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Capacity management in Scottish health boards

Published: 30 Sep 2015 13:00

Scottish Government and RCEM Scotland launch new guidance.

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The Scottish Government and the Royal College of Emergency Medicine in Scotland have released capacity management guidance to Health Boards in Scotland today.

The aim is to reduce and eliminate Emergency Department crowding by improving patient flow through the urgent and emergency care system, and through the hospital. Tackling crowding improves the quality of care and safety for patients and their families, as well as the clinical and working environment for the Emergency Department medical and nursing team.

Crowding and Exit Block harm patient safety and increase mortality. Solving the problem of crowding is central to the College's STEP campaign. The guidance issued today will demonstrate how clinicians, service providers and hospital executives can work collaboratively to improve the patient experience in times of service pressures.

The guidance was released during a meeting in Edinburgh with Health Secretary Shona Robison, Health Board Chief Executives and Chairs, Unscheduled Care leads, and leaders in health care, who are coming together to review current performance in the urgent and emergency care system.

This builds on the six essential actions for improving unscheduled care, launched in partnership with health boards and Royal Colleges earlier this year, which are ensuring that best practice is rolled out across all health boards.

It also follows on from work underway to prepare for winter – which presents additional challenges for unscheduled care – with the Scottish Government last week announcing £10.7 million to tackle winter pressures, bring total winter funding so far to around £55 million.

Cabinet Secretary for Health, Wellbeing and Sport, Shona Robison, said: "The Scottish Government is committed to sustainably improving urgent and emergency care performance and I welcome this joint working with health boards and the Royal College of Emergency Medicine.

"Today's summit will allow key experts to share learning and make sure we are driving forward performance and ensuring that patients get quick, high quality treatment, not just in all our emergency departments but across the whole system.

"This new guidance will help to proactively manage Emergency Department capacity in order to improve patient experience and flow. The guidance will help improve the quality and safety of care for patients and their families when they attend hospital.

"This follows on from our winter guidance, issued in August, the earliest we have issued winter guidance – which asks boards to have in place strategies for staffing additional capacity and maintaining progress towards minimising delays in discharging patients.

"With more people now living with long term conditions and a growing number of older people with multiple conditions and complex needs, it is vital that the Scottish Government continues to work closely with NHS boards and industry experts to drive forward change and improvement, with events such as this being vital catalysts for sharing and progressing best practice examples."

The Royal College of Emergency Medicine Vice President for Scotland, Dr Martin McKechnie, said:

"The guidance we issue today with the Scottish Government will mitigate against the unsafe harms suffered by patients and staff as a result of crowding. We have had a productive partnership with the Scottish Government in relation to these and other issues affecting Emergency Care. This guidance represents some of the fruits of our collaboration. More importantly for patients, their families, and all the staff who routinely go the extra mile in Scotland's Emergency Departments, it represents a transition from a commitment from all parties to tackle these issues, to actual implementation of the actions and solutions required."

Notes to editors

About the Royal College of Emergency Medicine

The Royal College of Emergency Medicine is the single authoritative body for Emergency Medicine in the UK. Emergency Medicine is the medical specialty which provides doctors and consultants to A&E departments in the NHS in the UK and other healthcare systems across the world.

The Royal College works to ensure high quality care by setting and monitoring standards of care, and providing expert guidance and advice on policy to relevant bodies on matters relating to Emergency Medicine.

The Royal College has over 5,000 fellows and members, who are doctors and consultants in emergency departments working in the health services in England, Wales, Scotland and Northern Ireland, Republic of Ireland and across the world


For further information, or to speak with a spokesperson for The Royal College of Emergency Medicine (between 9am and 5pm), please contact Matt Chorley at or on 0207 067 1275. For out of hours enquiries, please contact Ben Walker on 0757 834 7339