NHS staff are being "asked to do the impossible" amid bed and staff shortages, according to a leaked email from Glasgow's flagship superhospital.
Scottish Labour leader, Anas Sarwar, who shared the email during today's First Minister's Questions said delays facing some of the sickest patients treated in Acute Assessment Units prior to admission are also being missed because they are not included in A&E statistics.
The AAU, sometimes known as a medical receiving area, is a dedicated facility for patients who present as clinical emergencies or develop an acute clinical problem while in hospital.
Generally these units have both trolleyed areas and staffed beds which are included as part of the hospital's bed capacity.
It comes as freedom of information data obtained by the party shows that more than 4000 people have spent over 24 hours in emergency departments over the past year, including 243 waiting over 48 hours.
READ MORE: Scotland's winter deaths third highest in 20 years in 2021/22
Mr Sarwar said: “The facts show that A&E is in disarray – but they only show one part of the picture.
“Thousands of people every week are seen in Acute Assessment Units.
“These people are amongst the most sick and have been referred straight to hospital by their GPs.
“They wait hours for treatment, but many of their waits aren’t recorded.
“At the Queen Elizabeth – in one unit, in one night this week – 48 patients spent the night on trolleys in waiting rooms, in side rooms, in corridors and some even had to sleep on chairs.
“None of them will be captured in waiting times statistics."
Mr Sarwar noted that an email sent to doctors from management at the Queen Elizabeth University Hospital (QEUH) in Glasgow this week said the was "no space" left in medical receiving areas or in the Emergency Department to accommodate new patients, with clinicians urged to free up beds where possible.
The memo, passed on by a whistleblower, states: "Yesterday was an extremely busy day and the receiving areas are very substantially over capacity this morning.
"There is currently no space to assess any new patients in the medical receiving areas or in ED and generating some beds early is very important.
"We are all being asked to perform the impossible in extremely challenging circumstances. The current staffing (particularly nursing staffing) pressures make providing high quality care very difficult and the degree of acuity and frailty in our in-patients is greater than it has ever been."
The email urges staff to "prioritise seeing patients who may be able to go home after dealing with any sick patients today and focus on promoting discharge whenever it is possible", adding that "there is likely to be limited boarding capacity today as patients awaiting surgical admission are also facing long delays".
READ MORE: Is it really true to say that Scotland's A&E departments outperform England?
Boarding refers to moving patients to another department where a bed is available but which does not specialise in their particular condition.
First Minister Nicola Sturgeon said there was "much work to be done" with Scotland heading into a "very challenging winter period", but the most recent week had seen a reduction the numbers of people waiting over eight or 12 hours in A&E and improvements against the four-hour target.
She said: "The situation is challenging in Accident and Emergency but it is because of the actions we are taking to employ more staff, to put more money into the National Health Service - the £50 million urgent, unscheduled care collaborative for example - that we will see progress in A&E waiting times."
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