Ministers urged to avoid ‘patient-blaming language’ over A&E attendance

Scottish ministers have been told by a senior doctor to drop “patient-blaming language” around “unnecessary attendances” at emergency departments.

Lailah Peel, deputy chairwoman of the British Medical Association Scotland, said the messaging – which urges patients to seek alternative support from NHS 24, pharmacies or GP practices – is unhelpful, especially as delayed discharges remain the main concern over hospital capacity.

On Monday, First Minister Nicola Sturgeon urged patients not to attend A&E unless their condition is life-threatening as she warned that hospitals are nearly full.

Scottish Labour leader Anas Sarwar said that messaging is “sending the wrong signal” and could lead to people who do require emergency care avoiding hospitals.

Dr Peel wrote on Twitter: “Lots of chat right now about reducing pressure on A&E seems to be focussing on ‘unnecessary attendances’ to A&E.

“This shows a lack of understanding of the current crisis. Exit block is the problem in A&E – the lack of flow through our EDs. Not the number of people turning up.

“Patient blaming language also isn’t helpful – any patient in A&E has felt it necessary to present or been advised to by someone.

“Even if A&E isn’t the right place there’s likely a reason or barrier from stopping them accessing what they need other ways.”

Mr Sarwar, who held a roundtable with health representatives at the Scottish Parliament on Wednesday, said of the messaging: “It’s sending the wrong signal and wrong message that… the reason why we’ve got problems in A&E is because the wrong kind of people are turning up with the wrong kinds of conditions.

“I think we ought to take those warnings really seriously and we’ve got to be careful that we are not excluding people from the vital healthcare they need.

“I would emphasise that challenge on being really careful about the message the Government is sending with those constant lines on what the patients should and shouldn’t do.”

He acknowledged there had been an appropriate time where triage in A&E was necessary to deal with rising demand.

But he said: “I think the challenge you have is when it looks like it’s not actually more physical numbers of people turning up at A&E, but there’s still longer waits. That’s demonstrating there is a wider systemic problem.

“I’d be really worried if we have people who really need urgent medical assistance who are opting not to seek that medical assistance.

“The system is broken, it’s in crisis and lives have been lost, and people are dying unnecessarily in this NHS crisis because the Government has failed to get a grip.”

A Scottish Government spokesman said: “In order to try and ease pressure at busy acute sites, we are trying to reduce the numbers of delayed discharges, and reducing the numbers attending A&E by ensuring people get the right care, at the right place at the right time.

“That’s why we’re spending £8 million on 200 new care home beds and recruiting additional staff to NHS 24.

“Emergency care is always available for those who need it, however we know many people are seeking help with common winter illness and NHS Inform have useful self-help guides to let everyone know when to stay home and when to seek more care.

“If you do think you think you need to visit A&E, but it is not an emergency, you can contact NHS 24 where you may be referred to a more appropriate urgent care service.

“Local GPs and pharmacies can also be contacted as a first port of call for non-critical care.”