This item was published during the term of a previous administration that ended in April 2007
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Scottish A&E departments lead UK
29/11/2001
Stirling Royal Infirmary, with some of the shortest waiting times for emergency treatment anywhere in Scotland, was today held up as an example of the NHS at its best.
First Minster Jack McConnell visited the Accident and Emergency department on the day a survey of A&E waiting times was published and said other hospitals should learn from what Stirling has been able to achieve.
The survey shows that A&E departments across Scotland are dealing with nearly 1,500 more patients per week, or 6 per cent, than a year ago but that doctors, on average, manage to see nine out of 10 more serious "trolley cases" within 19 minutes of arrival, providing the fastest casualty performance in the UK. At Stirling the waiting times are consistently lower.
Mr McConnell said:
"The delivery of first-class public services is at the top of our agenda. It's a priority we share with health service staff across Scotland who work incredibly hard to provide the high quality services the public demand.
"Stirling Royal Infirmary's Accident and Emergency Department is a good example of the NHS at its best. Motivated staff, working as a team, delivering fast, effective care for patients and using their resources and talents to the full.
"It has one of the best records for A & E waiting times in Scotland and is an example of best practice which I know other hospitals will look to when planning improvements to the services they provide. That is the big challenge ahead for all our public services.
"With me, I want all those who work in and lead our health service to look to the shining examples of good practice around the country. To look. To learn. To act. The standards of the best must become the standards for all. Our job, together, is to raise the standards of all to meet the standards of the best.
"We have made record levels of investment in our health service over the last few years, but we must look at using that investment more effectively. We need to target our investment wisely, make the best use of the experience and ability of everyone in our local health teams, support our local leaders to lead.
"By letting the front-line staff in hospitals and health boards across the country lead, we can deliver the people's priorities by making the improvements that really matter."
Health Minister Malcolm Chisholm praised all Scottish casualty staff for their "superb peformance" and promised that GPs, nurses, pharmacists and other local family health professionals would be given more support to take the strain off front-line A&E services.
The Minister also set out the package of measures already underway to expand local family health services and so free up hard-pressed casualty staff to deal more effectively with serious emergencies like heart attacks and road traffic accidents. These measures are backed by £100 million of public investment in the NHS.
Measures include:
- the roll-out within the next year of NHS24, Scotland's first round-the-clock patient advice line delivered over the phone by trained nurses
- recruitment of extra practice nurses and other health professionals to support GP's and expand the delivery of services like minor surgery, which have traditionally been carried out in hospitals
- £18.5 million to support GP's and their teams to work more flexibly to improve access to services for patients, including later opening hours and Saturday clinics
- the modernisation of A&E services in 12 areas of the country backed by £11 million of additional investment, with further public investment in a major A&E service for the Highlands already planned
Mr Chisholm said:
"The doctors and nurses working in our frontline casualty departments are doing a tremendous job. They are seeing more patients than ever before - 1,500 a week more than just a year ago. And, as more minor complaints are treated in local health centres and GP practices, they are seeing a higher concentration of serious cases than ever before.
"Despite these pressures, patients are being seen faster in Scotland's A&E departments than in any other part of the UK. Nine out of ten patients with more serious problems, known as 'trolley cases', wait less than 20 minutes before being seen by a nurse, most see a doctor within half an hour, and full treatment is completed in less than 4 hours. By any standard, that is a superb performance and one that should be praised by everyone.
"However, we cannot be complacent. The long-term trend shows that there are 5,000 more patients a week presenting themselves at A&E now than in 1997 - an increase of 25 per cent. A&E services in 12 areas of the country are now being modernised and upgraded - backed by £11 million of extra investment. More investment is planned. But we need to do more still. Patients are concerned by delays in the NHS. I want to turn that concern into positive action.
"The NHS needs to get better at providing patients with the right services, in the right place, and at the right time for their needs. Increasingly, that means expanded services close to home, in local health centres and local GP practices. It's happening in a small number of places - but I now want to see good practice spread quickly and widely.
"More services provided in a more flexible way by family doctors, practice nurses, health visitors and pharmacists will take more pressure off our busy casualty departments - leaving them to deal with real emergencies like heart attacks and the effects of road traffic accidents.
"Expanding these local services needs investment - and changes to the traditional way the NHS works. Expanding services like minor surgery in the community, and developing flexible opening hours are central to building a truly patient-centred NHS. And we are delivering investment to recruit more practice nurses and health visitors, and pilot new contracting arrangements to allow GP's to be employed directly by the NHS.
"But we must also use investment more effectively - doing better not just doing more. We need to make best use of the skills and talents of all the local health teams - the nurses, pharmacists, health visitors and others who support family doctors. And we must harness the benefits of new ways of delivering health care, like our 24 hour NHS advice line due to 'go live' next year - providing patients with advice from a trained nurse on the end of a phone.
"But the key message today is about delivery. Improvements must stop being isolated examples - they must become the norm. We must get best - and better - value for the national investment we are making in health. We must deliver the support frontline staff need to do their jobs. And we need to see local leadership in the NHS speed up the pace of change and improvement in local services for patients."
The survey of A&E waiting times was carried out over a one week period in April/May 2001. Almost 1,500 more patients were seen in the week-long survey compared with the previous year - an increase of 6 per cent.
The A&E survey looked at 'trolley waits' (for more serious health needs) and 'walking wounded' (for less serious complaints.) The survey found:
- 9 out of 10 trolley cases triaged within 19 minutes, and 26 minutes for walking wounded
- 9 out of 10 trolley cases had entire treatment completed in less than 4 hours, and less than 3 hours for walking wounded
- more than half of all trolley cases see a doctor within 30 minutes.
An independent survey of waiting times in A&E departments held earlier this year confirmed that performance in Scotland was the best in Britain.
NHS in-patient waiting lists are also published today by the Executive's Information and Statistics Division. They show that at September 30, 2001, some 81,250 patients were waiting for in-patient and day case treatment - a reduction of 2,237 on June and a fall of 5,290 compared with a year ago. Three patients waited longer than 12 months for treatment, compared with 446 patients a year ago.
Average (median) waiting times for a first outpatient appointment are 47 days and 34 days for inpatient and day case treatment. Around 80 per cent of patients in Scotland are still treated within three months of entering a waiting list.