The Royal College of Emergency Medicine (RCEM) has issued a clarion call to the government, urging them to broaden their focus beyond elective care waits and address the pressing issue of prolonged stays in Emergency Departments (EDs). These dual challenges must be approached with equal urgency to ensure holistic improvements in the healthcare system.
Recent data from Public Health Scotland paints a stark picture of the current situation. In April 2025 alone, a staggering 117,827 individuals sought treatment at major Accident and Emergency Departments (Type 1) across Scotland. Alarmingly, almost a third of these patients (32.9%) endured waits of four hours or more. Moreover, over 10% faced delays exceeding eight hours, with 4.2% waiting for 12 hours or longer. These figures highlight a distressing trend of increased waiting times compared to April 2018, where only 1.3% waited over eight hours, and 12-hour waits were a rarity at 0.3%.
Compounding this issue is the significant number of hospital beds occupied by patients medically fit for discharge. An average of 1,854 beds per day were taken up by such patients, marking the second-highest figure for any April since the guidelines were revised in 2016. This bed occupancy directly impacts the ability to admit new patients promptly, exacerbating the bottlenecks in the system.
Despite the Health Secretary, Neil Gray MSP, announcing a £106 million investment to reduce elective care waiting times, with the promise of an additional 150,000 appointments and procedures this year, there was a notable absence of strategies to tackle long ED waits. This has sparked concern among healthcare professionals who witness the repercussions daily.
Dr Fiona Hunter, Vice President of RCEM Scotland, emphasised the necessity of a dual approach: “While reducing elective care waits is commendable, it is not the panacea. Addressing the severe issues within our Emergency Departments is equally crucial. Patients are left waiting in corridors, and there is a stark shortage of available ward beds. These are not just logistical issues; they are matters of patient safety and dignity.”
Hunter continued, “For an effective healthcare system, patient flow from ambulances to the ED, then to ward beds, and finally home must be seamless. Without this, prolonged ED stays will persist, compromising patient safety and care quality.”
As the RCEM calls for urgent political prioritisation of this issue, it is imperative that comprehensive strategies are developed to ensure that both elective and emergency care needs are met efficiently. This dual focus is not just a necessity but a moral obligation to provide patients with the timely and dignified care they deserve.
The RCEM has provided compelling graphic visualisations of the data, underscoring the urgency of this issue. The time for action is now, and with a concerted effort, significant improvements can be achieved in the Scottish healthcare system.
Source: RCEM: Government must address elective care waits AND long ED stays