More patients set to be redirected away from A&E in bid to cut wait

Patients arriving at accident and emergency departments will be sent away if more appropriate treatment is available elsewhere in a bid to reverse record-long waits for treatment.

Humza Yousaf has issued new guidance for A&E departments across Scotland that would see them refer patients to GPs, pharmacies or told to look after themselves.

It follows yet another week where A&E waiting time performances have fallen to record low levels, with 30.4% of patients not seen within the four-hour target.

Despite patient numbers being significantly lower than before the pandemic – September 2021 saw 19,417 fewer patients attend A&E compared to September 2019 – the percentage of patients seen within the target time has plummeted over the past year.

The guidance being issued by the Scottish Government is based on a redirection policy that NHS Tayside has had in place for the last 23 years.

Yousaf said the aim is to get patients to the most appropriate place for their ailment and free up doctors to focus on emergency care.

Issued to all of Scotland’s health boards, the guidance cites feedback about “inconsistencies” redirecting patients away from A&E and so provides a script for senior nurses and doctors to go through with patients to see if they require emergency treatment or could be seen elsewhere.

Health secretary Humza Yousaf. (PA Media/Andrew Milligan) PA Media

Yousaf said: “It is widely recognised that more people could be better seen away from hospital and closer to home by a more appropriate care provider such as a pharmacy or GP practice or indeed, managed with self-care guidance.

“As part of the NHS Recovery Plan we have invested £27m towards the Redesign of Urgent Care to ensure people receive the right care, at the right place.

“This guidance will form part of this work and will help our healthcare staff safely signpost people to care more appropriate to their need in the right place and at the right time for their condition.

“By adopting a consistent approach across Scotland, we can reduce delays in assessment and treatment, prevent overcrowding in emergency departments and ultimately release doctors to deliver emergency care to those who really need it.”

Royal College of Emergency Medicine Vice President (Scotland) Dr John Thomson said it was “essential we have the capacity to care for those who require the skill and expertise of the emergency department team” and the guidance would help staff redirect other patients elsewhere.

He added: “To ensure everyone receives the right care, at the right time, in the right place, it will on occasion be appropriate to signpost or redirect some people who have presented to an emergency department – but do not require after an assessment to be seen there – to another part of the healthcare system.”

Emergency Medicine Clinical Lead for NHS Tayside Dr Alison White said: “NHS Tayside has had a redirection policy since 1998 as a long-term improvement to our service.

“This provides people with better care than could be provided by emergency department staff.

“It also ensures specialist emergency medicine skills are directed towards those who need us such as people who have suffered a stroke, significant injury or heart attack, so care is delivered in a timely manner.”

Deputy medical director for NHS Greater Glasgow and Clyde, Dr Scott Davidson, added: “We already work closely with NHS 24 to direct people to the right place from their own homes.

“This new guidance enables us to support people who have attended an emergency department but who do not need to be seen there to be directed elsewhere with appropriate advice.”