Dear Sir/Madam,

I write regarding claims made by Prime Minister Rishi Sunak in a BBC interview, as referenced in the story linked: PM lies directly about A&E Waiting times in England and Scotland – Talking-up Scotland

I am concerned that Mr Sunak selected statistics that are not a like-for-like comparison and in using them he misled the viewers and therefore the country on a serious public health matter.

As a consequence, I am requesting that the UK Statistics Authority investigate whether the claims made by Mr Sunak comparing A&E stats in England and Scotland were accurate?

I draw your attention to the following: NHS England’s agency NHS Digital produce an annual comparison of the four nations’ A&E performance – Hospital Accident & Emergency Activity 2021-22 – NDRS.

The file on ‘home nations’ comparison notes it

“…provides a comparison of the number of unplanned A&E attendances and percentage of attendances spending i) 4 hour or less and ii) over 12 hours in type 1/Major A&E departments from arrival to discharge, admission or transfer for each of the four Home Nations (England, Scotland, Wales and Northern Ireland). Given the different models of service provision across the four nations the comparison is restricted to Type 1 or Major A&E departments within each nation…

“Whilst this allows a nearer like for like comparison it does not take account of the differing casemix of patients that present at type 1 services which will be influenced by the provision and accessibility of alternative types of A&E.”

The Royal College of Emergency Medicine observed that in NHS England

“December’s performance figures are truly shocking, more than 50% of all patients facing waits over four-hours and nearly 55,000 patients facing 12-hour waits from the decision to admit. 12-hour waits from decision to admit obfuscate the truth and are only the tip of the iceberg, we know the reality is far worse.”

How far does Emergency Department performance need to fall for political leaders to take meaningful action? – RCEM

The NHS England A&E attendances and emergency admissions data was published for December 2022. For ‘all’ sites the performance was 65% in December (68.9% in November). But the Type 1 performance was 49.6% in December (54.5% in November). From this its clear that the leading body, RCEM, are clear that the A&E measure that should be focused on is Type1 (Major/Core).

As NHS Digital clear that for compatibility Type1/Core/Major sites should be used, and as RCEM are clear that Type1/Core/Major is the measure which shows A&E performance most clearly it is far from apparent why the PM would claim England’s A&Es were performing better than Scotland’s. As for over 7 years Scotland Core A&Es have performed better than England’s Type1 A&Es.

I hope this helps inform your consideration and I await your reply.

Yours faithfully,
Gillian Martin MSP


Related links:

Response from Sir Robert Chote to Gillian Martin MSP – A&E comparisons