By stewartb

The Royal College of Emergency Medicine (RCEM) is a persistent and highly critical commentator on the responses of UK and devolved governments to the waiting times and capacity challenges facing NHS Emergency Departments in England, Northern Ireland, Scotland and Wales.

For background, it is my contention – and I’d argue, provable by analysis of the RCEM’s past monthly press statements that following the release of performance data for the NHS in each of the four nations – that the RCEM (i) fails to acknowledge the relatively better performance of NHS Scotland; and (ii) adopts a tone in its press statements that is more critical and alarmist when commenting on Scotland than it does for the NHS and responsible governments in the other three parts of the UK, notwithstanding the relatively better performance of NHS Scotland.

With this in mind, the RCEM’s latest press statement following the release of NHS Wales waiting times data is notable.

Source: Royal College of Emergency Medicine (23 May 2024) It must not be forgotten the Urgent and Emergency Care crisis is a UK-wide issue.

The statement notes: ‘In April 2024: 64,700 people visited a Welsh ED:

• of these, just 59.4% were, treated, discharged or admitted within four hours. The NHS Constitution states this figure should be 95%
• of the patients who waited more than four hours, 14,669 waited more than eight hours, and 9,351 waited more than 12 hours – which means that of all the people who visited a Welsh ED last month one in every seven were there for 12 hours or more.’

And here is the notable bit! In the same statement, RCEM Vice President for Wales Dr Rob Perry said: “Whoever forms the next Westminster Government must commit to providing the devolved nations with the resources and support they need so they can deliver the UK-wide improvement in Emergency Medicine which our members want, and our patients need and deserve.”

So even the RCEM – at least its VP for Wales – considers that Westminster government is the critical party in the provision of necessary resources to solve A&E performance across the UK. All ‘responsibility for resourcing’ roads do lead to Westminster!

An RCEM statement on 7 May commented on the NHS Scotland Emergency Department waits performance for March 2024. It noted that : ‘In March, one in three people attending Scottish Emergency Departments waited four hours or more to be seen, one in eight waited eight hours or more, and one in 20 waited 12 hours or more.’

(In passing, it’s noteworthy how the RCEM reports statistics in its monthly press releases for each the four nations in quite different ways/styles: does it not wish to permit ready cross-nation comparisons?)

So for March 2024, the RCEM tells us that ‘one in three people attending Scottish Emergency Departments waited four hours or more to be seen’: in other words, 66% were ’seen’ within four hours compared to 59.4% in NHS Wales. And I very much doubt that 33% of patients in NHS Scotland waited over four hours just ‘to be seen’ – no triage, no diagnostic testing, no therapeutic treatment? Really? How does the RCEM determine this from the published statistics? The published metrics relates to time to discharge, transfer or admission – not time ‘to be seen’!

The RCEM’s commentary on the March 2024 performance for NHS Scotland refers to 1 in 20 experiencing 12 hour plus waits. That is a hugely better performance that the NHS Wales performance in April of one in seven experiencing 12 hour of more waits. Yet from the outputs of the BBC, wider MSM and from the Labour Party in Scotland one would never know of this huge difference!

Such distinctions favouring NHS Scotland are ignored in the RCEM’s statements, by the BBC and mainstream media – and the reality of the performance of NHS Scotland relative to NHS Wales (of course) plays no part in the pronouncements of that most hypocritical of political groupings, the leadership of the Labour Party in Scotland!

In closing, note again the quote from the RCEM’s VP in Wales: ‘the next Westminster Government must commit to providing the devolved nations with the resources and support they need …’