12 August 2010
Stronger leadership is needed for the provision of hospital emergency services in Scotland, according to a public spending watchdog.
An Audit Scotland report published
today said there was widespread variation in the services provided at emergency
departments and a lack of clarity about where best to treat different patients.
The watchdog advised that NHS Scotland
could do more to manage the services more efficiently with attendances, costs
and workforce pressures rising.
However, patient satisfaction was found to be high and four out of five
patients surveyed said the care they received was excellent or very good.
The report, Emergency departments,
called on the Scottish Government to provide a clearer strategic direction for
emergency care services, underpinned by a review of the services provided,
workforce attendance rates and how patients are recorded.
Despite staffing increases, Audit Scotland pointed out that the European
Working Time Directive and the 2004 consultant contract had reduced the number
of available working hours for medical staff.
More than half of staff surveyed said that a lack of middle-grade doctors –
those in higher-grade training posts – was having a major impact on their
departments.
Auditor General Bob Black said the emerging staffing issues, such as the
shortage of junior doctors and the impact of European legislation, had to be
tackled at national level, not just locally.
He added: ‘All of these factors highlight that there is a real need for a clear
national approach to emergency care so that we can get the best out of the
resources available.’
But Dr Brian Keighley, chair of the BritishMedical Association in Scotland, said there was ‘no evidence’ to the
suggest that the consultant contract and the EWTD has had any impact on
workforce availability.
‘The NHS had more than ten years to prepare for the implementation of the
working time regulations and it is a failure to effectively plan for changing
working patterns that is the problem.’
