NHS Ayrshire and Arran faces an uphill task to tackle Accident and Emergency waiting times after it revealed its worst figures in almost a decade.

And it is also struggling to deal with the ongoing issue of delayed discharges.

Earlier this year NHS Ayrshire and Arran agreed its annual delivery plan. This included a number of targets for June 2024, including:

Increasing the number of patients being seen at A&E within four hours to 65.9 percent

Cutting the number of those waiting 12 hours or more to 20 or less.

Improving ambulance turnaround times

Reducing occupancy of acute sites to 123.4 percent or less

Reducing the average number of beds occupied per day for patients whose discharge has been delayed.

They appeared to be achieving their aims for emergency admissions in April and May, in relation to four hour waits, ambulance turnarounds and over 65s being discharged within 72 hours.

But they have brought back down to earth with a bump as figures for June show a serious deterioration.

A report to Ayrshire and Arran Health Board states: “Numbers of attendances at the Emergency Departments (EDs) in the current rolling 12-month period (July 2023 to June 2024) have increased by 3.2 per cent when compared to the previous 12-month period.

“Compliance against the 95 percent ED 4-Hour National standard/target has decreased in June 2024 to 61.6 per cent, the lowest monthly performance on record over the past eight years.”

The figures for Ayrshire were also lower than the national average for the third month in a row.

The report continues: “The daily average number of patients waiting over 12 hours to be seen, treated or discharged within our EDs has deteriorated with numbers rising to an average of 30 per day in June 2024.”

The aim had been to reduce this number to 20 by June.

Delayed discharges have been a major issue in Ayrshire for some time, coming about when suitable accommodation or support is not available for patients ready to leave hospital.

This has largely been driven by delays in South Ayrshire, which has a higher amount of care provided by the private sector than its neighbouring authorities.

However, the disparity has reduced, from having 56 per cent of Ayrshire delayed discharges in 2023 to 43.5 per cent in 2024.

North Ayrshire has also seen a reduction in cases, to 61, but East Ayrshire has seen an increase from 31 in 2023 to 43 in 2024.

The number of bed days occupied through delayed discharge has followed the same pattern.

The numbers of bed days occupied due to a delayed discharge have increased in East Ayrshire HSCP, rising from 889 in May 2023 to 1,206 in May 2024.

The percentage of acute beds occupied also increased following a drop to 120.3 percent in May rising to 125.7 percent in June.

At the same time there has been a reduction in the number of bed days occupied due to a delay in both South and North Ayrshire HSCPs. However they remain at higher levels than East Ayrshire HSCP.

Despite this, East Ayrshire continues to perform significantly better on the national target of zero delays over two weeks for ‘non complex’ patients, having posted no delays for a number of years.

This compares with 35 in South Ayrshire and 16 in North Ayrshire.

Both East and North Ayrshire have met their targets for occupied beds due to delayed discharge. However, South Ayrshire, with 81, missed their target.

Across Ayrshire, ambulance turnaround times of an hour or less had risen in line with the target trajectory in May, to 61 percent before dropping to 52.9 percent in June.

Similarly, the percentage of over 65s being discharged within 72 hours had reached 52.2 percent in May before hitting 44.9 per cent in June.

Ayrshire and Arran Health Board were set to consider the report this week.