So, I spent an evening in A&E with my friends, and was surprised at how busy it was. It’s a cold night in Scotland, and it’s not uncommon to see patients waiting for hours. At one point, a number of us were chatting in the waiting area, when the door to A&E finally opened. We rushed over, and were surprised to see that a handful of people were being wheeled out on the trolley of the ambulance.
The proliferation of health problems in the 21st century has placed a great burden on emergency departments around the world. The Scottish government, through the NHS in Scotland, faces a considerable challenge in providing access to care for its citizens.
An article in the Scottish press, from the STV website, reported that emergency departments in Scotland were “stretched” due to the flu. In the article it was stated that the emergency departments were “stretched” and that “patients are being turned away for lack of beds”.. Read more about bbc news and let us know what you think.
Scotland news by Christopher Sleight
picture courtesy of Getty Images
caption for picture Scottish hospitals are dealing with “winter-like” demands in their emergency rooms.
Emergency department admissions this year are almost 40% higher than pre-pandemic levels, figures show. One senior doctor told Scotland that accident and emergency (A&E) departments across the country were currently experiencing “winter-type pressures”, with no sign of any relief. What’s going on and why does it matter?
What conclusions may be drawn from the admissions data?
Monthly statistics on emergency department admissions are published by Public Health Scotland, with the most current reflecting admissions up to June 27.
In the first week of 2021, weekly admissions surpassed the 2018-2019 average and have stayed there ever since.
When compared to the 2018/2019 average, 3,120 more people have been hospitalized via accident and emergency this year, a 37.6 percent increase.
Admissions were 67.4 percent higher in early April than the previous year’s average, but that number has since dropped.
Other PHS data indicate that the percentage of individuals who waited more than eight hours in emergency rooms in May was also unusually high for the season.
At the same time, “attendances” at A&E – the number of people who turn up at the door – are actually lower than normal.
During Scotland’s lockdowns in 2020 and 2021, attendance fell significantly. It’s currently on the rise, although it’s still far below normal.
So while there are fewer people turning up at emergency departments, a higher proportion of those that do are being admitted through A&E for further treatment.
Do we have any idea why this is taking place?
Dr. John-Paul Loughrey is vice chairman of the Royal College of Emergency Medicine (RCEM) and a consultant in emergency medicine in a Scottish hospital.
He believes there are a number of factors behind the rise in admissions, but told Scotland the primary reason was people arriving at A&E with more serious conditions at a more advanced stage.
Many of these patients are “very sick” and have illnesses not commonly seen by A&E doctors.
caption for media “People will come to us when they’re scared or uncertain what to do,” says Dr. John-Paul Loughrey.
Dr. Loughrey told the that “we’re seeing a lot of individuals who are coming late with issues that they may have attempted to get treatment but had difficulty.”
“However, it’s frequently other individuals who have been hesitant to seek medical help because of Covid’s presence in hospital systems.”
Added to that are lots more children than normal being brought to A&E with “feverish illnesses”.
Dr. Loughrey said that they would normally have been exposed to these viral infections throughout the winter while mingling at nurseries or school, but that they were instead isolated at home.
“We’re seeing a lot more of it throughout the summer, which would normally have subsided by now.”
People turn to A&E when they don’t know what else to do
Dr Loughrey also thinks there’s another factor at play – the fact that A&E remains a “recognisable brand” when much of the rest of the NHS has been reconfigured to deal with the pandemic.
“We’re open 24-7 and people know what they’re getting when it comes to an emergency department. There’ve been such big changes in so many other services that some people struggle to understand and to navigate their way through the healthcare systems,” he said.
“It’s entirely natural that people would come to us when they’re scared or uncertain what to do.”
Dr. Loughrey’s remarks have been repeated by NHS Lanarkshire, Scotland’s only health board with an above-average frequency of emergency department visits.
picture courtesy of Getty Images
sunburn or bug bites are causing some individuals to seek medical attention in emergency rooms.
The health board said “exceptionally high numbers” were turning coming to A&E, including many who arrived with minor conditions like sunburn or insect bites.
“The continuous strain we are experiencing across our three acute hospitals is showing no signs of lessening,” said Judith Park, director of acute care.
“In fact, the strains on our hospitals are as high as they’ve ever been throughout the epidemic.”
Admissions to Covid are still having an effect.
Vaccination seems to have reduced the connection between Covid infection and severe disease, according to recent research.
However, the connection has not been broken, and individuals are still being treated in hospitals.
The number of individuals being treated in hospitals for Covid-19 in Scotland has increased from around 60 in early May to 529 on July 21.
This necessitates hospital reconfiguration in order to keep Covid admissions distinct, limiting flexibility and capacity.
And, just like everywhere else, emergency rooms must adhere to social distance, making it more difficult to manage larger patient populations.
There are fewer people available to work.
The vast majority of NHS workers have already got two doses of the Covid vaccination.
Although this should prevent most of them from becoming severely sick as a result of Covid-19, employees must nonetheless self-isolate if they are recognized as a close contact.
During May and June, as the number of cases increased quickly in Scotland, so did the number of NHS employees reporting as absent for a Covid-related cause.
Between June 8 and July 6, the number of NHS employee absentees more than doubled, but the figure is currently decreasing.
Why are emergency room admissions important?
The emergency department is frequently referred to as a barometer for the rest of the NHS, and what we can see this summer is a very heated health service.
More individuals required to be hospitalized for additional treatment as a result of youngsters coming with illnesses that are common in the winter and adults with severe disease who may have delayed seeing a GP or whose previous procedures were canceled, but beds are few.
Normally, the summer months imply greater hospital capacity, but hospitals are busier than ever due to a mix of Covid cases, staff absences, and an increase in non-Covid patients.
There’s also pressure on the opposite end of the spectrum: attempting to move patients out of hospitals necessitates community-based support so that they may be safely released. Some health boards are having to cancel regular work simply to make room, which is causing issues to worsen.
All of this causes a bottleneck at the hospital’s main entrance, the emergency department, which physicians say is worse than they’ve ever seen. Too many people are waiting for beds or an ambulance to take them home for more than eight or twelve hours.
Staff say they’re trying their best, but they’re tired and morale is poor, and there’s no sign of things slowing down anytime soon.
What does the remainder of the summer have in store?
According to Dr Loughrey, long waits at A&E are usually something you’d see in winter months rather than May, but he says there are “no signs” of this trend going away.
“We’ll have to attempt to take a breath and brace ourselves for the changes that are coming,” he added.
“While the connection between Covid infections and hospital admissions has decreased, it hasn’t completely vanished.”
“After hearing from friends and colleagues around the nation, I’m concerned about what emergency departments across the UK will face in the next three months, before the winter even arrives.”
Peter Cade’s picture is licensed under a Creative Commons Attribution-Noncommercial-No
caption for picture Staff will need to “steel” themselves for the next shifts, according to Dr. Loughrey.
What does the Scottish government have to say about it?
The Scottish government said it wanted to encourage people to consider options “closer to home” before going to A&E, including the NHS Inform website or contacting their GP or local pharmacy.
“We are keenly aware that hospitals are experiencing major difficulties as a result of an increase in non-Covid attendances, and that certain health boards are taking appropriate steps to preserve urgent and emergency care capacity,” a spokesman said.
“That’s why we’ve given health boards throughout Scotland an extra £12 million to assist non-Covid emergency treatment.”
“With an emphasis on increasing staffing levels and available beds, this will assist put measures in place to decrease waiting times for urgent or emergency care.”
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Not every part of life is perfect. While everyone at some point will suffer from sickness or injury, some more than others. The NHS has always had the occasional emergency ward packed with patients. But in recent years the number of people attending has increased. We are told that this is due to an ageing population, but a series of reports have suggested that something else is at play.. Read more about what time is the scottish government update today and let us know what you think.
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