Hospital Emergency Departments (Waiting Times)
To ask the Scottish Government what it is doing to support hospital emergency departments in light of reports of increased waiting times and concerns that general practice closures over the festive period will exacerbate the situation. (S4T-00866)
Every year, national health service boards and their partners develop robust plans for winter. The winter planning guidance for NHS boards that was issued in September specifically focuses on the two four-day festive holidays.
This year, we have invested more than £18 million to support health boards, to improve how emergency care operates in hospitals and to address delayed discharges, particularly over the winter months. The investment will provide increased nursing, increased emergency ambulatory care capacity to reduce unnecessary hospital admissions and increased consultant presence at weekends. Furthermore, NHS 24 has received additional resources to answer calls over the festive period. It plays a key role in facilitating access to NHS boards’ out-of-hours general practitioner services, which are available, each year, throughout the festive period. The NHS 24 111 freephone number will often be the best first port of call for anyone with health concerns this festive period.
The issue is not about the outstanding work of those in our NHS; indeed, they have our full support.
I am not comforted by the minister’s response. This year, more than 100,000 patients waited more than four hours in accident and emergency departments. In the 12 weeks to the end of September, almost 2,000 patients had to wait more than eight hours. That is more than twice as many as last year. Winter is knocking at the door, which will only exacerbate the situation.
What will the Scottish Government do in the next week with that new information to work with NHS boards to ensure that struggling emergency departments are able to cope throughout the winter?
It is right that we pay tribute to the outstanding work of our health service staff; winter always brings challenges, and they do a fantastic job to overcome them.
We have been working with local boards to make sure that their winter plans are robust. That conversation is on-going. I have been asking the boards to test their plans to make sure that they have the capacity to cope with winter pressures. They are used to dealing with such pressures. Every year, they staff up and make sure that they have winter-resilient plans. This year is no different, other than the fact that we have the two four-day festive holidays. Because of that, there has been particular focus on making sure that health boards are absolutely prepared.
There is an important message to the public in all this, so NHS 24 has been running the be health-wise this winter campaign, which is advising people not just to stock up on the usual remedies and to ensure that they have their repeat prescriptions, but to know—this is important—where to turn if they become ill. NHS 24 opens the door to out-of-hours GP services and all the other the services that people may require. It is important that we all, collectively, send a message to the public that NHS 24 should be the first port of call.
The British Medical Association has said that there is a “weekly crisis” in A and E departments and GP out-of-hours services. The Government said six years ago that it would reduce pressure on emergency departments by improving primary services for minor ailments, but the numbers attending A and E are, at 198 an hour, higher than ever.
The system is in crisis after seven years of this Government. With that in mind, and with the trend increasing, how does the Scottish Government propose to reverse that trend, given that the work to date has not been adequate?
I could remind Jim Hume about the number of delayed discharges and pressures on A and E before 2007, but I will move on to talk about what we have done, the considerable work that has gone in and the £50 million investment in unscheduled care.
We have done that to make sure that systems are in place that avoid people turning up at A and E in the first place. A lot of work is going on in the community to avoid admissions, particularly by vulnerable elderly people, and to make sure that, where possible, elderly people can be treated at home or in other settings. We are also making sure that we have step-up, step-down facilities to get people out of acute beds as quickly as possible. Importantly, however, we are making sure that we avoid people needing to go into hospital in the first place by giving them a different place to go where rehabilitation and support can be given. All those measures are important, which is why they are being taken forward.
In addition, I have given top priority to delayed discharge, because, as Jim Hume said, a challenge in getting people through accident and emergency speedily is the availability of beds in the system, and delayed discharge has a huge impact on that.
That is why the issue is a top priority. Investment is going in, not just to deal with delayed discharge this winter, which we will have to do if we are to alleviate pressure on the system, but to tackle the issue and get delayed discharge out of the system once and for all. That is my commitment as we go forward over the next few months.
NHS Lothian is struggling to recover from the waiting times scandal, and we read in the Evening News that there is a £70 million funding gap, which a senior board member described as a “very dire picture”. Given concerns about increased waiting times and GP practice closures over the festive period, what assistance and advice can the cabinet secretary offer patients who are worried about the impact of the budget crisis on NHS Lothian and on patients?
First, the assurance to patients will be that NHS Lothian will manage its financial processes, as other boards do, and will get into financial balance by the end of the year. Of course, boards are getting a real-terms increase in their uplift and will get that in the next financial year.
Just last week, the member was calling for money to go into social care. One week he calls for money to go into social care, and the next week he calls for the same money to be magically produced and spent in the health service.
No crisis, then?
As the member would know if he had heard John Swinney announce this, we have committed to the consequentials from the autumn statement all going to health—again, that is something that the member, who is his party’s health spokesperson, has refused to confirm that he would do.
No crisis, then. It’s all fine.
Mr Findlay—
I do not underestimate the challenges that face the health service, and I am determined to tackle them. However, I will take no lectures from the member on those matters.
Mr Findlay, you must stop heckling across the chamber.
I call Dave Thompson to ask question 2.
Sorry, Presiding Officer, my microphone is not working. It has come on now—I do not think that that was my fault, anyway. [Interruption.]
One moment, Mr Thompson. Will you sit down, please?
Mr Findlay, I have warned you about heckling
I—
Mr Findlay, will you stop arguing with me? I have warned you about heckling; will you please desist and behave yourself?
I call Dave Thompson.
Cold Weather Disruption
To ask the Scottish Government how it will ensure that disruption as a result of cold weather this week is kept to a minimum. (S4T-00870)
The current weather situation is that we have a windy and unsettled week ahead of us, with many areas of the country experiencing their first snowfall of the season.
Although such weather is not unusual in Scotland at this time of year, it is necessary to prepare accordingly. Plans are in place and all responders are working together to that objective. Gritters have been active in supporting the essential work that is required on the trunk road network.
In addition, the resilience division has convened a meeting of our resilience partners from across Scotland this afternoon, and later today there will be a ministerial resilience call to discuss the preparations. The Scottish Government’s resilience response has been activated, along with the Transport Scotland multi-agency response team, to oversee the co-ordinated efforts of responders and local partnerships.
On Sunday the transport minister observed gritting preparations in the west of Scotland, and earlier today I visited the new Transport Scotland control centre in South Queensferry, where I saw the extensive arrangements that are in place to keep the country moving and provide the best possible advice to members of the public.
One of the challenges in previous winters has been the availability of salt. Can the Deputy First Minister reassure people that stocks this year are appropriate? Is there any way that motorists can get information on where gritters will be and when?
The salt stocks in Scotland as at 1 December 2014 are 639,120 tonnes, which includes 90,000 tonnes in the strategic salt reserve. That is almost double the stock that was used last winter, and as much as was used during the severe weather in 2010-11, which was a particular challenge for our resilience operations.
The information on gritting operations that are undertaken on the trunk road network is visible in real time on the Traffic Scotland website. It indicates the routes that are supported and is updated daily so that members of the public can access it. There are also back-up arrangements by which additional gritting services can be deployed if urgent circumstances materialise.
Highland Council is planning to leave secondary roads with little traffic unsalted in the early morning as the salt does not work unless it is driven on. Does the cabinet secretary agree that that is worth considering?
Obviously, judgments must be arrived at a local level by individual authorities, which will have to take into account particular circumstances in their own localities, given that conditions can vary quite dramatically from area to area.
Although we take a proactive approach to the trunk road network, and the gritting operations are well advertised on the Traffic Scotland website, individual local authorities come to appropriate conclusions depending on the circumstances in their locality.
During the particularly cold period that we experienced exactly four years ago this week, there was considerable disruption on the railways as a result of frozen points. We were told at the time that there was a programme in place to heat points electrically in the future. At this stage, do we know whether the programme has been completed, and can we avoid the same problem if we should suffer similarly cold weather?
A series of incremental steps has been taken to ensure that that has taken place. The rail network has been upgraded to ensure that we have greater resilience on these questions. Mr Johnstone will appreciate the extremity of temperatures that was experienced four years ago; the circumstances that we believe we will face in the next seven days will not mirror temperatures of anything of that order whatsoever. There is greater resilience, but the process is incremental and will take some time to complete.
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