Aberdeen Royal Infirmary ambulance diversions stood down but region still at 'critical' level

NHS Grampian remains at a critical incident level on Friday as it stood down its ambulance diversions from Aberdeen Royal Infirmary.

The health board, which is responsible for around half-a-million people in the north-east, said the diversions had been necessary due to "sustained and continuing pressure" on the hospital.

Ambulance patients were taken to hospitals outside of Grampian unless they required immediate life-saving care on Thursday (November 28).

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Several patients told our sister title the Daily Record of their shock at left in ambulances outside the hospital and of lengthy delays waiting to see a doctor at ARI.

One woman shared how she endured a five-hour wait in an ambulance to get into A&E at the infirmary a few weeks ago. She was moved into another ambulance three hours into the wait so paramedics could respond to an emergency in Fraserburgh.

A relative also described how their elderly uncle had to wait 11 hours just to get an ambulance this week. When he finally arrived at hospital, he spent the entire night in the back of the vehicle.

In one shocking incident, a woman explained how a loved one died while waiting in the back of an ambulance.

She said: "This is dreadful news, but I suspect most of us knew it was coming. A family friend died in the back of an ambulance sitting outside the emergency department earlier this year. Had he been accepted into the department, he would have lived."

Another patient explained that she was sent to A&E in Aberdeen for anaphylactic shock a few nights ago.

She said: "The woman on 111 told me to go straight there and be seen immediately. I got there, but after an hour and a half, I was told there would be another 8–9 hours before anyone might see a doctor!"

One woman, who waited in A&E for eight hours on Tuesday, said medical staff seemed "overwhelmed" when they told patients that anyone who had not been triaged needed to go home and make alternative arrangements.

Chief executive, Adam Coldwells, confirmed diverts had been stood down and that patients west of Elgin will continue to be taken to Raigmore Hospital in Inverness to ease pressure on Dr Gray's Hospital.

He said: "Thanks to the hard work of our staff and our partner agencies, the situation at Aberdeen Royal Infirmary has improved slightly overnight.

"We remain in a board level critical incident, however we are no longer diverting ambulances away from Aberdeen Royal Infirmary.

"Patients from west of Elgin, who require an ambulance, will continue be taken to Raigmore Hospital, in Inverness, to alleviate pressures on Dr Gray’s Hospital.

"A small number of patients were diverted away from the Grampian area during the period it was in place and we’d like to thank our colleagues at neighbouring boards and the Scottish Ambulance Service for their assistance.

"Throughout this situation any patients requiring life-saving treatment – for example following a stroke or heart attack – have continued to be admitted, via ambulance, to our hospitals.

"A small number of elective procedures have been postponed as a result of the critical incident and these will be rescheduled as soon as possible. If any further individuals are affected going forward, we will contact them directly."

Mr Coldwells highlighted the severity of the situation, with average occupancy at ARI having not fallen below 100% since early September.

He added: "The situation at ARI, Dr Gray’s Hospital, and in community settings across Grampian, remains extremely pressured, due to the volume of acutely ill patients, delayed discharges, capacity in community healthcare settings and staffing pressures.

"Over the last week the average occupancy at Aberdeen Royal Infirmary has been 111%. The hospital has not been under 100% since September 8. At Dr Gray’s, in Elgin, it has been at an average of 124% over the last week. The hospital has not been under 100% since September 7.

"We have also seen an increase in delayed discharges across the north-east. Yesterday (November 28) we had 199 delayed discharges across our system – accounting for 13% of all beds in the region.

"Since January 1, 2024, we have seen a 26% rise in patients whose discharge has been delayed across the region.

"The general public can help us by meeting friends or relatives due for discharge promptly - before midday if possible -so we can prepare the bed for another patient. Using NHS Inform to guide their self-care, or speaking to their GP practice, community pharmacy, or NHS 24 on 111 if they need further advice is also strongly encouraged."

Health Secretary Neil Gray said: "We are working urgently with NHS Grampian to help mitigate the impact of the current pressures on unscheduled care at Aberdeen Royal Infirmary and facilitate the necessary support.

"I have spoken to the Chief Executive to understand the board’s resilience plan and took assurance from the immediate actions in hand and from the engagement and support from the wider health and social care system.

"Patient safety is paramount, and the board is prioritising those with the greatest clinical need and communicating with the public accordingly.

"This type of sustained pressure on services is not unique to Scotland —similar challenges are being felt across the UK—but performance is not of the standard we all expect.

"We are protecting investment levels accordingly, including ensuring a record number of NHS 24 call handlers to direct people to the most appropriate care this winter, helping reduce unnecessary A&E attendances. We are also continuing investment in the Scottish Ambulance Service workforce."