Waiting lists come down at NHS Lothian despite patients’ reluctance to travel west for surgery

Edinburgh patients have proved reluctant to undergo surgery in Glasgow
Edinburgh patients have proved reluctant to undergo surgery in Glasgow
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HEALTH bosses say they are “turning the corner” in NHS Lothian’s waiting list crisis – despite a huge number of patients rejecting the chance to be treated more quickly at private hospitals in Glasgow.

The health board has reported that the number of patients waiting longer than the 12-week target for inpatient and day case treatment is on course to fall to 880 by the end of this month – down from 1432 at the end of August and 1658 in July.

And with the number of outpatients waiting more than 12 weeks also reducing, health board chairman Dr Charles Winstanley said: “There’s clearly a long way to go, but it does seem to me that we are turning the corner.”

The reductions have been made despite a large-scale rejection of NHS Lothian’s initial plan to pay for thousands of overdue patients to go to private hospitals in the west for operations.

When the £20m plan to tackle the backlog was revealed it was forecast that more than half of these patients would be sent to Glasgow, but at the end of August, just 15 per cent of them had been treated outside of Lothian.

In June, it was predicted that £5.2m would be spent at BMI Ross Hall Hospital in Glasgow while more than £1m had been earmarked for the Nuffield Health hospital in the city over the course of the financial year. But at the end of August, just £631,000 had been spent at Ross Hall and £24,000 had been paid to Nuffield Health.

Just over £1m was spent on sending patients to the Golden Jubilee National NHS Hospital in Clydebank – also lower than anticipated.

Tom Waterson, Unison branch chairman for Lothian, said the figures reflected a reluctance among Lothian patients to be treated in private hospitals. He said: “It doesn’t surprise me that there’s been a low acceptance for places at the private-sector hospitals. The population in Scotland isn’t keen on private healthcare – there’s a marked difference between attitudes here and the rest of the UK.

“Money should be reinvested to build up capacity in the NHS. A pound spent in the NHS goes much further than one in the private sector. It’s our own staff that will sort out the waiting list disgrace.”

More than predicted has gone on sending patients to the Spire Murrayfield private hospital in the Capital, with the £3.3m paid by August almost the full amount that it was predicted would be spent in ten months.

NHS Lothian’s medical director, Dr David Farquharson, admitted the plan had “changed substantially” as more patients than expected were able to be treated in NHS hospitals by private teams.

Patients will continue to be offered appointments in Glasgow, despite their reluctance to travel, and could be offered accommodation or transport as sweeteners.

The number of outpatients waiting more than 12 weeks for treatment is set to fall to around 4000 this month, from 4962 in at the end of August and 5069 in July. The reduction has largely been due to an increased use of Medinet – the external company that has provided the staff to work in NHS Lothian facilities mainly at weekends. The staff have been largely concentrated in general surgery and urology departments, which have seen significant reductions waiting list sizes.

Speaking at a health board meeting, NHS Lothian chief executive Tim Davison said the reduction in patients waiting more than 12 weeks suggested the board had “broken the back” of the issue. It is predicted that there will be no overdue inpatients and day case patients by the end of the year, and it is hoped no outpatients will be waiting more than 12 weeks by March.

A 12-week treatment time guarantee, which means patients will have a legal right to receive treatment within a maximum of 12 weeks from when they are diagnosed and agree to the treatment, comes into force today.

Mr Davison said: “Our endeavour is not just to get rid of the backlog but to create a sustainable system where we take as many off the list as we are putting on it. It’s a long haul and it takes unremitting effort – it’ll probably be two years before we can say, what next?”

Dr Farquharson added: “I am encouraged to see that the numbers of patients waiting to be treated has continued to fall. We are making real progress, but I would like to reassure those affected that we will remain attentive and will not become complacent.”

The waiting list figures do not include patients who are overdue for endoscopy procedures – with 2400 waiting up to four years for a surveillance colonoscopy at NHS Lothian facilities.


NHS Lothian has revealed a plan to increase its capacity so that it will not be so reliant on the private sector to treat patients.

Plans have been approved to hire the equivalent of 79 staff – at an initial cost of more than £3.3m – and more additions to the workforce are expected to follow.

Among the new staff members being recruited are:

• An upper limb surgeon

• A back surgeon

• A consultant urologist

• A plastic surgeon

• Six anaesthetists

• 45 nurses

The investment will be spread across the orthopaedics, urology, plastic surgery, endoscopy and anaesthetics and theatres departments.

Many of the posts have already been advertised and it is hoped that they will be filled within months.

Tom Waterson, Lothian branch secretary for Unison, welcomed the recruitment of new NHS staff.

He said: “To be fair, Tim Davison has been listening to the concerns of the trade unions. We have been saying we need to invest to bring up capacity.

“We’re delighted with these steps – but they should have been taken a long time before now.”

The crucial dates

October 2011: NHS Lothian denies doctoring waiting times targets by offering patients procedures in England and removing them from lists if they refused.

January 2012: Auditors are brought in amid claims a huge “hidden waiting list” exists at NHS Lothian.

March 2012: Then Health Secretary Nicola Sturgeon takes charge of the investigation

March 2012: The probe finds thousands were bumped off waiting lists in “appalling” manipulation of figures.

April 2012: Chief executive James Barbour retires amid waiting list scandal and as report reveals bullying culture at NHS Lothian. Tim Davison steps in.

May 2012: It emerges 7000 people are waiting too long for treatment as true extent of problem is revealed.

June 2012: A £20m plan, including extensive use of private sector, is unveiled in a bid to treat patients.