Virtually every clinical lead in EM I have spoken too, as well as Scottish Board members think that the bed capacity of their patch has been reduced. I can find little data around this, where I have local data it seems to be true. How can this be adequate preparation for winter?
2) Virtually every service I encounter , apart from EM, also says that in some way it is reduced or restricted in some way.
3) Emergency Departments are the canary in the coal mine.
It has stopped singing.
Long waits are back inc overnight. 4 hour standard performance dropping, but now with staff absence due to isolation becoming a factor.
4) We pulled out all the stops and had a fantastic whole system response less than 6 months ago, but that feels a long way away and it does not feel the same now. I understand the need for "business as usual", but if the system fails, the ED becomes the default safety net.
5) I said in the summer the thing I feared the
most was a "return to normal", the biggest threat to "wellness" was things going back to the way they were. Both are being realised all over the UK ( inc Scotland) now
6) As a priority, we need a match between current demand and capacity. Where are all the extra beds that were opened in summer?

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More from @VP_Scot_RCEM

3 Jun
1)There were assaults on Staff in at least 3 Scottish Emergency Departments over the weekend. Didn't take long for the clapping to stop.
2) This is unacceptable and shows a disgusting attitude towards a service which is still taking personal risk to provide a safe service for patients
3) For a brief period, we felt that we were all working together, and patients were starting to appreciate that they could also think about using the NHS in a sensible way
Read 6 tweets

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