Tag: backlog

Dentists: Ministers need to fix broken payment system

‘Dentistry in Scotland is still light years away from business as usual‘

The British Dental Association has responded to new figures showing the number of claims for payment made to dentists for NHS treatments have fallen by more than 50% in some health boards since 2019.

It stresses the Scottish Government must rapidly move forward to fix the broken payment system at the heart of the service.

The Scottish Liberal Democrats analysed the number of NHS dental claims in all 14 health boards between 2019 and 2022. The analysis revealed that:

  • Across Scotland the number of NHS dental claims fell from 5,583,137 in 2019 to 3,184,858 between January and November of 2022
  • NHS Dumfries and Galloway saw a 55% drop in NHS dental claims, with claims falling from 139,988 in 2019 to 62,481 between January and November of 2022. 
  • NHS Orkney saw a 64% drop in NHS dental claims, with claims falling from 20,149 in 2019 to 7,175 between January and November 2022. 
  • NHS Shetland saw a 53% drop in NHS dental claims, with claims falling from 15,873 in 2019 to 7,510 between January and November 2022.
  • All 14 health boards saw a decrease in the number of claims submitted between 2019 and the first eleven months of 2022.

The BDA say that while COVID emergency measures have been withdrawn, practices continue to face of an historic backlog, with many patients requiring more extensive treatment having bottled up problems during the pandemic. 

On 1 October the Scottish Government cut the ‘multiplier’ designed to support the pandemic recovery, that increased NHS fees by 1.3. A lower bridging payment’ took effect uplifting NHS fees at a rate of 1.2 for the next three months, falling to 1.1 for the period up to April 2023.

Dentist leaders stress that in the months ahead progress must be made to deliver needed change to the broken high volume/low margin model NHS dentistry is based on. Without reform, this package will simply delay an inevitable exodus of dentists from the NHS that is already evident in other UK nations. 

Facing surging practice running costs, the BDA says that without an adequate interim funding package several key treatments, and anything – like dentures – that requires laboratory work, risk being delivered at a financial loss. 

Robert Donald, Chair of the British Dental Association’s Scottish Council said:  “Dentistry in Scotland is still lightyears away from business as usual. 

“Ministers pledged free NHS dentistry for all, but to keep that promise they need to fix a broken system. 

“Dentists are struggling, facing demand that can’t be met, with some NHS treatments already being delivered at a loss. They need to know that come April they will see real change, not just see the last safety net pulled away.”

NHS dentistry: Support extended, but there can be no return to ‘business as usual’  

Dentists have warned that the Scottish Government’s last-minute extension of financial support for NHS practices must go hand in hand with meaningful reform to avert a crisis in the service.

A new ‘bridging payment’ will replace the current ‘multiplier’ set to expire on 1 October, uplifting NHS fees a rate of 1.2 for the next three months, falling to 1.1 for the period up to April 2023.  

The Cabinet Secretary had previously told the BDA that the multiplier – which at its current level increased NHS fees by 1.3 – had not been included in the Scottish Government’s budget forecasting. The professional body has not ceased reminding officials that without an adequate interim funding package several key treatments including extractions, and anything – like dentures – that requires laboratory work, risk being delivered at a financial loss.

The BDA stress that the new support package cannot presage a return to ‘business as usual’ from April 2023. Dentist leaders stress that in the months ahead efforts must be made to deliver needed change to the broken high volume/low margin model NHS dentistry is based on. Without reform, this package will simply delay an inevitable exodus of dentists from the NHS that is already evident in other UK nations.  

While COVID emergency measures have been withdrawn, dentistry in Scotland has not returned to anything resembling pre-pandemic norms, with practices continuing to work under capacity in the face of an historic backlog.  Latest figures indicate 261,537 claims were made by dentists delivering NHS treatments in July 2022, less than 60% of the number made in the same month in 2019.   

Recent research by the BBC indicated 9 in 10 practices UK-wide were unable to take on new adult patients. In Scotland figures stood at 82%, the multiplier likely playing a decisive role.  

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “The Scottish Government seem to have recognised the wholesale inadequacy of the funding model for NHS dentistry.  

“It’s not rocket science. Without additional support, the basics of NHS care – from extractions to dentures – would have been delivered at a loss. No business can operate on that basis.   

“We now need some serious long-term thinking. Unless Ministers are prepared to revisit the system this service is built on, this funding will amount to sticking plaster on a gaping wound.

“If this is just delaying the return to a broken ‘business as usual’ then millions of patients stand to lose out.”   

Passport processing times and unprecedented levels of demand

There has recently been considerable press coverage of people facing holiday cancellations or travel disruption due to waiting times for passports.

There is no backlog in passport processing as a result of the coronavirus (COVID-19) pandemic. However, we are now seeing unprecedented demand as more than 5 million people delayed applying for passports during COVID-19 because of restrictions in international travel.

Her Majesty’s Passport Office (HMPO) anticipate 9.5 million British passport applications will be made this year and in March 2022 alone, HMPO processed more than one million new passport applications, the highest output on record.

In preparation for the demand for international travel returning, since April 2021 HMPO have been advising people to allow up to 10 weeks when applying for their British passport. This remains the case.

The vast majority of all passport applications are being dealt with well within 10 weeks. However, a passport can only be issued once all the checks have been completed satisfactorily and will take longer if applications are submitted with missing or incomplete information.

What is HMPO doing to meet this increased demand?

HMPO have prepared extensively for this surge in demand and have increased capacity – people and systems – across all elements of the production process. The priority is to ensure we can continue to process as many passport applications as possible.

To do this:

  • we have increased staff numbers by 500 since April 2021 and are in the process of recruiting another 700. In total, as of 1 April 2022 there are over 4,000 staff in passport production roles – this has helped us to handle more applications than ever before
  • additional staff are being recruited to assist with customer queries on the Passport Adviceline which is currently run by Teleperformance
  • we have onboarded more delivery companies to ensure passports and supporting documents are delivered on time to customers
  • we have increased availability for fast-track appointments and extended working hours across the 7 HMPO public counters – new appointments are released daily, 3 weeks in advance

What can customers do to ensure there are no delays?

We urge people who need a new passport to apply for one as soon as possible to ensure their passport arrives in time for the peak summer season. We do offer urgent services for applicants who need a passport more quickly. However, in busy periods these are booked quickly.

Customers can also help to ensure there are no delays with their application, such as using a high quality photo with a digital code, applying online and applying for a new passport more than 10 weeks before they are due to travel.

And it is important to stress, you should not book travel until you have a valid passport – your new passport will not have the same passport number as your old one.

Are HMPO staff working from home and is this affecting output?

Our dedicated staff are working tirelessly to deal with this unprecedented demand. Working from home has no impact on HMPO’s capacity to process passport applications.

Where you can go for more help?

We advise customers to call the Passport Adviceline on 0300 222 0000 if they have a query relating to their specific passport application.

Photo guidance: Get a passport photo: Digital photos

General guidance: Apply online for a UK passport

Customers can track the progress of their passport application online at: Track your passport application

Further details about our urgent services, available from all of HMPO’s 7 public counters across the UK

Lothian MSP concerned at record number of patients – 17,432 – waiting for a key diagnostic test

Lothian MSP, Miles Briggs, has raised concerns about the number of people waiting on key diagnostic tests in NHS Lothian.

Diagnostic tests give doctors more information about a patient, so that they can confirm or rule out conditions and diseases. Key diagnostic tests include endoscopy and radiology. Endoscopy is where a long flexible tube with a light and camera shows images of a patients organs on a television screen. Radiology is the science of x-rays for taking images to diagnose a patient.  

The eight key tests and investigation are upper endoscopy, lower endoscopy (excl. colonoscopy), colonoscopy, cystoscopy, CT scan, MRI scan, barium studies and non-obstetric ultrasound.  

In NHS Lothian a record 17,432 patients were waiting to be seen for a key diagnostic test at the end of September 2021. This is an increase of 790 from the end of June 2021 when 16,631 patients were waiting, an increase of 4.75%.

The number of patients waiting for a diagnostic test in NHS Lothian has risen by 2,989 in the last year from 14,443 at the end of September 2020, an increase of 21%.

Over the last two years the number of patients waiting for a diagnostic test has risen from 10,657 at the end of September 2019 by 6,775 patients, 64%.

Across Scotland 125,557 patients were waiting to be seen for the eight key diagnostic tests, an increase of 8.9% (+10,304) from 30 June 2021 and 22.2% higher than at 30 September 2020.

Lothian MSP, Miles Briggs, said: “We are seeing a very concerning increase in the number of patients waiting for a key diagnostic test in NHS Lothian over the last two years.

“The number of patients waiting over 6 weeks has more than tripled over the last two years.

“Diagnostic tests are vital for doctors to be able to diagnose and treat patient’s diseases.

“The quicker a patient’s illness is diagnosed the sooner they can get treatment, which improves their chance of recovery.

“The pandemic will inevitably have impacted diagnostic tests in NHS Lothian, however consistent underfunding for the health board by SNP Ministers had made diagnostic waiting times very long even before Covid-19.”

Diagnostic waiting times – Waits for key diagnostic tests 30 November 2021 – NHS waiting times – diagnostics – Publications – Public Health Scotland

Diagnostic Test & InvestigationIndicator 31-Mar-1930-Apr-1931-May-1930-Jun-1931-Jul-1931-Aug-1930-Sep-1931-Oct-1930-Nov-1931-Dec-1931-Jan-2029-Feb-2031-Mar-2030-Apr-2031-May-2030-Jun-2031-Jul-2031-Aug-2030-Sep-2031-Oct-2030-Nov-2031-Dec-2031-Jan-2128-Feb-2131-Mar-2130-Apr-2131-May-2130-Jun-2131-Jul-2131-Aug-2130-Sep-21
                                  
8 Key Diagnostic Tests & InvestigationsNumber on List 13,15612,09211,30410,79110,26110,08710,65711,63812,24812,62112,96813,36112,84413,84014,63714,27713,34913,81514,44314,37014,39115,24815,30615,10915,86416,43416,92516,63116,32116,64217,432
 Number Waiting > 4 Weeks 4,8844,5253,5283,1793,1002,9202,9953,6753,8544,7554,4274,8666,34511,64011,2329,8958,2117,4697,6807,5476,9368,3568,1517,9857,8038,3818,5108,8159,2069,4499,541
 Number Waiting > 6 Weeks 3,9263,4842,8252,4232,1712,0701,9132,2992,5973,0983,7933,2503,81410,33310,5308,8357,0906,2466,2656,2735,5266,1897,0126,2435,9596,1076,2516,5026,9657,2527,220
                                  
Upper EndoscopyNumber on List 2,1861,8681,4291,3341,0791,1531,0211,1161,2551,5441,6731,8261,9172,0162,0902,1862,2062,2652,3312,3092,2442,2972,2682,1862,1712,3422,4042,3122,3072,3332,385
 Number Waiting > 4 Weeks 1,6341,2828687777046435546277359691,0891,2501,5081,9211,9501,9331,8541,9001,9791,9551,8381,8831,9051,8521,7591,8921,9581,9211,9381,9411,926
 Number Waiting > 6 Weeks 1,4271,117759

Over three and a half MILLION lost dental appointments: new figures point to perversity of Scottish Government plans

The British Dental Association Scotland has warned new data underlining the scale of the backlogs facing practices demonstrates the absurdity of government plans to return to pre-COVID models of care.  

The new figures from Public Health Scotland indicate that the number of treatments delivered in the year to March 2021 was less than 25% of those delivered in previous 12-month period, corresponding to over 3.5 million appointments lost as a result of the pandemic.

Last week Cabinet Secretary Humza Yousaf wrote to all NHS dental teams in Scotland that all emergency support will be withdrawn by 1 April 2022. Since the first lockdown NHS practices have operated under a COVID support package, reflecting pandemic pressures and tight infection control restrictions that continue to limit capacity across the service.

Owing to ongoing disruption dentist leaders stress patients are now presenting with higher levels of need, requiring additional time. BDA Scotland have warned that the return to a ‘business as usual model’ – low margin and high volume – will put practices under unsustainable financial pressure and will likely lead to closures or movement to the private sector. 

In light of the SNP’s centrepiece policy of providing free NHS dental care for all, BDA Scotland have stressed the need to develop a new, sustainable model for delivering care. In the interim, a workable interim funding model is needed to support dentists and their teams to care for their patients.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “Dentists are facing an unprecedented backlog, as we continue to work to restrictions designed in the first lockdown.

“This new data underlines the sheer perversity of government plans to pretend COVID is yesterday’s news.

“Withdrawing emergency funding will pull away the life support from hundreds of dedicated NHS practices serving communities across Scotland.”

Army called in to support struggling NHS

In response to the immediate pressures on the NHS because of COVID-19 and the backlog in care caused by the pandemic, military assistance has been requested for NHS Lanarkshire and NHS Borders.

Acute services in both health board areas are operating at capacity because of workforce shortages associated with the virus.   

A total of 63 military personnel will be deployed to NHS Lanarkshire – this includes three nurses, 45 military medics, 12 General Duties Troops and three drivers who will be working in acute settings.

In NHS Borders, 14 military medics, two nurses and four additional military personnel will provide assistance in acute settings. A military driver will provide transport. Two military medics will oversee operations from the army’s headquarters in Scotland.

Military support within the two health board areas is due to start on 19 October and continue initially until 10 November 2021 though this will be kept under constant review.

Health Secretary Humza Yousaf said: “The NHS is experiencing significant pressure at the moment because of COVID-19 admissions and the backlog in care built up during the pandemic and we are taking a range of steps to introduce additional capacity in order to help with the unprecedented pressures on the health and care system.

“Earlier this month we announced a record winter package funding of £300 million to support a range of measures to maximise capacity in our hospitals and primary care, reduce delayed discharges, improve pay for social care staff, and ensure those in the community who need support receive effective and responsive care.  

“In the NHS Borders and NHS Lanarkshire areas, staff shortages because of COVID-19 are affecting bed capacity and temporary military assistance has been requested to support the boards at this time.

“With increasing levels of social mixing and close social contact it is expected that this winter COVID-19 will circulate alongside respiratory viruses, such as flu, adding to the winter pressures usually faced by the NHS.

“This military support will allow both boards to support existing staff to reduce waiting times, enhance care and provide a better experience for our patients.     

“As always I would like to thank all those involved in our healthcare systems for their continuing hard work and dedication over this particularly busy time.” 

No silver bullet to clear courts backlog, Committee warns

MSPs on Holyrood’s Justice Committee have called for a ‘basket of measures’ to help clear the backlog in Scotland’s courts exacerbated by the Coronavirus pandemic, acknowledging that some of these may be unpalatable, but necessary.

Members of the Committee have been looking at the impact of Covid-19 on the justice system, with delays caused by the halting of most criminal court business during the height of the pandemic one of the most concerning issues.

The Committee heard that while delays to criminal cases was a problem before the pandemic, just to get back to that level of backlog would take eight to 10 years if nothing is done to increase or speed up court business.

While the Scottish Government and the Scottish Courts and Tribunals Service have taken forward some proposals, such as setting up ‘remote jury centres’ in cinemas to allow juries to socially distance while participating in trials, the Committee is calling for:

– The Scottish Government to urgently convene a round-table discussion with representatives of affected groups to discuss and agree a way forward for both criminal and civil systems;

– For these discussions to include proposals for more remote jury centres; remote jury empanelling; and more digital technology – for example recording evidence from specialist witnesses;

– For consideration to be given in these discussions to sentence discounts for early pleas; and, in the short-term, extended court sitting hours;

– The Cabinet Secretary for Justice to ensure that sufficient funding is in place to resource and staff any changes without adverse or unforeseen consequences.

This would follow on from a previous roundtable held in April 2020 which agreed interim measures for court business.

At that meeting, some options previously considered, such as trials without juries, were discounted by those present. This is a conclusion the Committee agreed is beyond the pale, as it would be too fundamental a change to make to Scotland’s justice system.

Speaking as the report was launched, Justice Committee Convener, Adam Tomkins MSP, said: “The scale of the challenge faced by our courts is not to be underestimated.

“Current delays are not acceptable for the victims, witnesses or the accused of crimes.

“While that point may not be controversial, we need to ensure changes to improve the situation, whether long or short-term, have the widest possible backing.

“To that end, we want the Scottish Government to convene a meeting of all interested parties to agree a way forward. Time is of the essence.

“By following the collaborative approach taken in the early days of the pandemic, and by being open and transparent with thinking, we can have a grown-up conversation about the pros and cons of the options available.

“The Committee hopes that this would help those responsible for the day-to-day operation of the courts and those responsible for the system to coalesce around a common way forward and agree upon necessary actions.

“Although the problems are at their worst in the criminal courts, there is still a mismatch in our civil courts, which are largely functioning, and other services linked to them, such as family contact centres, which are at best partially open.”

Scottish Tories: Government must plan to clear backlog of operations

The Scottish Conservatives have called for the Scottish Government to publish a plan outlining how they will clear the backlog of operations created while the NHS concentrates on Covid-19.

The call comes as the latest figures show that the number of planned operations for March this year in Scotland has fallen over 30% compared to March last year.

In addition, the number of cancelled operations for the same month has almost doubled to 15% compared to March 2019.

The Scottish Conservatives have said that it is understandable that the NHS has been prioritising Covid patients but the Scottish Government must outline a plan to clear this backlog and ensure there isn’t any avoidable suffering beyond the pandemic.

3,429 operations were carried out in NHS Lothian during March 2020, a decrease of 1,875 from 5,304 in March 2019 – a decrease of 35%.

The percentage of cancelled operations has more than doubled compared to March 2019, with 21.3% of operations cancelled in March 2020, compared to 9.9%.

Miles Briggs, Scottish Conservative shadow health secretary said: “Our NHS has rightly diverted time and resources to tackling Covid-19 and we wouldn’t expect anything else.

“But the dramatic reduction in hospital operations is not without cost and must be reversed as soon as possible.

“The Scottish Government must put a plan in place to clear these operations or Covid could cause even greater suffering.

“Prior to the Covid-19 outbreak SNP Ministers were failing to meet their own waiting times targets.

“It is clear that for many patients the wait to get the treatments and operations they need is going to be significantly longer.

“I am enormously grateful to everyone working in our NHS right now – the Scottish Government must plan now so doctors and nurses can continue to save lives now and in the future.”