Edinburgh and Lothian hospitals under pressure as Royal Infirmary hits 100.5 per cent capacity

The day-to-day pressures facing Lothian's hospitals have been revealed in an official snapshot which found Edinburgh's Royal Infirmary operating at 100.5 per cent capacity.

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The snapshot showed that across the region's three main hospitals on one day last week there was a queue of 51 people waiting to be admitted from emergency departments, 268 patients whose discharge was delayed and 48 patients with Covid over the three sites.

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In a briefing for local MSPs, NHS Lothian said: “Our system remains under considerable pressure due to prolonged staffing challenges, demand for services and the enhanced infection prevention and control measures that are still necessary in healthcare settings.

"As a random snapshot, on Tuesday, June 7 at 0830, the Royal Infirmary, Western General Hospital and St John’s Hospital were very busy, with bed occupancy rates at 100.5 per cent, 98.1 per cent and 98.4 per cent respectively.”

Normally, 85 per cent is seen as the maximum desired occupancy to reduce the risk of bed shortages and cope with unexpected surges in patients.

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The briefing added: "Although this is a snapshot of one day, this is a consistent daily pressure that acute services are and have been experiencing for many months.”

It said there were regular meetings to monitor staffing and identify hot spots where there were difficulties.

Edinburgh's Royal Infirmary was operating at 100.5 per cent capacity.  Picture: Greg Macvean.Edinburgh's Royal Infirmary was operating at 100.5 per cent capacity.  Picture: Greg Macvean.
Edinburgh's Royal Infirmary was operating at 100.5 per cent capacity. Picture: Greg Macvean.

The briefing outlined a slow recovery from the pandemic. Outpatient activity had returned to levels the same or higher than pre-Covid and the number of patients waiting a long time had been reduced. “Despite this we currently have 61,000 patients waiting for a routine new outpatient consultation, and over 76,000 outpatients waiting overall.

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"For in-patients and day cases the waiting list continues to rise with more than 15,300 patients waiting for routine treatment, (with over 24,200 waiting overall), with over 5,100 routine patients waiting over one year (and more than 6,200 overall).”

It said the number of people attending emergency departments had been gradually declining since September 2021. But it added: “There continue to be significant challenges in delivering the four-hour emergency access standard, with performance remaining low at 64.4 per cent in April 2022, resulting in long waits for patients within the emergency departments. Waits for admission is one of the main causes for long waits.”

The briefing said tackling delayed discharges was a key priority for NHS Lothian board. An “interim bed placement scheme” had been in operation for some months to help reduce the number of delayed discharges. “This scheme allows faster discharge of patients who are fit to leave to an appropriate place of care, while they wait for their preferred care home placement or package of care to support them to return home, and maximises the use of the places available across Lothian.”

But it acknowledged that the problem had been increased with many care homes closed to admissions and high sickness and absence rates among care-at-home staff. And it was still difficult to recruit new staff because of a competitive local jobs market.

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"We continue to work with our Health and Social Care Partnership colleagues, care homes and families to arrange supported discharge for patients as quickly as possible and are working with Internal Audit to identify further areas we can improve across the whole system.”

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