‘Our’ MSM take advantage every time there is a weekly dip in A&E waiting time performance. A 14-year-old Modern Studies pupil knows that a weekly variation is not evidence of a trend on its own, is statistically unreliable, and any attempt to rely on it would lead to a fail.
That, of course, does not stop BBC Scotland or the Herald triumphally headlining a scare story for their more vulnerable audience members. Notably, only NHS Scotland publishes weekly data.
Monthly figures over more than one month do tell you something meaningful, worth knowing and telling about.
Here is the real news about NHS Scotland’s A&E departments.
In August 2022:
From 135 532 attendances, NHS Scotland’s A&E departments saw 69.7% of attendances in 4 hours.
From 1 304 378 attendances, NHS England only managed 58% in 4 hours up from 57% in July 58.8% in June, 60.2% in May and 59% in April.
Pro rata, NHS Scotland saw 3.4% more attendances than NHS England.
In July 2022, NHS Scotland saw 69.9% in 4 hours. In June, they saw71.3%. In May, they saw 73%. In April, it was 72.1%. In March it was 71.6%.
So, in Scotland, we have a slight decline in performance, flattening out in the last two months.
In NHS England, we have third-world levels of performance and no media attention whatsoever.
Sources:
Talking-up Scotland 
Today’s BBC News website’s offering to Scotland entitled ‘Summer A&E waiting times were worst on record’ has an ‘interesting’ feature. It states: ‘.. the length of A&E waiting times often depends on where you live. Scotland’s BIGGER HOSPITALS, which attract the LARGEST NUMBER OF PATIENTS, are STRUGGLING THE MOST.’ (my emphasis)
And adds: ‘Forth Valley Royal was the worst performing A&E in the week-ending 25 September, with 39.6% of people seen within four hours. The figure for Edinburgh’s Royal Infirmary was 43.5% and Glasgow’s Queen Elizabeth University Hospital was 54.3%.’
Firstly (and at last) a recognition of variability between Health Boards: next, might an investigative journalist ask why? Is it related to a whole ‘system’ failure or to different ‘issues’ at the level of individual health boards, local authorities, and/or the local/regional state of health and social care integration processes? Or something else?
After all, the BBC’s reporting that ‘Scotland’s BIGGER HOSPITALS, which attract the LARGEST NUMBER OF PATIENTS, are STRUGGLING THE MOST’ gives a rather partial picture!
The article refers to the poorest performer, Forth Valley Royal Hospital (39.6% treated in 4 hours), which had 1,107 attendances in the week ending 25 September. So it seems this is categorised as a ‘bigger hospital’ of the type ‘struggling most’.
Using latest weekly figures, the BBC could have referred to Monklands Hospital: 1,247 attendances and 63.3% seen within 4 hours. It could have referred to St Johns at Livingston: 1,037 attendances and 70.5% seen within 4 hours. ‘Bigger hospitals’ performing a lot better?
But the most newsworthy example of a ‘bigger hospital’ is surely Ninewells in Dundee: 1,185 attendances and 85% seen within 4 hours! And to add to its newsworthiness, the BBC journalist will no doubt regret (!) not spotting this for inclusion in the article: only FIVE patients out of 1,185 attending the ‘big’ Ninewells Hospital waited over 8 hours in the week ending 25 September.
And if that’s not notable enough, NONE waited over 12 hours!
How does NHS Tayside achieve this performance if the WHOLE NHS Scotland system is broken? I’m genuinely curious. Why not public service journalists?
This BBC article quotes Tories in Scotland using terms such as “chilling’ and ‘terrifying’. A Labour MSP talks of a ‘humanitarian crisis’ in Scotland and is naming and blaming the Scottish health secretary in her personal attacks.
In the way opposition politicians are choosing to respond to the undoubted pressures on NHS Scotland, there is a notable lack of constructive advice from them on how to solve the problems. Given that both parties are in government with NHS responsibilities in England and Wales respectively, would some ‘knowledge transfer’ into Scotland regarding solutions not be a public service?
Perhaps the reason is that they and their own parties’ health secretaries in England and Wales have no access to an easy or quick fix for NHS A&E waiting times. That is why the performance on waiting times is so poor – poorer than in Scotland – at a national level in England and Wales. Of course IF there was a ready fix, only one party, the Tories, is in a government with access to ALL the financial resources to throw at solving the A&E ‘problem’ – if it chose to do so.
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Re your point about investigative journalists not looking into underlying causes. I’m surprised that no-one in the SHNS, central govt or even the SNP doesn’t try to address that. At the very least you might have though the SNHS/Health Boards/Integration bodies would be looking into to it – even if only to identify what the causes are so they can be addressed.
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It will likely be a number of factors involved. Low staff at times, (Brexit has a big part in that for sure) and funding in fact. Funding for the Scottish NHS, is provided by Scotland but the amount it receives is set by the English government. When the EngGov chop back English NHS funding, they chop back Scottish NHS funding. ‘Barnett consequentials’. A term used to describe how Scotland gets what England’s choice of government decides it should get (out of the vast sums of money that England takes from Scotland every year, sending a few crumbs back with added contempt!) not what is needed.
Scottish councils are still forced to pay £billions to private companies as a consequence of Labours’ PFI scheme, (scam) and no doubt that has a knock on effect on services and the NHS etc. Some of the builds via Labours’ PFI scams, were hardly fit for purpose, Edinburgh’s royal infirmary hardly suitable for the capacity of the city and areas outwith Edinburgh that need to use the services there as well.
I am sure the SNHS and the ScotGov/SNP know what the causes for any delays in treatment are. Juggling the £’s, and mitigating horrendous EngUKGov cuts will impact services, there is no way a shrinking GERS budget, set by England, is going to continue to fill the gaps in funding which come about as a direct result of being shackled to the so called union, where most fiscal powers are reserved to the government next door. The only way for Scotland to solve this problem is to choose independence. The ‘block GRANT’ is an insult to Scotland, while the EngGov literally thieves away the abundant natural resources and massive revenues from Scotland, it has to end and soon.
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Oh, I can easily list a number of factors that may, or may not, be the cause(s) of failing to meet the target. However, saying something is “likely” is no answer. What makes you think the SNHS/Scot Govt/SNP know the causes? If they do why don’t they publish details to stop the constant carping and to reassure staff? Thanks for the lecture though.
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It may well be – indeed likely given the challenges being faced in the NHS across the UK – that there is an underlying ‘system’ wide shortfall in the overall level of resources necessary to keep the PRESENT operating NHS model across the UK functioning satisfactorily. That is down to the Westminster government’s spending decisions over more than a decade – and should be called out!
However, as well as any ‘system’ level resourcing issues, there are clearly wide variations in performance between health boards and hospitals in Scotland. This suggests – intuitively – that there are sub-national and sub-system factors also in play.
What are they and how can/should they be addressed? Is this a function of board/hospital level staffing and/or operational /management processes? Or something else?
Is it a function of the allied health and social care resources and/or processes OUTSIDE the acute hospital sector?
Is it a function of intrinsic local/regional population health issues – i.e. of basic, necessary demand?
Once known, then TARGETED action can be taken – on process/management improvement and/or on a revised resource allocation to better meet geographic or operational needs etc.
And if NHS Scotland and the Scottish Government know the causes of the variability in board/hospital performance then I suggest it would be in the public (and the SG’s political) interest to share their understanding and their planned, TARGETED action plan.
I should say – I am no health system expert just trying to apply a wee bit of logic to what will of course be a complex of issues.
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