A&E waiting time crisis could take centuries to fix, frontline medics warn
Warning that issue will take generations to solve without ‘urgent’ reform
The lack of meaningful improvement in tackling the crisis across Scotland’s hospitals means it could take centuries before waiting times are reduced to the levels seen a decade ago, according to the leading body of emergency medicine professionals.
The Royal College of Emergency Medicine (RCEM) said the numbers of people enduring a wait of 12 hours or more in accident and emergency departments was a “national disgrace,” and warned that people are dying “because of the system not working as it should.”
The body said that last year, more than 75,077 people waited 12 hours or more to be admitted, discharged or transferred from major emergency departments in Scotland.
It said that while this figure represented an “ever so slight improvement” compared to 2024, when it stood at 76,510, based on the current annual reduction rate of 1.8 per cent it would take a staggering 237 years to reduce the extreme long waits to the 2016 level of 1,000.
Of those patients who waited 12 hours or more, 58,870 were waiting to be admitted to a hospital ward for further care.
In a new report detailing the state of emergency medicine in Scotland, the RCEM said that using the standard mortality ratio - a method which calculates that there will be one additional death for every 72 patients that wait eight to 12 hours prior to their admission - it conservatively estimated that there were 818 associated excess deaths related with long waiting times in 2025, the equivalent of 16 deaths a week, and the same as in 2024.
The RCEM said that in order to drive down waiting times and prevent unnecessary deaths, change needed to be driven by “anger” and “upset” from those in power in order to deliver a system that is “fit for purpose.”
Dr Jayne McLaren, the RCEM’s vice chair in Scotland, said: “It’s deeply concerning, and put bluntly, a national disgrace, that over the course of a year, there has been no meaningful improvement in the number of patients waiting 12 hours or more in emergency departments across the country.
“A small reduction of just over 1,400 patients waiting this long in the space of a year is nothing to celebrate. Because look at the sheer scale who still waited this long. These are people, not just numbers. And more often than not, they would’ve experienced this extreme wait on a trolley in a corridor, or another inappropriate space that was never designed to deliver care in.
“But what’s most upsetting, as an emergency medicine consultant, whose whole profession is to help people in their time of need, is seeing how many people died because of the system not working as it should. Ultimately, because there wasn’t an inpatient bed for them when they needed to be moved to a ward.”
The new report, entitled State of Emergency Medicine in Scotland, states that some 171,854 patients waited for eight hours or more in 2025, a decrease of 1,437 compared to the previous year.
Some 65 per cent of patients were admitted, transferred or discharged within four hours. While that represents a year-on-year increase of 0.7 per cent, the RCEM stressed it “falls far below” both the NHS constitutional standard of 95 per cent and the interim target of 78 per cent.
1,934 patients daily were remaining in hospital despite being deemed medically fit to leave, a decrease of just 20 over the entire year, it added.
The report points out that according to a survey carried out in December 2025, clinical leads in emergency departments reported that one third of patients were receiving care in an “undesignated space,” such as a floor, corridor, or chair.
The report also sets out a series of measures it wants to see the Scottish government take in order to ensure tackling overcrowding is a “top priority” in the coming year They include a commitment to ending the current of practice of caring for patients in corridors or other non-designated spaces, and avoiding new policies which increase pressure in A&E departments without “demonstrated improvements” in hospital flow.
Dr Joanna Bredski, chair of BMA Scotland’s consultant committee, said the report laid out the need for “urgent reform” of the NHS in Scotland.
“If politicians fail to grasp this and to implement action to tackle the many issues the NHS is facing with the speed and priority that is required, then it is a shocking but inevitable reality it will take not just decades, but generations to reduce waiting times in emergency departments,” she said.
“With demand for services still rising and an ageing population, figures showing slight improvements demonstrate that the current approach to the NHS is doing no more than chipping away at the edges of a significant problem.”
“At the heart of this are the patients who are facing the stress of failing to get access to the care they need at the time they need it, but these pressures also take their toll on doctors who are trying their best in impossible circumstances.”
Scottish Conservative shadow health secretary, Dr Sandesh Gulhane, said: “These findings are a damning indictment of the SNP’s mismanagement of Scotland’s NHS. On their watch, our A&E departments are in full blown crisis mode and lives are being lost as a result.
“It’s shamefully now the shocking norm for thousands of patients to suffer these delays every week at A&E because of the nationalists’ dire workforce planning and staff still having to rely on Humza Yousaf’s flimsy Covid recovery plan.”
Health secretary Neil Gray said: “I have met with the Royal College of Emergency Medicine to discuss A&E waiting times and I understand their concerns.
“Our A&E departments are facing sustained pressures, health boards continue to report high levels of hospital occupancy which is impacting on patient flow and leading to delays at the front door. This situation is not unique to Scotland with all other UK nations experiencing similar pressures.
“Long waits of this nature are unacceptable and we are determined to reduce these occurrences.
“We are investing £220 million to reduce waiting times, improve hospital flow and minimise delayed discharges. This investment has supported the development of front door Frailty services in every Health Board in Scotland and is supporting the expansion of Hospital at Home capacity.”
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