Audit of critical care in NHSScotland
Reporting on 2022

About this release

This release by Public Health Scotland (PHS) and the Scottish Intensive Care Society Audit Group (SICSAG) provides a summary of the activity, quality indicators, interventions and outcomes of critical care services in NHSScotland during 2022.

Main points

• During 2022, there were 16,705 admissions to intensive care units (ICUs) and combined units. There were 21,222 admissions to high-dependency units (HDUs).
• Mortality in ICUs/combined units was 12.3% and in HDUs was 4.7%. After allowing for differences in case-mix and illness severity, no ICU/combined unit had a significantly higher standardised mortality ratio than the national average.
• Delayed discharges continue to be challenging, with 62% of ICU patients delayed for more than 4 hours. This is a substantial increase compared with previous years of 52% in 2021 and 44% in 2020, reflecting bed pressures across hospitals. This is similar in the HDU units with 59% delay in 2022, 52% in 2021 and 50% in 2020.
• Four out of 22 ICUs did not achieve compliance with three SICS minimum standards and quality indicators (MSQIs), with staffing challenges contributing to three of these instances.
• Units not meeting MSQIs have provided a summary of how they plan to achieve these in the coming year.

Background

Critical care units are specialist hospital wards for the most severely ill or injured patients. They treat patients with a high level of complexity. This audit includes all ICUs and the majority of HDUs in NHSScotland during 2022.

It is not possible to provide an accurate figure on the number of HDUs due to differing provisions across all specialties and Health Boards. However, it is estimated that more than 95% of all HDUs participated in this audit. The audit covers nearly 35,000 patients admitted to critical care units in NHSScotland during 2022.

SICSAG aims to improve the quality of care delivered to critical care patients by monitoring and comparing activities and outcomes. The audit of critical care is a co-ordinated quality improvement programme which provides data, analysis and feedback to raise standards and continued improvement in patient outcomes.

Critical care units have provided detailed comments where any MSQIs were not fully met. Specific COVID-19-related data are available in the 10 COVID-19 reports published in 2020, 2021 and 2022.

Further information

The next release of this publication will be 13 August 2024.