NHS Lothian's backlog of cases 'will take years to clear'

NHS Lothian is facing a backlog of nearly 40,000 appointments which will take “years” to clear – amid fears two-metre social distancing will prolong waiting times.

Interim chair Esther Roberton addressed the two-metre distancing issue with national clinical director Professor Jason Leitch, a meeting was told.

The backlog for outpatient appointments was said to be about 37,500.

Ms Roberton said: “We will not resolve this in months, it will be years.”

She said a reduction to one-metre distancing would make a substantial difference in dealing with patients and urged Professor Leitch to help.

Ms Roberton added: “I urged him to progress as soon as they possibly can.

“The review we know is under way on that two-metre distancing and made the point about the impact that moving to one metre would make on our ability to move forward.”

Jacquie Campbell, chief officer for acute hospital services, told the board the backlog for outpatient appointments was about 37,500 and for patients with a treatment time guarantee just over 9000.

She said: “We’re still seeing a rising number of patients coming through the ‘urgent suspicion of cancer’ route; a stabilisation, but back at pre-Covid levels, of urgent referrals, and a rising number of routine referrals that are just about hitting the pre-pandemic level.

“So, as we see an increased number of ‘urgent suspicion of cancer’ patients, more of our capacity is being skewed towards them and less to more routine patients.”

She said work was going on with primary care colleagues to ensure patients were referred at the right time and to explore whether there were alternatives to face-to-face appointments.

Ms Campbell said operating theatres were working at 88% of pre-Covid levels, but a staff shortage was a constraint.

She added: “The vacancy rate is about 8.6%; prior to Covid our vacancy rate sat at about 4.4%.

“We have seen an increase in the number of people leaving for a variety of reasons.”

But a report to the board also highlighted areas of good performance, including the emergency department at the new Royal Hospital for Children and Young People, which has consistently met the four-hour maximum waiting standard.

The emergency department at St John’s Hospital in Livingston, West Lothian, was said to have had a “relatively strong” performance, although falling short of the 95% four-hour standard, and breast cancer treatment consistently achieved the 62-day performance target each month since June 2020.

Deputy chief executive Jim Crombie warned there would inevitably be changes in the way healthcare operated in the wake of Covid.

“Recovery from this pandemic is seismic in nature,” he said.

“We cannot return wholesale to previous ways of working.”

He cited remote consultations and shifting away from face-to-face appointments.
But he praised staff for their dedication throughout the pandemic.

Mr Crombie added: “Our teams have worked incredibly well during the pandemic, they have demonstrated quite outstanding resilience and ongoing commitment.”