Covid Scotland: NHS Lothian forced to 'reconsider normal' as pressure continues

NHS Lothian is investigating ways to streamline care and “work smarter” in the face of continuing pressure across the system, officials said.

It comes after weeks of warnings of high pressure in NHS Lothian and other health boards across Scotland.

Non-urgent operations have been cancelled in many areas, including the Lothians, so that staff can focus on the most urgent cases.

NHS Highland, where non-urgent orthopaedic care has been cancelled, warned of a “significant increase” in Covid cases recently.

A Covid 19 patient is cared for in a negative pressure room at the Royal Alexandra Hospital, Paisley

One outbreak has been linked to a tournament last weekend at Oban Lorne Rugby Football Club.

Some 31 positive cases have been identified.

NHS Highland said that due to the “scale of the outbreak”, all players and anyone who entered the clubhouse had been asked to self-isolate.

Demand on hospital services has been linked not just to Covid patients, but to non-Covid viruses and a backlog of care paused during the pandemic.

Staff sickness and absence due to annual leave and self-isolation after contact with positive Covid cases has left services struggling to cope, leading to longer accident-and-emergency (A&E) waiting times and the cancellation of non-urgent care.

Staff in NHS Lothian are being asked to volunteer to cover extra shifts, and special “bed-busting” teams have been set up to make sure patients are transferred and beds are made ready as soon as possible.

Some wards with smaller numbers of patients have been merged to reduce staffing needs.

Around 460 new nurses are expected to start in NHS Lothian over the next two months, while extra admin and domestic support has been brought in to give clinical staff more time for patients.

Nurse director Professor Alex McMahon said long-term changes may be made in the way the health board operates, based on a reconsideration of “normal” during the pandemic.

“Teams across Lothian are investigating ways of streamlining services and working smarter to ensure we can continue to deliver the best possible care for our patients,” he said.

Prof McMahon added: “We are doing everything possible to mitigate the additional pressures we are facing. However, we have to be realistic.

"These challenges will not disappear overnight. We continue to work through appointments that have already been re-scheduled in recent months and to see people who may have delayed seeking treatment because of Covid-19. This will take time.

"We also continue to be restricted in the number of people we can see each day because of the enhanced infection control measures in place. Covid is still with us.”

It comes as Scotland recorded an increase in daily Covid cases for the third day in a row.

But the most recent survey from the Office for National Statistics, which operates with a time lag of at least a week, recorded a fall in cases.

As of the end of last week, around one in 190 people were estimated to have the virus.

Scotland recorded eight coronavirus deaths and 1,542 new cases in 24 hours to Friday.

Dr Simon Clarke, associate professor in cellular microbiology at Reading University, said the UK was “running hot” when it comes to managing Covid spread.

"Wider rollout of the vaccine may reduce infections, but high case numbers still place an unnecessary burden on the NHS,” he said.

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