WE CAN’T COPE

Health board make extraordinary admission as winter approaches

SCOTLAND’S NHS has admitted it ‘cannot cope’ with an anticipated surge in demand this winter, with patients facing months of cancelled operations and lengthening delays for treatment.

In the starkest warning yet about the escalating crisis, health board bosses described a ‘perfect storm’ of Covid, winter pressures and crippling staff shortages.

Hospitals already operating near capacity are braced for a further rise in demand amid fears it could affect patient care.

A report by NHS Lothian said that despite its best attempts to plan ahead, ‘the capacity requirement to cope with winter surges is not and will not be’ in place.

Experts warned that the Lothian situation is replicated across Scotland as it emerged the military will this week be drafted in to hospitals after the Scottish Government asked for help. Army nurses and medics are among personnel posted to Lanarkshire and the Borders to ease pressure.

Bosses said the NHS is already under ‘considerable strain’ because of staff and bed shortages, the effects of coronavirus and patients not being able to see GPs in lockdown.

In a fresh alert over coronavirus infections, they also warned that society reopening ‘has facilitated riskier behaviours’ and that ‘some citizens are clearly not going to take up vaccination’.

In addition, immunity to flu, colds, coughs and the winter vomiting bug is less than usual after reduced social contact in lockdown.

Scotland has just recorded its worst-ever A&E waiting time statistics, with people warned not to attend unless their condition was lifethreatening and the military drafted in to drive ambulances. Thousands of patients, including children, have also had operations cancelled.

Professor Jackie Taylor, president of the Royal College of Physicians and Surgeons of Glasgow, said: ‘There’s absolutely no doubt we are expecting an incredibly difficult winter because peaks of activity have come earlier, the performance in the acute sector started to deteriorate really in July and August, and it hasn’t improved.’

She added: ‘I do think there will be an impact on the standard of patient care this winter.’

NHS Lothian’s report highlighted delayed discharges, where patients cannot leave hospital due to a lack of outside care, delaying new admissions. It said: ‘Care at home and care home providers are describing an inability to recruit and retain staff.’

As well as increasing waits at A&E, operations had been cancelled ‘due to pressures on beds and theatre staffing’ including ‘the postponements of all priority 3 and 4 surgical treatments in children’s services’.

In addition, 16 beds were closed at St John’s Hospital, Livingston, and 11 at the Western General in Edinburgh ‘due to lack of staff’.

There was also a ‘gradual but inexorable rise’ in the number of Covidinfected patients. To try to address pressures, four extra critical care beds were introduced, along with seven-day extra staffing and measures to boost capacity and improve patient flow.

In addition ‘almost all non-urgent elective activity has now ceased within acute services’.

The NHS Lothian (NHSL) report sounded a further alarm over modelling projections of the number of Covid beds needed. It said: ‘As it stands, NHSL is unable to surge its bed capacity to match these projections.’

It also said that ‘nationally, the issues facing Lothian are replicated in almost all national boards’.

An NHS Lothian statement said action already taken in acute and community services included recruiting 460 newly qualified nurses and investing in Emergency Department staff.

But Professor Taylor said: ‘Additional beds are opened because that is how we try to cope with winter pressures. Often there aren’t the additional staff to provide care in those beds. Short-term solutions to help people leave hospital is a good plan – if we’ve got the staff and capacity in social care to do it.

‘There’s a massive recruitment drive needed to help with staffing for home care staff and staff within care homes. Whether or not that can happen quickly enough in terms of recruiting staff for over winter remains to be seen.’

‘I think there will be an impact on patient care’