Comment: NHS Lothian needs to find more beds

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‘Throughput” seems too cold and clinical a term for the proper working of a hospital. But careful planning of admissions, operations and discharge is central to their effective working.

As we report today, health chiefs at NHS Lothian are being forced to cancel a growing number of operations because of a shortage of beds. A total of 600 pre-planned operations scheduled for September had to be postponed.

That means around 20 patients had to have their procedures cancelled each day.

The number of operations cancelled due to bed shortages has tripled in just four months. That is a deeply troubling statistic. And it is one that causes anxiety, frustration and stress for many patients.

There are few more worrying periods for those in need of treatment – particularly the elderly – than the period leading up to a scheduled operation. To be then told it has had to be postponed is more than a disappointment.

Many will see in this yet another sign of NHS under-funding and the growing difficulty in coping with demographic trends. We are living longer – and inevitably this means greater need for care and attention in our later years.

Others will point the finger at ”bed blocking” – the plight of those patients who, through no fault of their own, have had 
successful treatment but who 
find they cannot be released from hospital because of pressure on care facilities subsequent to discharge.

Clearly NHS Lothian needs to look at ways in which more beds can be provided – particularly with the onset of winter, a critical time for many who are frail or who are already in need of support.

But there is much that patients, too, can do to alleviate this problem. As Ian Ritchie, president of the Royal College of Surgeons of Edinburgh, reveals, almost half of the cancellations were made by the patients.

NHS Lothian has a higher than average number of patients who defer their own operations. So it is vital that, over the coming months, a major effort is put into improving communications with patients, agreeing a firm date for treatment and ensuring that there is minimum delay or postponement when the day arrives.