What people actually experience at A&E in Scotland | Autonomy Scotland

What people actually experience at A&E in Scotland

This letter, from a Consultant based at Glasgow Royal Infirmary, published in the Scotsman, explains what normally happens when a person visits A&E.

The letter also highlights how misleading and sensationalist reporting in the press, damages public confidence in the NHS and also hurts staff morale within A&E departments.

I hope you find the letter informative and reassuring. I pasted the text below.


THERE is massive pressure on the NHS at the moment, exacerbated by the winter flu, particularly obvious for A&E departments.

It is damaging morale among staff, and very misleading for the public, that the BBC and newspapers are reporting repeatedly that “just 78 per cent of patients across Scotland were seen within the target time of 4 hours”. Most are actually “seen” within a few minutes.

That figure of 78 per cent in fact refers to the 78 per cent who, within four hours from arrival, have been seen, triaged, examined, investigated (with blood tests, X-rays, CT scans and so on), treatments started and then transferred to a ward or discharged home.

What actually happens in large busy Accident and Emergency department is this:

  1. All true emergencies and accidents are seen and treated immediately, without any delay.
  2. All other people arriving at A&E are seen for “triage” by a nurse, usually within 10-15 minutes to decide how ill the person is, and who needs to see them (for example, surgeons, physicians, nurses).
  3. For patients arriving by ambulance, the ambulance staff remain with the patient until they are seen.
  4. Those who need to see a doctor are all seen within 30-40 minutes.
  5. The doctor takes a history from the patient and carers, examines, assesses previous drug treatments etc, and as appropriate to each case, sends blood tests, orders X-rays and CT scans and so on to make a diagnosis.
  6. Blood samples have to be transported, processed in laboratories and reported.
  7. X-rays and scans have to be done and then reported by specialist staff.
  8. Treatment is started to relieve symptoms and to tackle the underlying diagnosis.
  9. Arrangements are made for transfer to an appropriate ward, or to return home.

As medicine has become more sophisticated, the extent of investigations has increased, and it is really extraordinary that so much is done within four hours. It should not be a serious criticism of the NHS if these steps exceed four hours in some cases, and an argument could be made to raise that target.

We call on the media not to refer to “patients not being seen for more than four hours”, or “not treated for more than 4 hours”. This negative language creates unwarranted anxiety amongst patients and carers, and is hurtful to dedicated hard-working NHS staff.

Mike Lean,

Professor of Human Nutrition, University of Glasgow, and Consultant Physician, Glasgow Royal Infirmary,

c/o Glasgow Royal Infirmary, Castle Street, Glasgow.

Support us by making a donation.

Help us for free by doing your Amazon shopping through this link (bookmark it!).

Or by commenting on and sharing the blogs and joining our newsletter.

Spread the love

You may also like...

Notify of

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Inline Feedbacks
View all comments
Hon Bugger le Panda
Hon Bugger le Panda
6 years ago

Copied the letter and posted on Twitter

Retweeted this article also

6 years ago

Thanks. Appreciated.

Elizabeth H. Scott
Elizabeth H. Scott
6 years ago

Pleased to share the letter on Facebook.

6 years ago

It’s been shared on facebook a lot now.

Donald McGregor
Donald McGregor
6 years ago

I read the letter in the National, so presumably also published in the Herald. Surprised the Scotsman published it.
Good for Mike Lean. We need more of us to stand against the media as he has here.

Would love your thoughts, please comment.x