image copyright image caption Scottish hospital emergency departments are under "winter-style
Emergency department admissions this year are almost 40% higher than pre-pandemic levels, figures show. A senior doctor told Hfrance.fr Scotland that emergency and emergency (A&E) services across the country are currently under "pressure winter type ", with no sign of relief. What is happening and why is it important?
What does admission data show?
Public Health Scotland publishes monthly figures on emergency services, most recent showing admissions until June 27.
Weekly admissions exceeded the 2018-2019 average in the first week of 2021 and have remained there since.
A total of 3,120 additional patients were admitted for accidents and emergencies this year compared to the 2018/2019 average, an increase of 37.6% .
At the start of April, admissions were 67.4% more than the 2018/2019 average, although this figure is now on the decline.
OthersPHS figures show that the proportion of people waiting more than eight hours in emergency departments in May was also very high for the time of year.
At the same time, " attendances "at A&E - the number of people showing up at the door - are actually lower than normal.
Attendance dropped dramatically during Scotland's two closures in 2020 and 2021. It is now increasing, but still below average levels.
So while 'there are fewer people who present to emergency services, a higher proportion of those who do are admitted through A&E forfurther treatment.
Do we know why this is happening?
Dr John-Paul Loughrey is the Vice President of the Royal College of Emergency Medicine (RCEM) and a consultant in healthcare Scottish hospital emergency.
He believes there are a number of factors behind the increase in admissions, but told Hfrance.fr Scotland that the main reason was that people came to A&E with more serious conditions at a later stage.
Many of these patients are "very sick" and suffer from illnesses rarely seen by A&E doctors.
media caption Dr John-Paul Loughrey: " People will turn to us from time to time when they are afraid or do not know what to do. " "
" We 're seeing a lot of people showing up late with problemss they may have tried to access health care but had difficulty ', Dr Loughrey told Hfrance.fr.
"But often these are 'other people who did not want to access care for fear of Covid in hospital systems. "
To this can be added many more children than normal brought to A&E with "febrile illnesses ".
Dr Loughrey said they would usually have been exposed to these viral illnesses during the winter when mixing in nurseries or school, but that they were rather locked in the house.
"We are seeing a lot more things this summer that would normally have calmed down by now.
People turn to A&E when they don't know what else to do
Dr Loughrey also believes that there is another factor at play: that A&E remains a "recognizable brand " "when much of the rest of the NHS was reconfigured to deal with the pandemice.
"We are open 24/7 and people know what they are doing when it comes to emergency service. has had such big changes in so many other services that some people find it difficult to understand and navigate health systems, "he said.
" People look to us when they're scared or don't know what to do - and that's totally understandable. "
Dr Loughrey's comments were echoed by NHS Lanarkshire , which is the only board of health in Scotland to see above-average emergency room attendance.
image copyright image caption Some of the people show up to the emergency room with sunburns or insect bites
The board of health said "unusually high numbers " were coming to A&E, including many who arrived with minor conditions like sunburns or insect bites .
Director of Acute Services Judith Park said: "The sustained pressure we are seeing at our three acute care hospitals shows no signs of sign of loosening.
"In fact, the pressures on our hospitals are as severe as at any time throughout the pandemic.
Covid admissions have always been impact
There is now strong evidence at vaccination has weakened the link between Covid infection and serious illness.
But the link has not been removed and people are still being admitted to the hospital for treatment.
Across Scotland, the number of people treated at home 'Hospital for Covid-19 fell from less than 60 in early May to 529 on July 21.
This means reconfiguring hospitals to separate Covid admissions, reducing flexibility and capacity.
And like everywhere else, emergency services must observe social distancing, which makes it more difficult to manage a higher number.of patients.
Fewer staff available to work
The overwhelming majority of NHS staff will now have received two doses of a Covid vaccine.
This should protect most of them from Covid-19 disease - but staff should always isolate themselves if identified as close contact.
As the The number of cases rose rapidly in Scotland in May and June, with the number of NHS staff reporting absences for a Covid-related reason as well.
Absences of NHS staff have doubled between June 8 and July 6, although the number is now thn decline.
Why are emergency room admissions important?
It is often said that the emergency department acts as a barometer for the rest of the NHS and what we can assess this summer is a health service that is running very hot.
Children coming in with infections usually expected in winter and people with advanced illness who may have had out to see a GP, or whose previous operations were canceled, more had to be admitted for further treatment, but beds are dhard to find.
Usually the summer months mean more capacity in hospitals, but the combination of Covid cases, staff absences and an increase in patients not Covid means hospitals are busier than ever.
There is also pressure on the other end - trying to get pe Opler out of the hospital means arrangements must be made be set up in the community so that they can go out safely. Some health boards have to cancel chores, just to create space, pushing issues further.
All of this is creating a backlog at the front door of the hospital - the emergency department - and doctors say it's worse than they've seen before. Too many patients wait more than eight or twelve hours for beds to become available or for an ambulance to take them home.
Staff say they are doing their best, but they are exhausted and theMorale is at an all-time low, not expecting things to get cold anytime soon.
What is the outlook for the rest of the summer?
According to Dr. Loughrey, long waits at A&E are usually something you would see during the winter months rather than May, but he says that there is "no sign " that this trend is going away.
"We will have to try to catch our breath and arm ourselves for the changes to come b because it is a challenge and it 's difficult "he said.
" Although the link between Covid infections and hospitalizations is weakened, it certainly has not broken up.
"Having seen reports from friends and colleagues across the country, I am worried what the UK emergency services will go through over the years. next three months, before even reaching winter. "
right Image copyright Peter Cade image caption Dr Loughrey says staff will need to "steel " them- same for upcoming changes
What is the Scottish government saying?
The Scottish government has said it wants to encourage people to consider options "more near them "before going to A&E, including the NHS Inform website or by contacting their GP or local pharmacy.
A spokesperson added: "We are fully aware that theHospitals are facing significant challenges due to an increase in non-Covid attendance and some health boards are taking action to protect emergency care capacity.
" This is why we have released £ 12million in additional funds for boards of health across Scotland to support non-Covid emergency care.
" This will help put in place measures to reduce wait times for urgent or emergency treatment, with a focus on increasing staff and available beds. "