Frontline health workers have sounded a worrying warning bell as the NHS braces itself for the most challenging winter in its history.
They said mounting staff vacancies and sickness, alongside delayed discharges – where people remain in hospital despite being medically fit to leave – was creating a “perfect storm”.
Meanwhile, with hospitals full, patients who do need care are being left waiting for hours in ambulances outside accident and emergency departments.
Caroline Whitworth, medical director at the Royal Infirmary of Edinburgh, told STV News: “We’re seeing people coming in with acute illness, and then not being able to get out of the emergency department.
“It’s a finite space. If people are coming in with acute illness, they’re having to wait; they’re waiting in ambulances, they’re waiting to be assessed and they’re waiting to move on.
“Because we’re running at high occupancy, we’re looking to discharge a patient before the next one comes in, and the backlog is being felt in the emergency department.
“The patient experience is poor, so all of us are feeling that our patients are suffering.”
Delayed discharge – has been rising sharply for months, with many beds normally used for other illnesses instead being occupied by Covid patients.
In September, there were almost 1600 patients in hospital when they were medically fit to leave – but a staffing crisis in social care means there is often nowhere to go.
Alison Macdonald, director of the East Lothian Health and Social Care Partnership, said: “It’s challenging to recruit into the care providers and the care homes.
“I have worked in this area for a number of years and this is the most challenging it has been. Things are incredibly busy and the staff are working hard.
“They are tired, they’ve had 18 months of working flat out. Vacancies, staff sickness and Covid are all coming together like a perfect storm.”