Doctors in Scotland’s busiest emergency division have informed hospital bosses they haven’t any confidence in them coping with rising affected person security considerations.

A complete of 27 A&E consultants on the Royal Infirmary of Edinburgh (RIE) wrote a letter of no confidence within the NHS Lothian government board final 12 months.

The docs claimed they “currently cannot deliver safe, effective timely care for our patients”.

NHS Lothian mentioned it’s working with them on a plan to enhance the service.

They are calling for a Scotland-wide evaluation of emergency therapy provision.

The security watchdog discovered “multiple systemic failures” over two visits to the A&E.

The following month, 27 emergency division consultants signed a letter to Prof John Connaghan, NHS Lothian’s chairman, to state their “loss of confidence” within the board’s executives to take care of “sustained and worsening patient safety issues” raised over the three earlier years.

The letter acknowledged: “We are trained to provide emergency and urgent care in the first hours after attendance, not for protracted periods of time beyond 12 hours and into days.”

The consultants pointed on the market was a 80% enhance of their workload throughout 2022 and the elevated stress on the A&E was “disproportionate” in comparison with different departments on the hospital.

The docs warn that if issues proceed as they’re then “significant patient morbidity and mortality will continue to occur”.

Prof Connaghan and senior executives met with the consultants after receiving their letter and NHS Lothian mentioned they agreed enchancment actions.

The emergency division on the RIE, which opened in 2003, was constructed to accommodate as much as 90,000 attendances per 12 months however is now coping with 135,000 per 12 months.

The varieties of considerations raised concerning the RIE emergency division have been raised by docs round Scotland in recent times.

Nearly each A&E marketing consultant at Glasgow’s QEUH wrote to Healthcare Improvement Scotland to warn affected person security was being “seriously compromised”.

They supplied 18 months’ price of proof of overcrowding and workers shortages to again their claims which weren’t initially absolutely investigated by the watchdog.

Elsewhere, in August final 12 months a gaggle of senior docs accused NHS Grampian of ignoring their security considerations about emergency departments in Elgin and Aberdeen.

Michelle Carr, chief officer of acute companies at NHS Lothian, mentioned it takes workers considerations “extremely seriously” and is working via an enchancment plan for the emergency division along with the consultants.

She added: “NHS Lothian, like all other health boards in Scotland, remains under significant pressure. Our hospitals are experiencing high numbers of patients, as well as increase in trauma cases and acuity of illness.

“Overall occupancy stays excessive and we’re working with groups all through the hospital and in Health and Social Partnerships to make sure sufferers proceed to obtain protected, efficient and timeous care, and circulation again into the neighborhood as quickly as they’re properly sufficient to take action.

The well being government additionally identified the “RIE is the busiest and largest hospital in NHS Lothian as well as one of the major trauma centres for some of the sickest and most seriously injured patients in south-east Scotland.”