Scotland's Accident and Emergency (A&E) departments are facing a "perfect storm" this winter, with a significant majority of senior medical staff reporting that facilities are poorly prepared to handle the anticipated surge in patients. A survey conducted by the Royal College of Emergency Medicine in Scotland (RCEM) revealed that 96% of clinical leads polled believe their departments are not adequately equipped for the winter season.
The survey found that three-quarters of respondents reported higher pressure in their departments this year compared to 2025. Nine out of ten medical leads expressed "very" or "extremely" grave concerns about the pressure on their departments, with 96% stating they were poorly prepared for winter.
Dr. Fiona Hunter, RCEM Scotland vice president, stated that emergency departments have been in a "state of crisis" throughout the year. She highlighted that thousands of patients each month face waits exceeding half a day for treatment, transfer, or hospital bed allocation. "We know that there is a link between ED overcrowding and an increased chance of death, particularly among the most sick and injured of our patients," Dr. Hunter warned. "Things are only going to get tougher. Winter brings seasonal illnesses and an associated rise in demand for our services."
Across the UK, 91% of A&E clinical leads surveyed expressed significant concern about winter pressures, and two-thirds indicated their departments were unsafe. Only 3% believed their A&E was well-prepared for colder months.
Of the 25 clinical leads surveyed in Scotland, representing nearly every ED in the nation, all but two reported being "very" or "extremely" concerned about anticipated winter pressures. Dr. Ian Higginson, RCEM President, described the situation as "disgraceful," noting patients waiting on trolleys for extended periods, with some of the most critically ill unable to secure a hospital bed and remaining in the department for days.
Scottish Conservative health and care spokesman Miles Briggs MSP criticized the current state of affairs, stating that "corridor care is becoming the norm" and A&E waits exceeding four hours have reached their worst levels since December 2022. He urged the Scottish Government to address issues such as boosting capacity and speeding up patient discharges.
Scottish Labour health spokesman Dame Jackie Baillie echoed these concerns, emphasizing that the Scottish Government must act to ensure A&E staff are "properly resourced" with the necessary capacity and support before winter.
These warnings follow reports of a concerning early rise in flu cases affecting Scottish EDs. In August, the number of patients waiting more than four hours in A&E departments reached a record high of 50,747.
A Scottish Government spokesperson acknowledged the RCEM's concerns and stated that efforts are underway to prepare the NHS for winter. Health Secretary Angela Constance has met with the College and is committed to working collaboratively to alleviate pressure on A&E services. The government has outlined winter planning measures, including expanding "Hospital at Home" services and encouraging eligible individuals to get vaccinated against seasonal viruses.