The First Minister Nicola Sturgeon’s recent trip to the US was not without controversy, as opposition politicians criticised her for neglecting the “day job” to sell a second referendum to those abroad.
In response, the SNP published a list of her government’s recent achievements. This included a claim on the state of Scottish accident and emergency waiting times in the NHS, which has been a point of contention between rival parties at Holyrood in recent years.
A google search shows this claim has been regularly repeated by SNP politicians in the press.
The Ferret Fact Service looked at the evidence, and found that the SNP’s claim that Scotland has the best accident and emergency waiting times in the UK is accurate, but there is more to the story.
Each country in the UK publishes monthly NHS usage statistics, with a breakdown of how many people use different areas and how long people have waited before being treated.
The SNP can point to the UK-wide monthly target for accident and emergency patients to be seen within four hours of coming to the hospital.
On this measure, Scotland’s performance outstrips the other UK nations. The latest comparable figures, which cover January, show Scotland had 128,648 attendances at A&E of which 91.8 per cent were “seen and resulted in a subsequent admission, transfer or discharge within 4 hours.”
In England, January’s figures show 85.1 per cent of patients were seen within four hours, while in Wales, 79 per cent were seen within the target time. Northern Ireland’s results are published quarterly, with the most recent figures from December 2016 showing just 69.9 per cent (compared to Scotland’s 92.6%) were treated and discharged or admitted within four hours.
These trends have continued for nearly two years, with June 2015 the last time Scotland’s four-hour percentage was outstripped by another UK nation (England).
There is some debate over whether the measurement of four-hour care is a good reflection of real waiting times.
Several reports have noted the limitations of the measure, and there is some evidence that a drive to avoid missing the target can lead to unnecessary admissions into hospital.
It is not sensitive to differences in waiting times within the four-hour period. For example, a health board where most patients are seen within an hour could have a similar ‘four hour measure’ percentage to an area where the majority of people wait nearly four hours.
The target also does not take into account the time taken to treat someone, as it refers to the entire period a patient spends in A&E rather than just the time spent ‘waiting’.
Therefore, the four-hour figures do not “provide a full measure of service quality” or give an exact reflection of waiting times, but instead act as an indicator of broad A&E performance.
A House of Commons Health Committee report concluded that “key indicators of hospital performance should be based on a broader assessment of patient outcome and experience”.
How are A&E waiting times measured?
The most common indicator of A&E performance is the ‘four-hour measure’.
This refers to the percentage of patients who spend less than four hours in A&E before being discharged, admitted to hospital, or transferred to another relevant institution.
This is the method of measuring waiting times that is used by all the nations in the UK, and usually includes major A&E departments, facilities that cater to specialist procedures (like eye hospitals), as well as minor injury units.
While they cover broadly the same types of institutions, the definition of different emergency facilities is not consistent throughout the UK.
It is important to note that the Scottish Government’s own target, which matches the wider UK NHS approach for four-hour waiting times, is 95%. The last time this was successfully achieved was in July 2016, meaning for seven consecutive months waiting times have failed to meet the national standard.
Ferret Fact Service Verdict: Mostly True
The SNP is correct to say that under the national standard of four-hour waiting times Scotland is the best performing nation in the United Kingdom. However, this common measure used to grade A&E performance may not give a full account of actual waiting times, and the Scottish Government has been less successful when judged against its own targets.
Ferret Fact Service (FFS) is a non-partisan fact checker, working to the International Fact-Checking Network fact-checkers’ code of principles. All the sources used in our checks are publicly available and the FFS fact-checking methodology can be viewed here. Any questions or want to get involved? Email us at email@example.com or join our community forum.
In response to an FFS request for evidence, the SNP provided a comparative parliamentary briefing on NHS waiting times across the UK.
Photos thanks to Skitterphoto and Pete, CC0 Public Domain