PATIENTS in Lothian are facing a winter of discontent amid fears soaring waiting times for outpatient treatment could leave the health service “on its knees”.
Waiting times are spiralling out of control as the number of people waiting more than 12 weeks for outpatient treatment has risen by nearly 65 per cent in just three months.
Despite serious attempts to clear the backlog which had crippled NHS Lothian for a number of years, a board meeting HAS heard that nearly 7000 patients were waiting beyond the target in August.
This shocking figure is believed to be the highest since the waiting times scandal in 2012, where staff were found to be doctoring times to meet Scottish Government targets.
Lothian residents face some of the longest waiting times in Scotland for outpatient procedures, which can include electives such as cataract surgery or hip and knee replacements.
This compares to health boards such as NHS Greater Glasgow and Clyde, which reported just 854 patients waiting longer than 12 weeks or NHS Lanarkshire which had 317 patients waiting beyond the limit, according to recent board papers.
Acute care boss Jim Crombie promised to slash the backlog to zero by March 2015 but admitted to the Evening News that his efforts had failed due to a number of “icebergs” in his path.
These included so-called bedblocking – where hundreds of patients are trapped in hospital due to lack of social care – as well as severe difficulties in recruiting key staff.
Mr Crombie told NHS Lothian’s board earlier this month that the situation was “disappointing” but an unprecedented rise in demand was simply outstripping capacity.
He said: “It is very challenging. For me it is disappointing that we have seen that the trend in outpatients has doubled in recent months.
“I would assure you all it is something which is a clear focus for leadership across the specialities.”
Health chiefs have been left scratching their heads over why the demand for these procedures has soared so fast, which Mr Crombie has pledged to investigate ahead of the next board meeting in December.
The number of delayed patients in ENT has doubled since May, while trauma and orthopaedic surgery saw 1291 patients wait over 12 weeks in August compared to 665 in May thanks largely to the ageing population.
NHS Lothian chief executive Tim Davison said the spike in demand was not conforming with any predictions and left a “worrying situation” for everyone.
A decision to cut down on use of Wales-based agency Medinet has also been blamed for contributing to the rise.
The firm was drafted in to help NHS Lothian with routine procedures in 2012 by providing staff and resources when they are otherwise not in use.
Squeezed budgets have contributed to the decision to phase out Medinet, but Mr Crombie said the reduction had certainly had an impact on NHS Lothian’s capacity.
The former nurse promised that a number of ideas were being explored to ease the strain, such as plans for follow-up appointments online so patients did not have to wait days for letters to be sent by post.
The figures were branded as “shocking” by politicians, who said patients would suffer as winter placed greater pressures on the already struggling service.
Lothian Labour MSP Sarah Boyack said: “The rate of increase in waiting times for outpatients is shocking. If waiting times are this bad over the summer, NHS Lothian will be on its knees this winter.
“We already know NHS Lothian is pouring money into private health services to tackle waiting times because there is not enough staff and capacity in-house, and today we learn thousands of outpatients can’t expect to be seen within 12 weeks.
“Our Lothian population is both aging and growing, so these pressures aren’t going to ease unless we get on top of our capacity issues.
“The solution is better access to GPs, more care services so patients can leave hospital when they are ready and, crucially, investment in the range of permanent NHS staff we need.”
She added: “The systemic problems in NHS Lothian need to be fixed.”
Nicola Sturgeon told the SNP conference last week of plans to invest £50 million in specialist centres at the Edinburgh Royal Infirmary (ERI) and St John’s Hospital, Livingston, to focus on elective treatments such as cataract surgery and hip re-placements to ease some of the strain.
But concerns have been raised over when the centres will be built, and how the service will cope until they are built.
Scottish Conservative health spokesman Jackson Carlaw said: “The SNP’s new elective centres may sound good, but patients will be extremely sceptical about whether or not they have an impact on these kinds of disgraceful figures.
“It’s completely unacceptable for this many people to be waiting more than three months to begin treatment. The Scottish Government has promised time and again that these figures would come down.
“Yet here we see the statistics moving sharply in the other direction.”
Mr Carlaw added: “It’s time for ministers to get a grip on this and provide health boards with the help they need to make sure patients aren’t waiting unnecessarily long to begin treatment on what can be painful and unpleasant situations.”
Union leaders welcomed the decision to cut spending on external providers, as that money can then be redirected into increasing NHS Lothian’s capacity.
Tom Waterson, Lothian branch convener for Unison, said: “These figures are very surprising.
“I am glad we have a reduction in the use of Medinet as I believe we shouldn’t be using them at all. I believe we can find slack in the system to address these ridiculously high waiting times.”
A raft of new measures were brought in by Mr Crombie – who was branded “The Terminator” – last year to tackle waiting times, including conducting pre-planned operations at weekends and sending patients for treatment at private hospitals as well as the Golden Jubilee Hospital in Clydebank.
The waiting list scandal came to light in 2012 when it emerged patients were being offered unrealistic offers of operations in England and were not included in the figures when they had to refuse the appointment.
NHS Lothian was given £3 million by the Scottish Government in February to help it hit waiting times targets.
‘RESCUE MISSION’ FAILS TO REVITALISE NHS LOTHIAN
HEALTH chief Jim Crombie was parachuted into NHS Lothian in 2013 to help the board slash waiting lists.
He pledged to cut the number of people waiting over 12 weeks for inpatient and outpatient care to zero by April 2015 on taking up the role.
This would have brought NHS Lothian in line with the Scottish Government’s treatment time guarantee, which provides legal assurance to patients for prompt inpatient treatment.
These would be non-emergency surgeries which require an overnight stay.
Mr Crombie also promised to reduce the backlog of outpatients waiting longer than 12 weeks to zero to meet another Holyrood target.
Despite significant investment for sending patients for treatment in the private sector, sending patients to other health boards and increasing weekend operations, NHS Lothian has failed to meet Mr Crombie’s ambitious targets.
Bedblocking and recruitment issues have posed a problem for the health board.
But vacant positions are starting to be filled, so Mr Crombie said he was “optimistic” that this would help to clear the backlog of patients by the end of this year.