Cancer services to restart as NHS begins its long recovery

●Mental health pioritised in bid to tackle ‘hidden crisis’ of the pandemic

Cancer treatments, mental health services and paediatrics are to be prioritised under a blueprint unveiled by ministers for restarting NHS treatments delayed by the coronavirus outbreak.

Health secretary Jeane Freeman said services would resume on a “cautious, phased” basis as lockdown measures are gradually eased.

It follows growing concern at the toll from serious health conditions going untreated as non-urgent appointments and surgeries were delayed, with more than 1,200 excess deaths from non-coronavirus causes in the two months since the outbreak claimed its first life in Scotland. Scotland’s excess death rate, while below the average for the UK as a whole, is estimated to be among the highest in the world, with Spain, at 861 per millions, thought to be the only country outside the UK with a worse rate.

Ms Freeman and Scotland’s

national clinical director Professor Jason Leitch also revealed that new advice will be issued in the coming days to the 120,000 Scots with serious underlying health conditions that have kept them “shielded” indoors for the past ten weeks.

The health secretary said she wanted to “move away from a blanket approach” that has imposed the strictest lockdown on those in the most vulnerable category.

The latest daily figures put the death toll in Scotland among those who tested positive for Covid-19 at 2,362, an increase of nine.

As of Saturday night, 1,073 people were in hospital with either confirmed or suspected Covid-19, a fall of 41.

Across the UK, there were 113 new deaths recorded in the previous 24 hours, taking the death toll to 38,489. The number of new confirmed daily infections fell below 2,000.

Announcing a “framework for NHS mobilisation”, Ms Freeman said the restart would begin with those services whose absence was “clearly having a detrimental impact on people’s lives”. She added: “But as we do that we must make sure we keep sufficient capacity to deal with any surge in Covid-19 cases.”

She said hospitals would start doing “some elective surgery that is urgent and has been postponed”.

In addition, mental health support will be made “more widely available”, Ms Freeman said, with cancer services also identified as a priority.

Care provided at emergency dental hubs will be expanded as dentists prepare to return to work.

She said: “The plan sets out an approach which is cautious, phased and based on evidence. It is informed by our experience in recent weeks.”

As services are reintroduced, she said there would be “constant checking” on the prevalence of the virus and the R number – the average number of people who are infected by each person who contracts Covid-19.

In a written parliamentary answer to Scottish Labour, Ms Freeman revealed there had been 1,209 excess deaths from non-coronavirus conditions between 16 March, the week the first death from the virus was recorded in Scotland, and 10 May, compared with the average number for this period over the past five years.

Scottish Labour leader Richard Leonard described the figures as “heartbreaking” and said the plan to restart NHS services was “too vague”.

The deaths include 153 more deaths from cancer than the average, and 430 more from dementia.

“I am concerned that this framework provides a lack of detail, and commitment to dates to reopen services, and a vague approach to moving forward,” Mr Leonard said.

He added: “The number of excess deaths for non-covid-19 illnesses has been heartbreaking and shows that we can’t delay reopening services for months.”

Scottish Lib Dem leader Willie Rennie told ministers yesterday: “We cannot ignore the plight of people suffering under the lockdown.”

He added: “Every week I am contacted by people who are either living with painful conditions, struggling with their mental health or waiting on operations that have been deemed non-urgent.

“These people have bravely and stoically put up with much discomfort because they understand the importance of the lockdown to keeping everybody safe, but this situation cannot last forever.”

Mr Rennie said he fears there will be a “significant backlog of mental health cases, surgery waits and the like”, adding that ministers should make clear how long patients could have to wait for “overdue” treatment.

Ten thousand fewer Scots were admitted to hospital for planned treatment in March than in the same time last year as the impact of Covid-19 was felt by the health service.

NHS data showed 16,561 patients were admitted to hospital for inpatient or day-case procedures in March this year, down from 26,033 12 months before.

Interim chief medical officer Dr Gregor Smith said the framework, called Re-mobilise, Recover, Re-design, “includes the significant innovations introduced across the NHS to assess patients utilising digital technology”.

Digital and remote consultations will be used to reduce the need for patients in remote areas of Scotland to travel for appointments and cut the risk of infection.

“The reality is, coronavirus is likely to be with us for some time to come, and so many changes made in the coming weeks and months have to be measured against the need to keep the virus under control, continuing to protect the NHS and save lives,” Dr Smith added.

After the first weekend under looser lockdown restrictions, Ms Freeman said she was still “a wee bit nervous”, with images from Loch Lomond to East Lothian showing people flocking to beaches and parks to enjoy the good weather.

“From what I’ve seen so far, the vast majority of people continue to follow the public health guidance,” Ms Freeman said. “The central advice continues to be stay at home.

“I know that it is hard in the good weather, but it is essential. The reasons you can leave your home are exceptions, they are not the norm.”