The Scottish Ambulance Service (SAS) has declared emergency status following significant pressures on its operations, prompting the Scottish Government to take decisive measures. The service escalated its resource escalation action plan (REAP) to level four, the highest possible level, which could lead to the cancellation of staff leave and the mobilization of all available personnel to address increased demand for emergency assistance.
Despite these challenging circumstances, the Scottish Government has reassured the public about the service's ability to respond to critically ill patients. According to government officials, patient safety remains the top priority. A government spokesperson emphasized, “The Scottish Ambulance Service has implemented a level four resource escalation action plan to utilize all available resources to respond to 999 calls.”
Last week alone, ambulance crews across Scotland successfully managed to respond to 514 of the highest priority emergency calls, achieving this within an average response time of seven minutes and 41 seconds. The Government is committed to ensuring there are no unnecessary delays when transferring patients to hospitals, working closely with health boards and the SAS to maintain rapid responses to the most critically ill individuals.
Current pressures on the ambulance service have prompted concerns from health officials and trade unions about the sustainability of the system, especially during the winter months. A spokesperson for the SAS noted, “We are working with health boards to do everything we can to get our crews back on the road to help patients. Our staff are working extremely hard and we continue to prioritize those patients who are most critically ill.” Non-critical patients may experience longer wait times for ambulances, potentially exacerbated by system-wide issues such as lengthy hospital handover times, and significant increases in respiratory virus cases.
Colin Poolman, director of the Royal College of Nursing Scotland, warns of the overwhelming demand becoming a year-round problem. He stated, “The pressures are getting unbearable and unsustainable ... these are symptoms of a service at breaking point, and the Scottish Government needs to invest in all parts of the system.” His call for expanded workforce support reflects growing concern over the potential impact on patient care as pressures mount this winter.
The situation is acute, as highlighted by reports indicating patients are waiting excessively long for treatment. The Daily Record reported on one occasion where a patient had to wait for 12 hours inside an ambulance outside the Royal Edinburgh Hospital. Tragically, both the Scottish Conservatives and Labour have pointed out statistics indicating over 2,000 individuals are estimated to have died this year from delays within A&E departments. They referenced research from the Royal College of Emergency Medicine, which noted there could be one additional death for every 72 patients who wait between eight and twelve hours in A&E.
According to the Conservatives, this means there could be as many as 2,181 excess deaths this year alone based on the number of patients who waited over eight hours for emergency care. Labour's estimates have suggested similar figures, with 147,223 Scots waiting beyond this threshold between January and October this year, equaling approximately 2,045 excess deaths. Ongoing statistics reveal alarming trends, such as just under three out of five patients (59.7%) being seen and either admitted, transferred, or discharged within the targeted four-hour window during the week ending on December 8.
Scottish Health Secretary Neil Gray defended the performance of Scotland's core A&E services, noting they have remained the best performing in the UK for the past eight years. Yet, he acknowledged the persistent pressures on health services since the COVID-19 pandemic. He stated, “The Scottish Government is committed to delivering improved performance across A&E services, ensuring we provide timely emergency care for all citizens.” The continuous recruitment efforts to bolster the workforce reflect this determination, with 1,388 additional staff hired since 2020 and more recruitment planned for the current year.
With these developments, the Scottish Ambulance Service stands at the forefront of addressing increasing healthcare demands, working tirelessly to balance immediate patient care needs with longer-term systemic challenges. The interplay of staffing, resources, and patient care remains under scrutiny, as stakeholders call for urgent government investment to rectify the mounting pressures on Scotland’s health services.
