Almost every Emergency Department clinical lead in Scotland is deeply concerned about the challenges facing A&E services this winter, according to a new survey from the Royal College of Emergency Medicine.
The findings paint a worrying picture of a healthcare system already under intense strain, with senior clinicians warning that emergency departments are operating in crisis conditions before the winter surge in demand has even begun.
RCEM surveyed 163 clinical leads from emergency departments across the UK to assess current pressures and preparedness ahead of the colder months.
Among the 25 respondents from Scotland, representing almost every emergency department in the country, 92% said they were either "very" or "extremely" concerned about the pressures their departments will face this winter.
The research also found that 96% of Scottish respondents reported current pressure levels as either "high" or "very high", while the same proportion felt their departments were poorly prepared for winter. Three-quarters said pressures were significantly higher than at the same point last year.
The survey highlights growing concerns around patient safety, emergency department overcrowding and hospital capacity, with RCEM urging the Scottish Government to act quickly to reduce lengthy waits for treatment and admission.
Dr Fiona Hunter, RCEM Scotland Vice President, said:
"Emergency Departments in Scotland have spent this entire year in a state of crisis. Thousands of people each month come to us, only to face waits for more than half a day before they are treated and sent home, transferred elsewhere – or given a hospital bed.
“We know that there is a link between ED overcrowding and an increased chance of death, particularly among the most sick and injured of our patients.
“That has been the state of play throughout 2026 – and now winter is on the horizon. Things are only going to get tougher. Winter brings seasonal illnesses and an associated rise in demand for our services.
“The government must do more to give us the breathing room we need, so that when winter hits we can stretch to meet the demand.”
RCEM is calling on the Scottish Government to halve the number of patients waiting more than 12 hours in emergency departments, arguing that reducing overcrowding is essential to improving patient safety and reducing avoidable harm.
Across the UK, similar concerns were echoed by frontline emergency medicine leaders, who warned that hospitals are struggling to cope with existing demand levels.
Dr Ian Higginson, President of RCEM, added:
“Overcrowding, corridor care and the impending surge of demand from winter are creating a perfect storm for EDs across the UK.
“Colleagues from across the four nations have been crystal clear: we simply are not ready for winter, and can barely manage as we are.
“We have patients lining our departments, many stuck in trolleys for hours upon hours. The sickest and most injured among them can’t get into a hospital bed and end up stuck with us, sometimes for days.
“It’s a disgraceful state of affairs and I cannot believe it has been allowed to get this bad.”
Healthcare leaders continue to warn that unless urgent action is taken to improve patient flow and reduce long emergency department waits, services across Scotland could face significant challenges as winter demand places further pressure on an already stretched system.
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