Lothian's NHS backlog of cases will take years to clear, warns health board chair

It will take the NHS years to clear the backlog of cases that built up during the Covid pandemic, the interim chair of Lothian's health board has warned.

Thursday, 24th June 2021, 4:55 am

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And Covid control measures, including two-metre distancing, are slowing the pace at which patients can be treated and having an impact on waiting times, the board heard.

Esther Roberton, chairing her last board meeting before she steps down, said large backlogs were a national issue and there was a need to help the public understand the gravity of the situation. "We will not resolve this in months, it will be years."

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Edinburgh's Royal Infirmary
Edinburgh's Royal Infirmary

And she said she had raised the two-metre spacing issue with Scotland's national clinical director Jason Leitch.

"I urged him to progress as soon as they possibly can the review we know is under way on that two-metre distancing and made the point about the impact that moving to one metre would make on our ability to move forward."

Jacquie Campbell, chief officer for acute hospital services, told the board the backlog for outpatient appointments was about 37,500 and for patients with a treatment time guarantee just over 9,000.

She said: “We're still seeing a rising number of patients through coming the ‘urgent suspicion of cancer’ route; a stabilisation, but back at pre-Covid levels, of urgent referrals; and a

rising number of routine referrals that are just about hitting the pre-pandemic level.”

She said priority was given to the most urgent patients. “So, as we see an increased number of ‘urgent suspicion of cancer’ patients, more of our capacity is being skewed towards them and less to more routine patients.”

She said work was going on with primary care colleagues to ensure patients were referred at the right time and explore whether there were alternatives to face-to-face appointments.

Ms Campbell said operating theatres were working at 88 per cent of pre-Covid levels, but a staff shortage was acting a a constraint. “The vacancy rate is about 8.6 per cent; prior to Covid our vacancy rate sat at about 4.4 per cent. We have seen an increase in the number of people leaving for a variety of reasons.”

But a report to the board also highlighted areas of good performance, including the emergency department at the new Sick Kids hospital, which has consistently met the four-hour maximum waiting standard, the emergency department at St John’s Hospital in Livingston, which has had a “relatively strong” performance, although falling short of the 95 per cent four-hour standard, and breast cancer, which has consistently achieved the 62-day performance target each month since June 2020.

Deputy chief executive Jim Crombie warned there would inevitably be changes in the way healthcare operated in the wake of Covid.

“Recovery from this pandemic is seismic in nature. We cannot return wholesale to previous ways of working.”

He cited remote consultations and shifting away from face-to-face appointments.

But he praised staff for their dedication throughout the pandemic. “Our teams have worked incredibly well during the pandemic, they have demonstrated quite outstanding resilience and ongoing commitment.”

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