NHS Tayside first mainland health board in years to meet A&E waiting time target

Tayside has bucked a national trend by becoming the first mainland NHS region in more than a year to meet a key A&E waiting times target.

Weekly performance data shows that of the 1,387 people who attended either Ninewells Hospital or Perth Royal Infirmary for emergency care, 96.4% were seen within four hours.

Fifty patients waited longer than that, and only two patients experienced a wait time of more than eight.

This compares to a Scottish average of 64.3% the same week.

No health board, other than NHS Tayside in January 2022, has met the target since late 2020.

Could others learn from Tayside?

At some hospitals ambulance are forced to queue outside due to a lack of space in the department. Image: DC Thomson.

NHS Tayside say the four-hour standard is “more than just a number” for its teams.

Medical director Dr Pamela Johnston said: “NHS Tayside’s consistently high performance against the four-hour target is something we are really proud of, and it’s all thanks to our hard-working teams in our acute and community services who have really taken responsibility and ownership together to make sure that this system works.

“Urgent and unscheduled care continues to be a priority for NHS Tayside and we have invested in our whole system response, from the moment the patient contacts their GP, Scottish Ambulance Service or NHS 24 through to our admission wards and discharge planning.”

How Tayside A&Es became best performing in Scotland

Clinical director for unscheduled medicine Dr Monica Doyle explained: “Each step of the patient journey is dependent on us having enough capacity in the next step to ensure that this flow can continue.

“So if we don’t have enough space in, for example, a community hospital ward we would be unable to transfer a patient from an acute hospital ward, which means the acute ward may then not be able to admit a patient from the acute medical unit, and a patient could then be delayed in the emergency department.

Staff say a “whole system” approach to managing bed space is crucial. Image: Kim Cessford/DC Thomson

“Across the system, we all work hard to maintain the best possible flow and prevent delays from occurring in particular areas.

“We all believe in the whole system approach and all play an essential role in achieving the 95% performance standard.”

An innovative system known at the Flow Navigation Centre is also in operation, which NHS Tayside say helps to reduce the numbers attending A&E departments such as Perth Royal Infirmary.

It offers professional advice from consultants and senior staff, who speak to colleagues elsewhere as well as directly to patients to give self-care advice by phone or video call.

They can also arrange for them to be seen at an appointed time in the emergency department or direct them to a more appropriate service.

The system means more than 35% of referrals do not need to attend, allowing staff to see those needing emergency treatment as quickly as possible.

Those who attend A&E who could be better given healthcare elsewhere, such as at a community pharmacy, are also re-directed.

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