The cruellest queue: 6000 NHS beds lost
Patients reveal awful cost of longer waits for treatment
The awful cost of NHS waiting lists on patients’ health is exposed today as we reveal how 6,000 hospital beds have been lost in Scotland in the last 10 years.
Official records detail the alarming drop in bed numbers as health boards routinely fail to meet legally imposed deadlines for patients to be treated. Today, leading doctors sound the alarm. Dr Dave Chung, head of the Royal College of Emergency Medicine in Scotland, said: “We run out of beds every day. It’s obvious we need more.”
But patients waiting for life-changing treatment expose the impact on their lives. One, who went blind while waiting more than a year for cataract surgery, said: “I couldn’t see so I couldn’t work and I couldn’t drive. It was a desperate situation.”
T
‘ There are hidden costs of waiting for surgery
he number of hospital beds in Scotland has dropped by more than 6,000 in 10 years while thousands of patients face long delays for treatment.
Analysis of NHS Scotland figures reveals the number of beds lost since 2009 is the equivalent of closing three hospitals the size of the new £900 million Queen Elizabeth University Hospital in Glasgow.
Meanwhile, thousands of patients are waiting longer for treatment than deadlines fixed in law. Today we reveal how the condition of many deteriorates badly as they wait, while others die before being admitted to hospital for postponed and delayed surgery.
Dr Dave Chung, head of the Royal College of Emergency Medicine in Scotland, said: “We run out of beds frequently – in fact every day – in Scotland. It’s obvious that we need more beds.
“There are hidden costs of waiting for surgery and often the patient pays this. People can be injured if they become infirm while waiting for surgery and become sicker in the long term. Every study has shown that it is cheaper to be treated early.”
NHS Scotland figures show the number of hospital beds has fallen by almost a quarter in the past
10 years, from 26,280 in 2009 to 20,250 in 2019.
While hospital budgets rose from £5.4 billion a year to £6.8bn in the same period, more than 250,000 people have waited longer than the legally binding 12-week treatment time guarantee since the target was introduced in 2012.
Only 83.3% of patients were treated within 62 days in the last quarter to September – well below the 95% target.
Earlier this month it was revealed that just two NHS boards were meeting the critical waiting time target for cancer treatment.
There has been a downward trend in the number of hospital beds, with developments in surgery meaning shorter stays in hospital recovering.
But medical experts have warned that too many bed reductions and a fast turnover is a major risk to patients across the NHS.
Lewis Morrison, chairman of BMA Scotland, said: “This is a complex issue and there may well be reasons for reductions in beds – such as the rise in outpatients seen in a single day.
“However, it is equally clear that the NHS in Scotland simply does not have the resources in place to meet rising demand.
“Our system is stretched to the limit and we need to urgently ensure that it is appropriately resourced – and that includes ensuring it has the right number of beds to operate more effectively and deliver the high-quality care that we all strive for.”
Royal College of Nursing Scotland associate director Norman Provan said: “It’s better for people to be cared for at home or in a homely setting close to their home. Cutting the number of hospital beds on its own will not achieve that ambition.
“You also need to move the money you save by cutting hospital beds out into the community so people can be cared for there. To date there has been a lack of evidence of progress in shifting resources into the community, including developing the workforce needed.”
Mark Dayan, policy analyst for the Nuffield Trust think tank, said: “On spending for buildings and equipment, it is notable that the Scottish NHS last year was given only £334m for longer-term investments.
“This is now even lower than the equivalent spending in England, which itself is well below most other developed countries.
“There’s a good argument that investment in long-term NHS equipment and buildings should rise to the average for a wealthy country. At the moment it is less than half that level in Scotland, at 0.2% of gross domestic product as opposed to an average 0.4%.
“Stretched resources are clearly associated with worse waiting times across the board in recent years. That does mean more people, many in pain or at risk of deterioration, are going without the care that would help them.”
At the last First Minister’s Questions of 2019, opposition politicians highlighted the failure to meet targets, including the 12-week treatment time guarantee, the 18-week mental health target and the 62-day target for cancer treatments.
Scottish Conservative health spokesperson Miles Briggs said: “These figures highlight the SNP’s spectacular mismanagement of our Scottish health service.
“With 6,000 fewer hospital beds under the SNP, it’s no wonder waiting times are at an all-time high, and the SNP has never met its own waiting time targets.”
Scottish Labour health spokesperson Monica Lennon said: “Scotland’s hospitals are struggling to cope because well-intended plans to integrate health and social care services have not been a priority for SNP ministers.
“Worryingly, thousands of hospital beds have disappeared, including specialist care. Community and home-care services are not necessarily filling the gaps.
“Despite the SNP being in charge since 2007, Nicola Sturgeon has squandered the opportunity to protect and modernise the NHS and social care. She has set us back decades by failing to plan for the longer term.
“People want to be supported to be at home for as long as possible. The SNP pledged years ago to end delayed discharges but that’s another broken promise and the pressure on hospital beds is increasing.”
“With Audit Scotland warning the NHS in Scotland is ‘running too hot’, Nicola Sturgeon must prove in 2020 that the NHS is her priority and activate a rescue plan.”
Scottish Lib Dems health spokesperson Alex Cole-Hamilton said: “Ministers will have their work cut out to convince us this is an effective way to cut waiting times.
“We have seen for years that workforce planning in the NHS has been neglected and now we see bed numbers dipping too.”
Official figures also show that, while bed numbers have fallen over the past decade, A&E attendances has risen from 1.6 million a year to 1.7 million a year.
Inpatient cases excluding lost stays have gone up from one million in 2009 to 1.1 million.
Long-stay cases have dropped from 327,759 weeks to 202,225 weeks.
The Scottish Government said: “Bed numbers in a hospital setting have been reducing to reflect the changing nature of our modern health service where, over the last 10 years, advances in treatment have meant the length of time patients spend in acute hospitals has reduced markedly and there are now more than 35,000 day cases per year.
“In addition, the number of beds necessary has reduced since 2009 due to provision of geriatric and mental health services in the community.
“We are supporting NHS boards to transform return outpatient appointments,” they added. “A number of services now offer virtual clinics at which consultants, nurses and allied health professionals are considering ~clinical information and communicating with patients, avoiding the need for many patients undertaking unnecessary travel and attendance in a hospital setting.
“It is important that health boards have the right number of hospital beds to meet changes in demand from season to season. Our waiting times improvement plan, backed with more than £850m of funding, will strengthen capacity in hospitals.
“We have also invested more than £13m this winter to ensure more capacity is put in place as well as supporting health boards to confirm robust planning to ensure resilience over the coming winter.”
More people are going without the care that would help them