Patients are happy but there is pressure on emergency care services
An Audit Scotland report, Emergency departments, says patient satisfaction with emergency care services is high, and four out of five patients we surveyed said the care they received was excellent or very good.
However there is widespread variation in the services provided at hospital emergency departments and a lack of clarity about where best to treat different patients. For example, it can be confusing for patients and staff about when it is appropriate for patients to be seen in a minor injuries unit rather than an emergency department.
Attendances, costs and workforce pressures are rising, and the NHS in Scotland can do more to manage these services more efficiently.
Auditor General for Scotland, Robert Black, said:
“Emergency care is a vital part of the health service in Scotland and more people are attending these services. Patients are happy with the care they receive and the length of time they wait to be treated has reduced with the introduction of a four-hour target.
However, information about the quality and effectiveness of care provided is limited, for example there is little information about the medical condition of patients attending emergency departments. The services available for vulnerable groups, including people with a mental health problem, vary across Scotland.
There are also emerging staffing issues, such as shortages in junior doctors and the impact of European working hours legislation, that must be tackled at a national level, not just locally. All of these factors highlight that there is a real need for a clear national approach to emergency care so that we can get the best out of the resources available.”
In 2008/09, there were 1.4 million attendances to emergency departments, a rise of nine per cent over a decade. The cost of emergency departments was £148 million in this year.
The report highlights that attempts to reduce attendances at emergency departments are not underpinned by an assessment of what works or how much it would cost to have people treated in another setting, such as a minor injuries clinic, where this is appropriate. Closer working across the whole health and social care system is needed to make further improvements.
