GPS ‘being pushed to the brink’ by staff shortages
●Family doctors issue dire warning as nurses offered 9 per cent pay deal
Scotland’s medical leaders have warned that patient safety is now at risk over the chronic lack of resources in the NHS – and the situation has “worsened” in the past year.
The decline is so stark that the NHS won’t be able to offer “comprehensive care” for Scots within a decade, according to a survey of 1,000 doctors by the British Medical Association in Scotland.
Staffing levels are inadequate to provide quality care in Scotland’s hospitals with the profession “stretched to the edge”, BMA Scotland chair Dr Peter Bennie will say in his final speech to the BMA’S annual representative meeting in Brighton today. He steps down this autumn. The latest warning comes as the bulk of NHS staff in Scotland have been offered a 9 per cent pay rise, spread across three years.
Major trade unions, including Unison and the bodies representing nurses and midwives, welcomed the offer as “the best that could be expected in the current climate”.
However, the GMB union said it would not recommend members accept the offer as it is “not a credible prescription for tackling a decade of austerity on staff ”.
Doctors in Scotland are slightly less negative in their views of the NHS than those south of the Border, the findings suggest.
But the health service in Scotland is experiencing the same problems as elsewhere in the UK and must
aim higher than the “very low bar” of simply being better than England, according to Dr Bennie.
“The survey results in Scotland demonstrate the stark reality of a profession pushed to the brink,” he will tell delegates.
“We are stretched to the limit of what we are capable of. Perhaps we have not quite reached the dire working conditions and morale seen in England, but we are clinging by our fingertips from sliding down a similar path.”
Demands and pressures on doctors have been rising in recent years, he will say, while vacancy levels have also increased.
“It is just not sustainable, for our NHS or for our profession,” Dr Bennie will add.
“We know from the survey that two-thirds of Scottish doctors who responded think resources are inadequate and this is significantly affecting the quality and safety of care, while 71 per cent feel that overall NHS services have worsened in the last year. Nine out of ten Scottish doctors say staffing is simply not adequate to provide quality patient care.
“This is simply not good enough, either for patients or doctors. We all want to provide the very best care we can, but we are being prevented from doing so by an under resourced and under staffed system. The plans for addi- tional investment in England’s NHS announced in recent days, and the expectation of further resources for Scotland, may give us an opportunity to stop that gap growing further.”
The waiting and treatment time targets which lead to a “culture of blame and political pressure” must also end, he adds, with a focus on patient outcomes. It comes after a weekend poll suggested Scots would be ready to pay more in tax if the cash went to the NHS.
Just 3 per cent of medics said they thought NHS resources in Scotland were adequate for patient care, the BMA survey found, the remainder saying they are inadequate and slightly (31 per cent) or significantly (66 per cent) affected the quality of patient care. Nine out of ten (89 per cent) said that staffing levels were not adequate, while a similar level (88 per cent) agreed that without a substantial increase in funding the NHS in Scotland will no longer be able to offer “comprehensive care” within a decade.
But health secretary Shona Robison insisted that the Scottish Government has a “strong commitment” to the NHS.
“Our NHS faces the welcome challenge of meeting the changing needs of the people of Scotland, with people living longer and driving rising demand. Our investment has taken NHS funding to record high levels, and we continue to push the UK government to deliver a net benefit to Scotland’s budget following their recent NHS funding announcement. We will continue to work alongside NHS staff to improve services and provide the high level of care patients expect.”
Tory health spokesman Miles Briggs said: “It’s no surprise to see doctors speak out over the state of Scotland’s Nhs.they’ ve put up with more than a decade of SNP mismanagement, and worked exceptionally hard to keep problems at bay.”
The survey prompted fresh calls for Ms Robison to go.
Labour’s health spokesman Anas Sarwar said: “It is increasingly clear that SNP health secretary Shona Robison is out of her depth and out of time, with the SNP government presiding over a recruitment crisis in our health service.”
Lib Dem Alex Cole-hamilton said: “Struggling services such as GPS and mental health clearly need a cash injection, fresh ideas and for Nicola Sturgeon to change her health team.”
“Nine out of ten Scottish doctors say staffing is simply not adequate to provide quality patient care”
DR PETER BENNIE
BMA Scottish chair
A Scottish hospital has become the first in the UK to dedicate a state-of-the-art robotic surgery system for lung patients, a move which could have a transformational impact on recovery times.
The £1.3million Da Vinci system enables surgeons to perform operations through a few small incisions, instead of more invasive procedures which take longer to heal.
While the machine has been installed at several NHS facilities across the country, the one installed at the Golden Jubilee National Hospital in Clydebank is the first to be used solely by a thoracic services unit.
Clinicians believe the system will pay for itself in the long term by allowing patients to return home quicker and require less care as their outcomes improve.
Cardiothoracic consultant Alan Kirk, who has used the Da Vinci on lung patients, said: “It is probably standard of care for most urology or prostate cancer work and recently over the past five years in the UK people have diversified and started using it for chest surgery.
“We are the first unit in the whole of the UK to buy one specifically for lung surgery.
“Although it looks very complicated, it’s really an extension of what we already do on a keyhole and minimally invasive platform, but this takes things one stage further forward.
“Over the past five years, we’ve gone from big open operations for lung cancer to 80 per cent of our lung cancer procedures now being done by conventional keyhole surgery and now there is a natural extension of that, which we hope and anticipate will result in improved patient outcomes.”
Mr Kirk added his colleagues at other hospitals had to compete with various departments for access to their respective Da Vinci systems.
He continued: “Our plan over the next 18 months is to develop this to the stage that those who need or want robotics will
ALAN KIRK
be able to get it. One of the reasons we are at this stage is that we are one of the biggest units in the UK.
“But we now have the ability to operate on more people with lung cancer – of which there are 4,600 cases in Scotland each year. Twenty years ago, only 10 per cent got an operation. Now it’s in excess of 25 per cent.”
The robotics system also benefits the surgeons who use it as well as the patients.
“The vision you get is highdefinition and in 3D and is fantastic,” added Mr Kirk. “You’re looking at 360-degree articulation, which you cannot have working under your own hand. The precision of the surgery, the dexterity, and the vision makes it better for all.”
There are currently 38 units delivering lung cancer and chest surgery across the UK, eight of which have access to robotics.
The thoracic team at the Golden Jubilee was relatively small a decade ago, but has since expanded and developed a reputation for innovation.
In 2015 the hospital became the first in Scotland to use 3D imaging during keyhole surgery on patients needing treatment for lung cancer.
Previously only used in gynaecology and colorectal surgery, the 3D imaging system offers improved depth perception on patient images, giving surgeons a more accurate picture of the patient’s condition and making operations quicker, safer and more effective.
“Although it looks very complicated, it’s really an extension of what wealreadydoona keyhole and minimally invasive platform”
Cardiothoracic consultant