How England’s NHS is outperforming ours

ALISON Johnstone MSP (Letters, June 9) rightly states “performance not personalities” matter more than “trying to claim a scalp” in reference to calls for the Health Secretary Shona Robison to step aside. The problem is the NHS Scotland performance is tumbling downwards year on year, and in many respects it is a Scotlandspecific NHS poor performance, not mimicked south of the Border.

Take for example two key NHS areas where the Scotland performance gap to England NHS is not just a gap, but a gulf. Key diagnostic tests should and can facilitate early targeted life-saving treatment or avoidable adverse health outcomes. The percentage of patients not receiving these tests within six weeks in England has narrow ranged between one per cent and three per cent every month, stable over the last decade. While Scotland matched this England NHS performance in March 2012, by March 2015 it was nine per cent not receiving these tests within six weeks. By March 2018 the Scotland NHS figure is now 19 per cent missing the vital six-week diagnostics target, compared to just two per cent in England as at the same date. This is a nine-times inferior Scotland NHS performance, inferior every month for more than four years, and a declining performance trend for five consecutive years. In other words, it is not a sudden NHS poor performance that appeared out of nowhere.

In terms of delayed discharge patients, there has been no sustained progress in Scotland since April 2012 when there were 1,290 blocked hospital beds every day, compared to in April 2018 a figure of 1,380 blocked hospital beds daily, and no improvement on the April 2017 figure of 1,360 blocked beds. The welcome reduction since peaking in December 2014 at a ludicrous 1,840 hospital blocked beds daily, has not yet returned to 2012 levels.

In NHS England (taking a 10 per cent comparator figure to equalise for Scotland’s smaller population) there were 500 blocked beds daily in March 2018 reduced by 20 per cent recently from 640 in March 2017, and 360 blocked beds daily in April 2012. The England NHS delayed discharge performance, a key barometer of NHS joint working efficiency, has been in a different league every month for at least seven years, with the Scotland NHS blocked beds rate well over double the England performance figure, and England NHS counts an additional category of delayed discharge patient.

Some localised downward movement in bed blocking in Scotland has been facilitated by the dubious practice of temporarily warehousing elderly people en masse in interim care home placements outside of hospital such as in both Glasgow and Edinburgh. The Care Inspectorate Joint Inspection of Services for Older People in Edinburgh of May 2017 was correctly concerned about this practice, reporting: “Older people were sometimes transferred to interim care while a care home or care at home services could be organised. While this helped reduce pressure on the acute hospitals, staff realised that this was often not in the best interests of the older person.”

The emotional distress, uncertainty, and disorientation this extra temporary move must cause to some older people with memory or other health issues can never be a policy substitute for getting core joint health and social care assessment and discharge processes person centred, and working efficiently, as they should.

Richard Richardson,

Albert Road, Glasgow.