Now I’m a fan of statistics. But statistics about apples are not the same as statistics about pears. It’s fine to compare apples and pears, but not if you insist that them’s all apples and there’s no pears!
Yet that is what happens on the BBC and other mainstream media about NHS A&E Depts. Them’s all A&E Depts…. Them’s all A&E waiting times…. No they’re not!
When is an A&E Dept not an A&E Dept?
In 2021 I injured my wrist on a Friday morning. By Friday evening I was speaking to a 111 doctor who said I needed to go to A&E for x-rays. Then he added “But Friday evening is not when you want to be in a Glasgow A&E, I’ll book you into the Small Injuries unit tomorrow morning.” A Small Injuries Unit does a great job of patching us up but it isn’t necessarily consultant-led, and isn’t open 24 hours a day.
We know what we mean by A&E Dept: full service, consultant led, and open 24/7, with beds for receiving patients from accidents and other incidents. This is the main entrance of the A&E Dept at QEUH in Glasgow, taken a week or so ago. Note the sign “Major Trauma Centre” and also the lack of a long queue of ambulances outside. In Scotland we call this a ‘Main’ A&E. In England it’s ’Type 1′, and in Wales it’s a Major A&E. The Minor Injuries Unit, just a bit further along out of shot, is a Type3 A&E in England. The Glagow Dental Hospital is referred to as a Type2 A&E in England.
The QEUH A&E Dept – like all A&Es in Scotland – is a Main A&E. They get all the complex, traumatic, major incident cases. When my cousin collapsed in her home over in Argyl, she was helicoptered to the roof of the QEUH. The small rural units and the small injuries units get people like me who fall off the back of a treadmill and break their wrist.
How A&E Stats are compared
When BBC Scotland reports figures for Scotland’s A&Es, they – quite reasonably – use statistics from Main A&E Depts. But when BBC reports figures for NHS England they more often use figures for ‘All A&Es’. This matters.
I was in and out of the minor injuries unit in an hour, with my wrist x-rayed, strapped up and a video appointment with an orthopaedic specialist set up for the week after. My cousin was in the main A&E for hours and later transferred to a medical ward. My attendance and waiting time are not included in Scottish Main A&E stats as reported by BBC Scotland. But had I lived in England my visit would be included in BBC reports on All A&E stats. That method of counting and reporting results in a lower average A&E waiting time for NHS England.
Is this a Unionist Conspiracy? Nah, probably not
I have a very low opinion of the BBC’s ability to report statistics well. There are some fine exceptions – Robert Cuffe is one, and the Radio4 ‘More or Less’ series is another – but on the whole they’re rubbish at it. So I tend not to think there is anything deliberate in the A&E discrepancies.
But even if BBC is just rubbish at statistics, politicians should, and probably do, know better than to take the figures at face value. So next time you hear comparisons being made between England, Wales and Scotland A&E performance, remember that they might be comparing apples with pears!
There are 170 Type1 A&Es in England. I’ve tried hard to find out what proportion that is of all A&Es but without success. If you know leave us a comment.