WIREDGOV

First weekly publication of A&E statistics.

Health Secretary Shona Robison has reinforced the Scottish Government’s commitment to improving unscheduled care and delays in discharge from hospital as new figures are published.

The first weekly waiting time figures for Accident & Emergency show that between February 16 to 22, 86.1 per cent of people were seen within four hours at core sites. This is slightly up on monthly figures for January, also published yesterday, which show 85.4 per cent of people were seen within four hours at core A&E sites.

Weekly figures show that ten out of 14 health boards are continuing to see nine of out ten patients within four hours, with six seeing 95 per cent of patients within this time frame.

Over the year to the end of January 2015, core sites in Scotland saw 91.3 per cent of patients within four hours compared to 91.1 per cent in England.

Ms Robison praised staff for working to see patients quickly, especially as attendances rose for the year to January 31, 2015, but stressed that more has to be done to reduce waits and drive forward performance throughout the whole hospital and care system.

This will include targeting areas experiencing challenges, such as in NHS Ayrshire & Arran, NHS Lanarkshire and NHS Greater Glasgow and Clyde which have seen more, sicker people present at A&E, and record levels of admissions. In addition the health boards have seen an increase in flu cases over the past two months when compared to the same period in 2014.

To tackle these challenges the Scottish Government has committed £5 million from its £31.5 million Performance Fund to support improvement across NHS Greater Glasgow & Clyde to relieve pressure at the front door of the hospital. This is in addition to plans the three boards, supported by the Scottish Government, have put in place to drive forward improvement across the system.

As well as this the Scottish Government put an A&E performance support team into the Royal Alexandra Hospital, in January. The A&E performance support team will now also support the Western Infirmary to build on lessons learned in Paisley and share good practice across all NHS GGC sites. Senior managers are now on site at all NHS Greater Glasgow & Clyde hospitals to help oversee improvements and feed into the work of the performance team to implement changes.

This comes ahead of the move to the new £842 million South Glasgow Hospital in May. This will be the largest hospital in Scotland and will replace services at the Royal Hospital for Sick Kids at Yorkhill, the Southern General Hospital, Western and Victoria Infirmaries and Mansionhouse unit. The ‘front door’ unscheduled care capacity at the new hospital will be greater than the combined unscheduled care ‘front door’ capacity of the Western, Victoria and Southern General hospitals.

The figures come as the January census for delayed discharges – a one day snap shot – show that the amount of people delayed from leaving hospital for longer than the recommended 72 hours, has dropped from 947, at the previous census in October, to 776. This includes 14 local authorities which had no delayed discharges over 72 hours.

Workforce figures published yesterday also show that NHS Scotland continues to have a record number of employees, with 137,511.9 whole time equivalent staff now in post – an increase of more than 10,000 under this Government.

Speaking during a visit to Forth Valley Royal Hospital’s A&E department, Ms Robison said yesterday:

“Staff in Scotland’s NHS are continuing to do a fantastic job to treat people as quickly as possible. This winter has been a very challenging time with an increase in attendances and admissions, as well as more severe flu related illnesses and treating more people with complex illnesses.

“It is promising to see we are making improvements in reducing the number of people who are delayed from leaving hospital. This is good for the patient and also improves on the flow through the whole hospital system, freeing up beds to help people move out of A&E.

“We are also employing a record number of staff within the NHS, with a further rise in nurses and consultants.

“But more clearly needs to be done to tackle the issues facing our NHS. Today’s A&E waiting time figures are on a par with those in NHS England, and far exceed those in NHS Wales and Northern Ireland. However, they do not meet the demanding, world leading targets we have set and the standards that patients should rightly expect.

“We are determined to improve performance through a whole system approach, improving patient flow through-out their journey from admission to discharge.

“While weekly figures show ten out of 14 health boards are treating around nine out of 10 A&E patients within four hours we are seeing particular strain on hospitals in the west, with NHS Ayrshire & Arran and NHS Greater Glasgow and Clyde falling below the national average for both weekly and monthly figures.

“To tackle this we are targeting £5 million from our £31.5 million Performance Fund to drive forward improvement across NHS Greater Glasgow & Clyde to relieve pressure at the front door of the hospital. This is in addition to the support team put into the Royal Alexandra Hospital, which is now using its learning across the health board.

“This comes on top of last month’s commitment of £10 million from the Performance Fund to NHS Lothian, NHS Highland and the Golden Jubilee to assist with the delivery of waiting times.

“In January we also committed £100 million specifically to help health boards and local authorities tackle delayed discharge. This is both good for the patient and frees up beds to help people move out of A&E and through the system.

“This is in addition of our substantial, £50 million investment in an unscheduled care action plan, which has seen increased staffing – particularly amongst emergency department consultants.

“The roll-out of a new collaborative approach to unscheduled care across Scotland will also work to minimise long waits in A&E as well as look to ensure best practice is installed throughout the hospital system, supporting joined up work across health boards to address wider issues of patient flow through hospital.

“As we move towards the integration of health and social care in April, these are the right steps to take and I am determined to work with all health boards across the country to improve performance and ensure waits are brought down for patients. Our targets are the most challenging in the UK but it means we need to work even harder to meet them.”

Notes To Editors

Weekly A&E waiting time figures:

The first publication of weekly A&E waiting time statistics for the week ending February 22 covers the 32 emergency departments in Scotland which provide a 24 hour emergency medicine consultant led service.

The latest Weekly Statistical Publication is available at:

http://www.gov.scot/Publications/2015/03/7923

The statistics included in the Weekly Publication are also published on ISD’s NHS Performs website:

http://www.isdscotland.scot.nhs.uk/Products-and-Services/NHS-Performs/

Monthly A&E waiting time figures:

During the month ending January 31, 2015, there was 129,269 attendances at A&E services across Scotland. The total number of attendances in the year to January 31, 2015 was 1,645,639.

The full statistical publication is available on the ISD Scotland website: http://www.isdscotland.org/

Comparison to rest of UK:

NHS England performance against the four-hour target in A&E in England at type 1 sites (a figure that is comparable with Scotland) was 86 per cent during the month of January.

The table below shows comparison between NHS Scotland, England, Wales and Northern Ireland during the month of January. To note, ‘core’ sites in Scotland relate to ‘type 1’ sites in England, ‘major’ sites in Wales and ‘type 1’ sites in Northern Ireland.

The Local Delivery Plan (LDP) for 2015/16 sets out that the A&E four hour standard follows clinical advice to sustain at least 95 per cent of A&E patients being treated within four hours, as a step towards achieving 98 per cent, which is among the toughest A&E standard anywhere in the world.

Delayed discharge figures:

Figures published yesterday cover the quarter from October to December 2014 as well as the January census.

The full publication is available on the ISD Scotland website: http://www.isdscotland.org/

Workforce figures:

Statistics published yesterday cover the quarter from October to December 2014. The total number of NHSScotland staff in post was 137,511.9 whole time equivalent (WTE) and 160,524 headcount at 31 December 2014. This is an increase of 1.8% and 1.5% respectively since 31 December 2013.

The full publication is available on the ISD Scotland website: http://www.isdscotland.org/

NHS Performs:

A preliminary version of the NHS Performs website is expected to be established by the end of March 2015 to aid discussion amongst the users of NHS data. ISD will also be identifying how it plans to enhance the accessibility of its website in consultation with the public and other developments in the availability of statistics on NHS services.

ISD will produce a new section within their website for the initial release of NHS Performs on 3 March 2015, this will be signposted on their front-page.

Initial statistics available via NHS Performs includes:

Weekly statistics relating to Emergency Departments at hospital, NHS Board and Scotland

Number of A&E attendances, % seen within 4 hours, number over 4, 8 and 12 hours

Quarterly statistics relating to Hospital Standardised Mortality Ratios at hospital and Scotland

Standardised Mortality Ratio (SMR) and % Change in SMR since 2007

Weekly statistics relating to norovirus at hospital, NHS Board and Scotland

Total number of wards closed

Quarterly statistics relating to Healthcare associated infection at NHS Board and Scotland including C.diffice infections (over 15s) and SAB Infections.

Essential actions for unscheduled care:

In January the Scottish Government announced plans to roll-out and embed a new collaborative approach to unscheduled care across Scotland.

Developed in partnership with the Academy of Royal Colleges, the Royal College of Nursing and other key partners, the new essential action points for unscheduled care aim to ensure the whole NHS system works together effectively from a patient’s first contact with the NHS to, if they require admission, their discharge from hospital back into the community.

More information on this is available here: http://news.scotland.gov.uk/News/Review-of-out-of-hours-primary-care-1568.aspx