EMERGENCY department delays will have harmed or killed more than 30 patients in the past week alone, clinicians have warned.
For the first time on record, more than 1000 patients spent over 12 hours in A&E departments last week and one in 10 were delayed by eight hours or more.
Previous research has shown that lengthy waits in A&E for patients requiring admission into hospital substantially increase the risk of poorer outcomes or death within 30 days.
Dr John Thomson, the vice president of the Royal College of Emergency Medicine (RCEM) in Scotland, said the situation is the “biggest patient safety crisis in emergency care for a generation”.
READ MORE: 'Living with Covid' is wrecking the NHS - so where do we go from here?
Pressure on beds is being driven by soaring rates of Covid which is resulting in high numbers of Covid positive patients being admitted to hospital who must be isolated, along with staff shortages due to the infection, and outbreaks in cares homes exacerbating delayed discharge.
Combined, these factors are significantly reducing the number of beds available on wards which in turn creates bottlenecks and overcrowding in A&E.
It comes as Nicola Sturgeon is set to update the Scottish Parliament on the Covid situation today, with pressure from opposition MSPs to finally lift legal requirements for facemasks from April.
Dr Thomson said: “Each week the Urgent and Emergency Care crisis worsens.
“Scotland’s Emergency Care system is failing patients who are coming to harm, and failing staff who are overworked, exhausted, and burned out but are left to cover the widespread shortcomings of the health system.
“Shortages of beds, shortages of staff, the social care crisis; existing staff do all they can to keep patients safe in these exceptionally challenging circumstances.
“It is an untenable and unsustainable situation.
“This week saw the highest number of long waits on record yet again. Data show that there is one excess death for every 82 patients delayed for more than six hours.
“This week 2,615 patients were delayed by eight hours or more, from this we can estimate that over 30 patients in this week alone could have come to associated harm or death as a result of their delay to admission.”
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Overall A&E attendances are normal for the time of year, but in the week ending March 20 only two thirds (66.2 per cent) of people presenting at emergency departments were seen, treated and then either admitted, discharged or transferred within the target time of four hours.
This is the lowest level of compliance on record.
Out of the 25,506 attendances in total, 1,015 patients - one in every 25 - spent more than 12 hours in A&E.
However, the RCEM has warned that delays in excess of 24 hours have also become increasingly common.
Dr Thomson added: “The significance of this appalling harm must not go unnoticed and must be met immediately with effective and meaningful action.
“The Scottish Government must understand the severity and extent of harm befalling our patients, and see that existing staff facing moral injury, going above and beyond, running on goodwill and adrenaline is not reasonable or acceptable.
“This can no longer be the sole answer to the biggest patient safety crisis in emergency care for a generation. This must not continue.”
Modelling by Scottish Government epidemiologists suggests that the number of Covid positive patients in hospital could soar to almost 7000 by April - equivalent to half of all acute beds - if the public’s behaviour becomes less cautious. Even central estimates put the figure at 3000-4000 within the next two weeks.
The latest data shows that there are 2,383 Covid positive patients currently in hospital, up from less than 2000 in mid-March.
The prevalence of the virus has also continued to climb, reaching a record one in 11 in the latest surveillance.
Health Secretary Humza Yousaf has said all four UK nations are “looking towards developing an exit strategy” for the NHS and “considering what a return to business as usual looks like going forward”.
This is expected to include a review of physical distancing - which remains in place for healthcare settings and reduces capacity - as well as reconsideration of isolation protocols in some circumstances in order to free up beds and potentially ending requirements for asymptomatic NHS staff to test for Covid twice a week.
Scottish Labour deputy leader Jackie Baillie said: “Thousands of lives are now being risked in A&E departments on a weekly basis – this is completely unacceptable.”
Scottish Tory health spokesman Dr Sandesh Gulhane said: “It’s now more than six months since Humza Yousaf’s patently inadequate Covid recovery plan was published, yet we’ve still seen no plan B for tackling the ever-growing A&E waiting times.”
Mr Yousaf said: "The Chief Nursing Office is now reviewing national Infection Control guidance with a view to easing current restrictions which have added to hospital pressures through reduced bed numbers.
"Staff absences and a growing number of acutely unwell patients, resulting in longer stays, is also having an impact."
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