Bed shortages blamed for waits

A lack of beds is being blamed for casualty waits

More investment is needed to tackle the "unacceptably high" waiting times in Scotland's accident and emergency (A&E) wards, according to the British Medical Association.

The call comes after a national survey of A&E departments concluded that bed shortages were to blame for the majority of delays.

In Scottish hospitals, delays in the discharge process for patients are cited as "creating significant problems".

The BMA report said that in many cases changes could not be made because of "inadequate funding, not enough staff and a lack of management support".

'Poor facilities'

During the study, 160 A&E consultants, representing 40% of hospital departments in the UK, were asked for their views.

The national survey found that:

• patients waited for more than 24 hours in one in five departments (during the week before the survey)

• the longest reported wait was three-and-a-half days (in the week before the survey)

• half the respondents did not accept that most attendees spend four hours or less in A&E.

Dr Peter Terry, chairman of the BMA's Scottish Consultants Committee, blamed poor facilities and staffing for the problems.

He said: "Accident and emergency departments are working at the NHS front-line.

Casualty units were surveyed

"Too often, the staff who work in this vital area are doing so in facilities that no longer meet the needs of modern emergency medicine.

"Sadly, many are prevented from making changes because of inadequate funding, not enough staff and a lack of management support."

The study concludes the single most important step for improving waiting times in A&E is increasing the availability of hospital beds.

It said this could be achieved by having a bed occupancy rate of less than 85% and having a senior member of staff on hand to prevent unnecessary admissions.

'Investment needed'

Significantly, the report called for improvements to "the funding and provision of community care".

Dr Terry added: "I would hope that the Scottish Executive consider the content of this study and recognise that while we are performing marginally better than our colleagues in the rest of the UK, emergency care requires continuing investment.

"They must encourage and support the development of services by sharing good practice from across the UK.

Facilities available to staff were criticised

"Solutions throughout Scotland will be different depending on local circumstances, but we could benefit from sharing ideas with colleagues across the UK."

The BMA study also highlights examples of "good practice".

It said that in Grampian, technology is helping to create a "Telemedicine link between Aberdeen Royal Infirmary and community hospitals in the remote and rural areas of the region".

The report said this innovation was allowing GPs working in small A&E units to provide care for patients who would previously have had to transfer to the city hospitals.