London Daily

Focus on the big picture.
Tuesday, Jul 22, 2025

Why are Scotland's emergency departments so busy?

Why are Scotland's emergency departments so busy?

Emergency department admissions this year are almost 40% higher than pre-pandemic levels, figures show.

One senior doctor told BBC Scotland that accident and emergency (A&E) departments across the country were currently experiencing "winter-type pressures", with no sign of any relief. What's going on and why does it matter?

What does the admissions data show?


Public Health Scotland publishes monthly figures on emergency departments, with the most recent showing admissions up to 27 June.

Weekly admissions rose above the 2018-2019 average in the first week of 2021 and have remained there ever since.


In total, 3,120 more patients have been admitted through accident and emergency this year when compared with the 2018/2019 average - a rise of 37.6%.

In early April, admissions reached 67.4% higher than the 2018/2019 average, although that figure has now fallen.

Other PHS figures show the proportion of people waiting more than eight hours in emergency departments in May was also very high for the time of year.
At the same time, "attendances" at A&E - the number of people who turn up at the door - are actually lower than normal.


Attendance dropped dramatically during both of Scotland's lockdowns in 2020 and 2021. It's now rising, but is still below average levels.

So while there are fewer people turning up at emergency departments, a higher proportion of those that do are being admitted through A&E for further treatment.

Do we know why this is happening?


Dr John-Paul Loughrey is the vice chairman of the Royal College of Emergency Medicine (RCEM), and an emergency care consultant at a Scottish hospital.

He believes there are a number of factors behind the rise in admissions, but told BBC Scotland the primary reason was people arriving at A&E with more serious conditions at a more advanced stage.

Many of these patients are "very sick" and have illnesses not commonly seen by A&E doctors.

Dr Loughrey says emergency departments are seeing patients with illnesses usually dealt with by other parts of the healthcare system

"We're seeing a lot of people who are presenting late with problems that they have perhaps tried to access healthcare but had difficulties," Dr Loughrey told the BBC.

"But often it's other people who haven't wanted to access healthcare for fear of Covid in the hospital systems."

Added to that are lots more children than normal being brought to A&E with "feverish illnesses".

Dr Loughrey said typically they would have been exposed to these viral illnesses during the winter when mixing at nurseries or school, but were instead locked down at home.

"We're seeing a lot more of that into the summer that conventionally would have quietened right down by now."

People turn to A&E when they don't know what else to do


Dr Loughrey also thinks there's another factor at play - the fact that A&E remains a "recognisable brand" when much of the rest of the NHS has been reconfigured to deal with the pandemic.

"We're open 24-7 and people know what they're getting when it comes to an emergency department. There've been such big changes in so many other services that some people struggle to understand and to navigate their way through the healthcare systems," he said.

"People will turn to us in times when they're frightened or unsure what to do - and that's completely understandable."

Dr Loughrey's comments have been echoed by NHS Lanarkshire, which is the only health board in Scotland seeing an above average number of attendances at emergency departments.

Some people are turning up at emergency departments with sunburn or insect bites

The health board said "exceptionally high numbers" were turning coming to A&E, including many who arrived with minor conditions like sunburn or insect bites.

Director of acute services Judith Park said: "The sustained pressure we are seeing across our three acute hospitals is showing no signs of easing.

"In fact, the pressures on our hospitals are as severe as at any time in the whole pandemic."

Covid admissions are still having an impact


There is strong evidence now that vaccination has weakened the link between Covid infection and serious illness.

But the link has not been eliminated, and people are still being admitted to hospital for treatment.


Across Scotland, the number of people being treated in hospital for Covid-19 has risen from under 60 at the beginning of May to 529 on 21 July.

This means reconfiguring hospitals to keep Covid admissions separate, which reduces flexibility and capacity.

And like anywhere else, emergency departments have to observe social distancing, which makes it harder to cope with higher numbers of patients.

Fewer staff are available to work


The overwhelming majority of NHS staff will now have received both doses of a Covid vaccine.

This should protect most of them from falling seriously ill from Covid-19 - but staff are still required to self-isolate if they are identified as a close contact.

As the the number of cases rose rapidly in Scotland during May and June, so did the number of NHS staff reporting as absent with a Covid-related reason.


NHS staff absences doubled between 8 June and 6 July, though the number is now declining.


Why do emergency department admissions matter?


The emergency department is often said to act as a barometer for the rest of the NHS and what we can gauge this summer is a health service that is running very hot.

From children arriving with infections usually expected in winter and people with advanced disease who have perhaps held off seeing a GP, or whose earlier operations were cancelled, more needed to be admitted for further treatment, but beds are hard to find.

Usually the summer months mean more capacity in hospitals, but the combination of Covid cases, staff absences, and an increase in non Covid patients means hospitals are busier than ever.

There's also pressure at the other end - trying to get people out of hospital means provision in the community has to be in place so they can safely be discharged. Some health boards are having to cancel routine work, just to create space, pushing problems further down the line.

All of this creates a backlog at the hospital's front door - the emergency department - and doctors say it is worse than they have seen before. Too many patients are waiting over eight or 12 hours for beds to become available or an ambulance to take them home.

Staff say they are doing the best they can, but they are exhausted and morale is low, with no expectation that things will cool off any time soon.

What are the prospects for the rest of the summer?


According to Dr Loughrey, long waits at A&E are usually something you'd see in winter months rather than May, but he says there are "no signs" of this trend going away.

"We'll have to try and take a breath and steel ourselves for the shifts to come because it is challenging and it is difficult," he said.

"Although the link between Covid infections and hospital admissions is weakened, it certainly hasn't broken.

"Having seen reports from friends and colleagues across the country, I worry about what emergency departments across the UK are going to go through in the coming three months, before we've even reached the winter."

Dr Loughrey says staff will need to "steel" themselves for the shifts to come
What does the Scottish government say?


The Scottish government said it wanted to encourage people to consider options "closer to home" before going to A&E, including the NHS Inform website or contacting their GP or local pharmacy.

A spokesperson added: "We are acutely aware that hospitals are facing significant challenges due to a rise in non-Covid attendances and that some health boards are taking necessary measures to protect urgent and emergency care capacity.

"That is why we have released £12m in additional funding to health boards across Scotland to support non-Covid emergency care.

"This will help put measures in place to reduce waiting times for urgent or emergency treatment, with a focus on boosting staffing levels and available beds."

Newsletter

Related Articles

0:00
0:00
Close
US Treasury Secretary Calls for Institutional Review of Federal Reserve Amid AI‑Driven Growth Expectations
UK Government Considers Dropping Demand for Apple Encryption Backdoor
Severe Flooding in South Korea Claims Lives Amid Ongoing Rescue Operations
Japanese Man Discovers Family Connection Through DNA Testing After Decades of Separation
Russia Signals Openness to Ukraine Peace Talks Amid Escalating Drone Warfare
Switzerland Implements Ban on Mammography Screening
Japanese Prime Minister Vows to Stay After Coalition Loses Upper House Majority
Pogacar Extends Dominance with Stage Fifteen Triumph at Tour de France
CEO Resigns Amid Controversy Over Relationship with HR Executive
Man Dies After Being Pulled Into MRI Machine Due to Metal Chain in New York Clinic
NVIDIA Achieves $4 Trillion Valuation Amid AI Demand
US Revokes Visas of Brazilian Corrupted Judges Amid Fake Bolsonaro Investigation
U.S. Congress Approves Rescissions Act Cutting Federal Funding for NPR and PBS
North Korea Restricts Foreign Tourist Access to New Seaside Resort
Brazil's Supreme Court Imposes Radical Restrictions on Former President Bolsonaro
Centrist Criticism of von der Leyen Resurfaces as she Survives EU Confidence Vote
Judge Criticizes DOJ Over Secrecy in Dropping Charges Against Gang Leader
Apple Closes $16.5 Billion Tax Dispute With Ireland
Von der Leyen Faces Setback Over €2 Trillion EU Budget Proposal
UK and Germany Collaborate on Global Military Equipment Sales
Trump Plans Over 10% Tariffs on African and Caribbean Nations
Flying Taxi CEO Reclaims Billionaire Status After Stock Surge
Epstein Files Deepen Republican Party Divide
Zuckerberg Faces $8 Billion Privacy Lawsuit From Meta Shareholders
FIFA Pressured to Rethink World Cup Calendar Due to Climate Change
SpaceX Nears $400 Billion Valuation With New Share Sale
Microsoft, US Lab to Use AI for Faster Nuclear Plant Licensing
Trump Walks Back Talk of Firing Fed Chair Jerome Powell
Zelensky Reshuffles Cabinet to Win Support at Home and in Washington
"Can You Hit Moscow?" Trump Asked Zelensky To Make Putin "Feel The Pain"
Irish Tech Worker Detained 100 days by US Authorities for Overstaying Visa
Dimon Warns on Fed Independence as Trump Administration Eyes Powell’s Succession
Church of England Removes 1991 Sexuality Guidelines from Clergy Selection
Superman Franchise Achieves Success with Latest Release
Hungary's Viktor Orban Rejects Agreements on Illegal Migration
Jeff Bezos Considers Purchasing Condé Nast as a Wedding Gift
Ghislaine Maxwell Says She’s Ready to Testify Before Congress on Epstein’s Criminal Empire
Bal des Pompiers: A Celebration of Community and Firefighter Culture in France
FBI Chief Kash Patel Denies Resignation Speculations Amid Epstein List Controversy
Air India Pilot’s Mental Health Records Under Scrutiny
Google Secures Windsurf AI Coding Team in $2.4 Billion Licence Deal
Jamie Dimon Warns Europe Is Losing Global Competitiveness and Flags Market Complacency
South African Police Minister Suspended Amid Organised Crime Allegations
Nvidia CEO Claims Chinese Military Reluctance to Use US AI Technology
Hong Kong Advances Digital Asset Strategy to Address Economic Challenges
Australia Rules Out Pre‑commitment of Troops, Reinforces Defence Posture Amid US‑China Tensions
Martha Wells Says Humanity Still Far from True Artificial Intelligence
Nvidia Becomes World’s First Four‑Trillion‑Dollar Company Amid AI Boom
U.S. Resumes Deportations to Third Countries After Supreme Court Ruling
Excavation Begins at Site of Mass Grave for Children at Former Irish Institution
×