Recent improvement but NHS in Scotland still faces challenges achieving A&E waiting times target

Performance against the four-hour accident and emergency (A&E) waiting times target has deteriorated since Audit Scotland previously reported on A&E departments. The number of patients who waited longer than four hours increased from around 36,000 in 2008/09 to around 104,000 in 2012/13, although performance improved during 2013.

The Audit Scotland report, Accident and Emergency Performance Update, which is published today, reports on the NHS in Scotland’s performance against the A&E waiting times target and looks at why patients are waiting longer than the four-hour target.

The report says:

• Although performance against the A&E waiting times target is not as good as when last reported, it has improved in recent months. In December 2013, more patients were seen within four hours compared with the previous December. However, performance against the A&E target varies considerably between A&E departments and many face challenges meeting the 95 per cent target.
   
• A&E departments are part of a complex health and social care system and a lot of factors can lead to patients being delayed. These include staffing pressures, and hospital beds not being available at the time when A&E patients need to be admitted.
   
• The Scottish Government launched the National Unscheduled Care Action Plan in February 2013. It is too early to comment on the impact of the Action Plan, but the Scottish Government and NHS boards are taking steps to address some of the causes of delays in A&E.

Auditor General for Scotland Caroline Gardner said:

“A&E departments provide a really important service in assessing and treating patients with serious injury and illness. Maintaining good performance in A&E was one of the Scottish Government’s key objectives in 2013/14.

“Delays in A&E can be a sign of pressure across health and social care. While there has been improvement in performance, such as the progress made in tackling the longest waits in A&E, performance against the target still remains lower than it was when we last reported.

“It is important that the Scottish Government and NHS boards build on their whole system work and continue to reduce delays for A&E patients.”

Today’s report recommends that the Scottish Government shares good practice on initiatives that can help improve performance and therefore improve the experience for patients.