NHS Scotland: More than 12,000 patients stuck in A&E for over 12 hours

However, the figures mean that, for the first four months of 2022, more than 12,600 people requiring admission have spent 12 or more hours on trolleys and chairs in A&E due to a shortage of available beds on hospital wards.

That compares to an average of just 1,584 for the same four-month period pre-pandemic, from 2017 to 2019.

READ MORE: 'It's not unusual for patients to wait days for a bed' - the inside story of Scotland's A&E crisis

Studies have repeatedly shown clear links between avoidable deaths and admission delays of five or more hours, which are typically caused by “exit block” - where patients cannot move out of A&E to their next stage of care due to capacity constraints elsewhere in the NHS.

Separate figures from PHS show that an average of 1,787 beds were occupied in April by patients well enough to leave but unable to be discharged amid a lack of social care.

Source: Public Health Scotland

The delayed discharge figure is the highest since the pandemic began, and exceeds a previous peak of around 1,600 in February 2020.

The median length of time a “delayed” patient was spending in hospital in Scotland had also climbed to 22 days in April.

It comes days after a report by the Royal College of Emergency Medicine (RCEM) warned that the NHS UK-wide requires an extra 13,000 staffed beds “to drive meaningful change and improvement in A&E waiting times, ambulance response times, ambulance handover delays, and a return to safe bed occupancy levels”.

It estimates that around 25,000 acute NHS beds have been taken out of active service since 2010, including 4,227 in Scotland.

Dr Adrian Boyle, vice president of the RCEM, said: “The situation is dire and demands meaningful action.”

During April, the number of hospital beds occupied by Covid positive patients - who must be isolated regardless of symptoms - roughly halved from a peak of 2,406 at the beginning of the month to 1,275 by the end of April.

(Source: Public Health Scotland)

More recently Covid occupancy has levelled off and plateaued around 600-700 hospital patients.

However, the number of elective procedures being scheduled during April on NHS Scotland remained a third (33.5 per cent) down on pre-pandemic levels, with an increase in the proportion of last-minute cancellations which were due to “non-clinical or capacity” reasons - such as a lack of inpatients beds, available theatre space, or staff.

It comes after figures published last week showed that the number of people on waiting lists for inpatient or day case treatment who had been waiting over two years had doubled between December and March, reaching 10,613 by March 31.

This included nearly 3000 orthopaedics patients, with general surgery, ENT (earn, nose and throat) and urology patients also facing some of the longest waits.

In total in Scotland, 131,620 people were waiting for an inpatient or day case procedure on the NHS by March 31 - an increase of more than 70% compared to 2019 levels.

Elective activity remains well below pre-pandemic levels (Source: Public Health Scotland)

Scottish Labour’s deputy leader and health spokeswoman Jackie Baillie said: “Delayed discharge is spiralling upwards and upwards, with the number of bed days lost soaring.

“At the same time the number of operations remain way below pre-pandemic levels and are continuing to fall.

“Our heroic staff are facing burnout and exhaustion with vacancies at unacceptable and worrying levels."

Scottish Conservative health spokesman Dr Sandesh Gulhane said the delayed discharge figures were "both a symptom and a cause of the crisis in Scotland's NHS and social care system", adding: "Having patients stuck in hospital because there is no place for them in a care home is not only soul-destroying for the individuals concerned, it has a huge knock-on effect elsewhere in our health service.

"The shortage of hospital beds adds to delays in A&E and leads to cancelled operations and procedures, worsening the already unacceptable treatment backlogs and waiting times."

READ MORE: 'It needs to be above inflation' - Nurses gear up for government pay talks 

A spokesman for the Scottish Government said the NHS is also dealing with "record numbers of patients delayed under the adults with incapacity legislation".

He added: "These are patients who, although clinically ready for discharge, cannot be legally discharged without a court-appointed guardian being in place.

"We employed a mental health officer to work with partnerships to identify the barriers within this legal process at local levels and will be turning this into an action plan to drive improvement."

Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton MSP said thousands were being left "in pain and unable to get on in life" while the backlogs gets "longer and longer".

He added: “Staff on the frontline need extra protection and if they aren’t retained then every plan to stem the backlog of operations will fall flat.”

Workforce figures, updated yesterday, reveal that the number of full-time nursing and midwifery vacancies rose by almost 40%, from 4,495 at the end of March 2021 to 6,209 by the same point this year.

READ MORE: 'Risk to patient safety' on 33 wards at Glasgow superhospital during latest Covid peak 

Of the unfilled posts, more than 1,550 have been vacant for three months or longer, while the rate of non-Covid sickness absence for the NHS workforce as a whole has also increased from 4.7% to 5.7%.

Colin Poolman, interim director of the Royal College of Nursing (RCN) Scotland, said: “These statistics make very difficult reading for nursing staff all across Scotland who have more than proven their worth in the past two years.

"They deserve more than to turn up to work shift after shift and be expected to deal with significantly increased demand with fewer and fewer nursing staff. NHS boards are having to spend even more money on bank and agency staff to try to fill the gaps."

The RCN, which is currently hosting its national congress for members UK-wide in Glasgow, is pushing for an above-inflation pay rise for nurses to improve recruitment and retention, and wants the Scottish Government to set out a "clear timetable" for the implementation safe staffing legislation, which was delayed by Covid.

This would require workforce targets to be negotiated based on safety needs, rather than budgets.

Speaking to the Scottish Parliament's finance committee yesterday, Finance Secretary Kate Forbes said healthcare workers were unlikely to be affected by plans to reduce Scotland's public sector workforce to "pre-pandemic levels".

Estimates suggest 30,000 jobs may need to be cut by 2026/27 to reduce the pay bill of more than £21 billion.

The Scottish Government previously set out plans to clear the NHS treatment backlog through the creation of a dedicated network of elective hubs capable of carrying out an extra 40,000 inpatient and day case procedures annually by 2025/26, with the recruitment of an additional 1,500 clinical and non-clinical staff.

A Scottish Government spokesman added: "The whole health and social care system is under severe pressure and staff continue to work tirelessly to provide safe care."