO ADMIT TO ADMISSION IS HIGHLY MISLEADING and we continue to URGE NHS ENGLAND TO REGULARLY PUBLISH THE 12-HOUR DATA MEASURED FROM TIME OF ARRIVAL. AS A MATTER OF TRANSPARENCY AND HONESTY, it is crucial to see this data ahead of winter so we can begin to see the crisis in its full scale and tackle it fully.’
NHS Scotland publishes data on actual 8 and 12 hour waits from time of arrival to admission, transfer or discharge – and does so weekly, not monthly as in England!
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I have to say we were at A&E for 4 hours yesterday, it was packed to the gunnels, standing room only, exhausting. The ERI needs more work to accomodate the people of the city, and it was so busy, said likely because of the Monday ‘holiday’ where many people held off going anywhere. All sorts of people with various afflictions, some serious, some just needing to find out if serious, and/or potentially serious. We couldn’t wait until 2am so headed home, having been seen briefly, luckily son was Ok until it flares up next time.
The ERI is way out of town, it could have been built more centrally, but the Labour party decided it should be out of the way, built on no doubt very cheap land at ‘Little France, which used to be a camp site I remember. I talked to an ex nurse, in the queue, we had plenty time to chat, who said that in 1970 she and her colleagues had been told the ERI in centre of Edinburgh was to be revamped. They were even shown the plans, and some streets around the then hospital, (used for nurses accomodation etc), were owned by the NHS. Nope, all sold off by Labour, an extensive area now expensive flats and a few shops.
Staff were amazing yesterday, I don’t know how they do it quite frankly. Some cases brought in by police who also had to stand around for hours. The waiting area leaves a lot to be desired, and of course we only have one A&E for half a million people, because, the Labour party closed down the A&E dept at the Western general hospital. Had Labour been at the helm any longer god knows what would have happened. Well in fact they ran down the Western General and planned to sell it off, lock, stock and barrel. A huge hospital covering a huge area, the developers must have been very disappointed when it was saved by the SNP who extended services, though still no A&E, that Labour trashed. Flick of a pen, Labour took a wrecking ball to Scotland’s public services, we must never allow them near the levers of power again in Scotland.
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