NHS Lothian – Page 17 – The NEN

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 & Investigation

Indicator

31-Mar-19

30-Apr-19

31-May-19

30-Jun-19

31-Jul-19

31-Aug-19

30-Sep-19

31-Oct-19

30-Nov-19

31-Dec-19

31-Jan-20

29-Feb-20

31-Mar-20

30-Apr-20

31-May-20

30-Jun-20

31-Jul-20

31-Aug-20

30-Sep-20

31-Oct-20

30-Nov-20

31-Dec-20

31-Jan-21

28-Feb-21

31-Mar-21

30-Apr-21

31-May-21

30-Jun-21

31-Jul-21

31-Aug-21

30-Sep-21

8 Key Diagnostic Tests & Investigations

Number on List

13,156

12,092

11,304

10,791

10,261

10,087

10,657

11,638

12,248

12,621

12,968

13,361

12,844

13,840

14,637

14,277

13,349

13,815

14,443

14,370

14,391

15,248

15,306

15,109

15,864

16,434

16,925

16,631

16,321

16,642

17,432

Number Waiting > 4 Weeks

4,884

4,525

3,528

3,179

3,100

2,920

2,995

3,675

3,854

4,755

4,427

4,866

6,345

11,640

11,232

9,895

8,211

7,469

7,680

7,547

6,936

8,356

8,151

7,985

7,803

8,381

8,510

8,815

9,206

9,449

9,541

Number Waiting > 6 Weeks

3,926

3,484

2,825

2,423

2,171

2,070

1,913

2,299

2,597

3,098

3,793

3,250

3,814

10,333

10,530

8,835

7,090

6,246

6,265

6,273

5,526

6,189

7,012

6,243

5,959

6,107

6,251

6,502

6,965

7,252

7,220

Upper Endoscopy

Number on List

2,186

1,868

1,429

1,334

1,079

1,153

1,021

1,116

1,255

1,544

1,673

1,826

1,917

2,016

2,090

2,186

2,206

2,265

2,331

2,309

2,244

2,297

2,268

2,186

2,171

2,342

2,404

2,312

2,307

2,333

2,385

Number Waiting > 4 Weeks

1,634

1,282

868

777

704

643

554

627

735

969

1,089

1,250

1,508

1,921

1,950

1,933

1,854

1,900

1,979

1,955

1,838

1,883

1,905

1,852

1,759

1,892

1,958

1,921

1,938

1,941

1,926

Number Waiting > 6 Weeks

1,427

1,117

759

NHS Lothian: Free staff parking permit scheme re-introduced at Little France to ease congestion

NHS Lothian is to re-introduce a staff car parking permit scheme on the Little France campus as part of a plan to help ease traffic congestion.

The scheme, which was suspended during the first lockdown of the COVID-19 pandemic, will be reinstated next year as a free permit for staff at the Royal Infirmary of Edinburgh (RIE) amid safety concerns around growing levels of congestion and queueing traffic on the site.

Jim Crombie, Deputy Chief Executive of NHS Lothian, said the site was unable to sustain the sheer volume of cars that arrive each day and the problem was causing delays for patients, staff and visitors, as well as blue light services which need access at all times.

He added: “The decision to re-introduce free staff car parking permits has been carefully considered and planned over recent months and is not a decision that was taken lightly.

“We have been experiencing significant congestion across the Little France campus which cannot be sustained. It causes delays to patients, visitors and staff and for the buses which are essential to service the hospital.

“Critically, however, it also causes serious issues for our blue light services which must be able to travel through the hospital site at all times.

“We are actively looking for additional long-term solutions for staff, including the implementation of a dedicated park and ride at Shawfair. In the meantime, a temporary new car park to provide more than 300 extra spaces on campus will also open in January.

“We will continue to engage with our staff throughout this process.”

The application process has been updated and staff who are interested in a permit are being asked to apply for the permit scheme, which will go live on January 17.

Forms will then be cross checked against the eligibility criteria, which is consistent across all NHS Lothian sites and includes questions about how far they have to travel, how long it takes, public transport links, the times of their journey and whether the role they perform requires them to move between sites during the course of a shift. Separate arrangements will be in place for those who have to attend in an emergency.

Staff who are already in possession of a staff parking permit will be able to use their current permit for one year, after which, it will be subject to an annual eligibility review.

Tracy Anne Miller, RIE Partnership Lead, NHS Lothian, said: “These next steps are essential. The site cannot cope with the levels of congestion we are experiencing. We will continue to engage with staff directly and help ensure they have equitable access to the scheme.”

NHS Lothian is actively investigating additional long-term solutions, and discussions are ongoing around the implementation of a dedicated park and ride at Shawfair.

In the meantime, a temporary car park, which will provide an additional 250 spaces will be available in January.

Staff are also being urged to consider car-share schemes. Where possible, car-sharing will be facilitated within departments, however plans are being developed to try and help match people from different departments, if required. More details will be released in due course. All car sharing schemes will be operated in line with Scottish Government guidance.

Book your booster jag

Booster roll-out continues

From today, adults aged 40 to 49 will be able to book their COVID-19 booster online.

You will not be sent an appointment letter, so please book your appointment at

nhsinform.scot/

Advance booking facility for 40-49 year olds

People aged 40-49 years old will be able to use the NHS Inform online portal or national phoneline to book their COVID-19 booster appointments from today (Saturday).

Appointments will be available from 30 November and the booking must be at least 24 weeks after the second dose.

16 and 17 year olds can use the portal from Tuesday 30 November to book a slot for their second dose of the vaccine as long as 12 weeks have passed since the first dose. However, anyone with a confirmed case of the virus since the first dose should wait for 12 weeks after that.

The portal is already open for the 50 – 59 age group, unpaid carers who are 16 and over, and those aged 16 and over who are household contacts of immunosuppressed individuals while anyone in earlier groups who missed an appointment can also book online. As the portal is now being opened to even more cohorts, 50-59-year-olds who have not yet received their booster, will be contacted shortly to invite them to make a booking as soon as possible via the portal or national phoneline.

Health Secretary Humza Yousaf said: “We have now delivered more than 1.5 million boosters and third doses and the excellent progress with the Autumn/Winter vaccination programme now allows us to invite people aged 40 – 49 to book online.

“Boosters are just as important as the initial vaccinations. Six months after the second dose, immunity levels wane with increasing risk of further infection. The booster dose improves your level of protection significantly and is the best way to protect your health and those around you. We encourage all those eligible to arrange their appointment via the portal or phoneline for 24 weeks after their second dose.

“I am pleased that, from Tuesday, 16 and 17 year olds can also use the portal to book their second dose. The portal will be in use for people in almost all health board areas but those in areas where that is not the case, people will be contacted directly by their local board with details of their appointment.

“We aim to vaccinate people as quickly as possible in line with clinical guidance and over the course of the Autumn/Winter vaccination programme, we will see up to 7.5 million flu and COVID-19 booster vaccinations administered.

“While vaccination is the bedrock of our fight against COVID-19, we encourage everyone to follow mitigations such as regular testing, particularly before socialising and meeting up with others people from outside your household, wearing face marks where required and opening windows to improve ventilation.”

Lothian’s Vaccination Delivery Gets Another Boost

Vaccination teams in Lothian are gearing up for the next stage of the programme which allows eligible patients to make their own appointments.

Patients from the new cohort group will be able to book their own time slot in advance and choose their venue for their lifesaving COVID-19 Booster and flu vaccine.

People aged 50 to 59, those who are 16 or over and are an unpaid carer and teenagers over 16 and are a household contact of an immunosuppressed person are being urged to log on to NHS Inform and book their COVID booster and flu jabs for the last days of November or December.

At the same time, more people aged 60-69 across Lothian will continue to receive an appointment letter for a slot within the next two weeks.

Extra staff are being recruited and capacity has been boosted across Lothian to service the next phase of the expanding programme.

Nearly 150,000 appointments have already been made available on the national portal for people to book throughout this winter and this number will continue to rise each week.

To date, across Lothian 213,806 doses of the flu vaccination and around 173,191 COVID-19 booster vaccines have already been delivered. This is in addition to 708,605 first and 650,663 second doses of the COVID vaccine.

Pat Wynne, Nurse Director of Primary and Community Care, NHS Lothian said “All of our teams are working phenomenally hard to ensure they can continue to deliver the lifesaving vaccines as quickly as possible during this next stage.

“It is no small task – the teams are administering different types of first, second, third and booster doses of the COVID vaccine and the flu vaccine at the same time as drop-in clinics and during pre-arranged appointments to people of all ages. The logistics of this vital work are complex and we are really grateful to all of them for the work they are doing.

“Vaccination is the best way to protect yourself and loved ones from the viruses and will help to reduce additional pressures on the NHS this winter.

“We urge everyone who is eligible to make sure they take up their appointment. Whether they keep the slot on their letter or make their own appointment through the online portal or on the national telephone helpline, we need them to get vaccinated.

“If you are an Edinburgh resident and are able to travel, please book your appointment at Edinburgh’s mass vaccination centre at the Royal Highland Centre, Ingliston. This will ensure appointment slots are available at more local vaccination for those who need them.”

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that people aged 40-49 will also be eligible for a COVID-19 booster.

They will be offered the booster vaccine once the earlier agreed priority groups have had their injections to ensure the most vulnerable groups are offered protection first. They will be able to book their own appointments using the online portal.

The JCVI has also advised that young people aged 16 and 17 years old will also be eligible for a second dose of the COVID-19 vaccine and a timetable will shortly be confirmed.

NHS Lothian is working closely with the four health and social care partnerships which are responsible for the delivery of the programme – flu vaccination is no longer being carried out by local GP practices.

The number of available local venues is being extended, with the launch of a drop-in clinic at Ocean Terminal, and vaccination clinics are being streamlined to increase capacity as teams prepare for the next intake.

Lowland Hall, for example will boost the number of available appointments from 17,000 appointments per week to 19,000, by increasing vaccination stations from 26 to 35.

The launch of the portal comes as the remaining people in Lothian aged 70 and above and those at highest risk are being invited to step forward for appointments during the last two weeks in November.

Patients are being urged to keep their appointment once booked, but if they cannot attend they are being urged to reschedule by calling the national vaccination helpline. They can also book an appointment using the same number of access help and advice on 0800 030 8013.

Success for Sammy in Helpforce Volunteer Awards

NHS Lothian have announced that Sammy McKee has won the Helpforce Champion Volunteer of the Year Award.

The Helpforce Champions Awards are a national awards designed to celebrate the invaluable contributions made by volunteers across the UK during the past turbulent year, fundamentally defined by the COVID-19 pandemic.

Head of Volunteering, Jane Greenacre, explains this is not just recognition of one person’s contribution but of all of the volunteers, past and present: “The contribution Sammy has made over the last 18+ months is incredible, and we are so pleased it has been recognised in these national awards.

“However, in the eyes of the Voluntary Services Team, all of the volunteers are winners. The roles that Sammy has taken on as Ward Helper, Vaccine Clinic Welcome Guide and at the Meaningful Activity Centre are really representative of support provided by 500+ volunteers so everyone can share in this success.”

“Sammy, like all of our volunteers, embodies NHS Lothian’s values of care and compassion, dignity and respect, quality, team work, and openness, honestly and responsibility.”

If you would like to volunteer, know more about NHS Lothian volunteer roles or if you work for NHS Lothian and want to know what support can be offered contact:

Volunteer.Enquiries@nhslothian.scot.nhs.uk

Sammy joined the volunteer team at NHS Lothian in March 2020, as he was keen to support his local community and the NHS during the pandemic.

Since then Sammy has given over 750 hours of his time volunteering twice a week (often three times a week) in a variety of roles and he has done all of this alongside family and other commitments and with continual professionalism and good humour.

From his first contact to date Sammy has embodied NHS Lothian’s values of care and compassion, dignity and respect, quality, team work, and openness, honestly and responsibility. Sammy has demonstrated his care and compassion for others as a volunteer in a care of the elderly ward where he supports patients (many of whom have complex needs) where he has volunteered since March 2020.

He has consistently treated the patients with dementia using the meaningful activity centre at St John’s Hospital with dignity and respect spending time getting to know patients, their likes and interests and planning activities to do with them one-to-one or in small groups.

Sammy has demonstrated his commitment to quality by actively participating in the Voluntary Services Team’s optional training programme giving up yet even more of his time to learn and develop his skills.

There is not a single person (staff or volunteer) who has worked alongside Sammy who would not agree that he is a team player. Sammy offering to change his usual volunteering site to support another volunteer who was lacking on confidence and his willingness to take on extra shifts to cover for colleagues unable to attend at the vaccination clinics are just two examples.

In addition Sammy is open to new ideas, honest about his experience and takes responsibly for the commitment he has made to those he supports. Sammy has two main roles with NHS Lothian as a Ward Helper in a Medicine of the Elderly ward In Findlay House and as an Activities Volunteer in the Meaningful Activity Centre at St John’s Hospital. Alongside these roles, he has also volunteered as a Vaccination Clinic Guide for 5 months.

In each of these roles, his volunteering was designed to achieve different things. The Ward Helper role aims to support positive health outcomes for patients by supporting day-to-day tasks and providing stimulation and to free staff time to allow them to focus on specialist tasks.

Many of the patients in this particular area have complex needs which can result in challenging behaviour or low mood. The support provided by the Ward Helpers enables patients to maintain their abilities and physical health, to improve mood and to support patients in the most difficult of circumstance to have the best possible experience. This support also helps families of patients by allowing them to take breaks from visiting safe in the knowledge that their loved one will not be alone.

The Meaningful Activity Centre was developed to provide a therapeutic environment for patients within the hospital. Patients with cognitive impairment can frequently become distressed in the hospital environment as not all their needs can be met on a ward through a medical model.

At the Meaningful Activity Centre, the volunteers aim to meet unmet needs that are related to boredom and lack of activity. However, it is not just playing some games to relieve boredom. By engaging in meaningful conversation and using excellent listening skills, the volunteers have been able to find ways to understand what is causing the distress of the person and to take steps to reduce distress.

As a Ward Helper Sammy completes many practical tasks including helping with meal distribution and the tea trolley (key to tackling issues with dehydration common in hospital settings) and the mealtime tidy up after eating, he will support patients to eat by providing company, encouragement and also practical assistance having been trained to safely feed patients who need assistance.

Outside mealtimes Sammy will help with practical takes such as answering the door to welcome visitors, top and up supplies like hand gel, masks. However, the key to Sammy’s Ward Helper role is the building of relationships with patients so that he can support them in a person centred way through small therapeutic interventions such as taking a patient in a wheelchair to spend time in the garden, taking short walks in the ward to maintain mobility, reminiscence and conversation to maintain mental stimulation and support good mood, sitting with a nonverbal patient listening to music to calm and relax them.

As a Vaccination Clinic Guide Sammy welcomes people to the clinics, guides them through the process giving explanations about what would happen next, how long things might take, giving directions, reassuring the nervous/making conversation with those who had been isolated often for months previously and supervising the post vaccination observation bay. Sammy’s cheerful manner and easy confidence help ensure that everyone feels valued and supported as they attend the clinic.

At the Meaningful Activity Centre Sammy supports patients one to one or in small groups through a range of person centred activities. There may be games or bingo to enjoy, looking at books and newspaper articles from yesteryear, listening to music or even karaoke to some old favourites, afternoon teas and the occasional dinner dance.

Whatever the activity Sammy is there leading the way and encouraging everyone to get involved, working at the understanding, confidence and enthusiasm level of the patient so that they feel comfortable and have a good time. contribution is invaluable.

While many of the patents Sammy supports are not able to articulate their gratitude verbally, it is obvious from the changes in their demeanour (not just while interacting with Sammy but following) that their time with Sammy has helped them to feel calmer, more settled and more at ease in the hospital.

Choudhury: NHS Lothian ‘in crisis’

ANOTHER WEEK OF ‘SHOCKING’ A & E FIGURES RECORDED

Lothian MSP Foysol Choudhury has warned that NHS Lothian is in crisis as another week of dismal A&E figures has been recorded.

Statistics published yesterday show that only 64.8 per cent of attendances in NHS Lothian at A&E in the week ending 31st October were seen within four hours.

363 patients spent over eight hours in A&E, with 132 waiting over 12 hours.

1,504 patients waited over 4 hours.

These are among the worst weekly A&E times on record for NHS Lothian.

Scottish Labour MSP Foysol Choudhury said: “Yet another week of shocking statistics showing the reality of SNP mismanagement of our NHS.

“Lothian patients are in dire need of medical help and they are not receiving the swift attention they deserve. These are truly shocking figures that show once again just how out of depth the SNP Health Secretary Humza Yousef is.

“The SNP has left NHS doctors and nurses over-worked, under-staffed and under-resourced – and it is patients who are paying the price.’’

Join NHS Lothian Board

Would you like to develop NHS Lothian’s future as a non-executive Board member?

Learn more here: …https://applications.appointed-for-scotland.org/pages/job_sear

COVID Vaccination Bus is back at Morrisons Pilton Drive this week

TUESDAY 9th – SUNDAY 14th NOVEMBER

10am – 5pm

Scottish health service set for gruelling winter as performance deteriorates yet again

The latest Emergency Department performance figures for Scotland published by the Scottish Government yesterday for September 2021 show a deterioration in performance for the fifth consecutive month. The data show the worst four-hour performance on record and both the highest number of 12-hour and eight-hour stays since records began.

In September 2021 there were 113,998 attendances to major Emergency Departments across Scotland, the number of attendances dropped by 3,500 patients (3%) compared to the previous month, August 2021.

Despite the slight decrease in attendances data show that four-hour performance reached a new record low, with 73.8% of patients being seen within four-hours, this is 1.5 percentage points lower than the previous month, August 2021. It is the second time in 2021 that performance has fallen below 75%.

In September 2021 1,840 patients spent 12-hours or more in a major Emergency Department, this is an increase of 31.5% compared to the previous month, August 2021. This number increased for the fifth consecutive month and is once again the highest number of 12-hour stays since records began.

Data also show that 6,413 patients spent eight hours or more in a major Emergency Department. This is an increase of 20%, equal to over 1,000 patients. The number of patients delayed by eight-hours or more increased for the fifth consecutive month and once again this is the highest number of eight-hour stays since records began.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “The consistent fall in performance is seriously worrying. What we are seeing: ambulance handover delays; dangerous crowding; long stays; put patient safety at risk and can lead to harm or avoidable deaths.

“Data show that for every 67 patients waiting 8-12 hours, one of them will come to avoidable harm – therefore we can estimate that in Scotland between January and August 2021 there have been 231 excess deaths directly caused by a long wait due to a crowded Emergency Department.

“These are unconscionable practices and both ambulance crews and Emergency Medicine staff are under pressure to resolve the problem – together with the College of Paramedics we laid out this guidance.

“The problem is poor flow throughout the hospital and exit block, this will not be resolved in the Emergency Department, it is a system-wide problem and requires system-wide solutions and collaboration.

“Boards must safely expand capacity where possible, provided doctors and nurses and other healthcare workers are available to staff the beds. Same-day emergency care can help to reduce unplanned hospital admissions, maximising the delivery of this service may alleviate some pressures.

“Discharge to assess, ensuring that patients can be discharged in a safe and timely way where they have the support they need to recover in the community, can help free up beds to increase flow throughout the hospital.

“Lastly, it is vital that adequate support and resources are given to social and community care so vulnerable patients do not face successive trips to the Emergency Department or hospital.

“Clear communication between Clinical Leads and senior Board management about the reality of ambulance handover delays; dangerous crowding; and long stays is also vital. Stating the threat these practices pose to patient safety and both reporting and escalating incidents as they occur should guide leadership to take swift action.

“It is a very difficult time, and we are preparing for a gruelling winter. The past five months of performance figures suggest that more deterioration is set to come. In Emergency Medicine we must continue to work towards collaborative solutions and work with other departments, specialties, and management.

“But we continue to call on the Scottish government to set out a long-term workforce plan. In Emergency Medicine (EM) in Scotland there is a vital need to both recruit new and retain existing staff, we need at least 113 EM consultants along with sufficient numbers of both junior and supporting staff and nurses.”

Today’s statistics revealed the worst weekly and monthly A&E statistics since records began.

The statistics show that only 65.6% of attendances at A&E services in NHS Lothian were seen and resulted in a subsequent admission, transfer or discharge within 4 hours for the week ending on the 24^th of October.

This is lower than the previous record low of 66.3% recorded in week ending 12th September. Furthermore, 508 patients in NHS Lothian waited more than 8 hours, with 240 not being seen for 12 hours.

Scottish Labour MSP Foysol Choudhury said: “A&E services in the Lothians are in crisis, with the situation rapidly deteriorating with every passing week.’’

“Hard-pressed frontline staff have been sounding the alarm for months, but the Health Secretary has spectacularly failed to take action. Patients in the Lothians are being put in danger thanks to the SNP’s catastrophic failure to support A&E services.

‘’The Health Secretary is without a workable plan, so we have a health service in freefall. Action must be taken now. Our NHS deserves better’’

Roll-out of new diabetes test

World-leading test to improve diagnosis

A simple blood test for people with Type 1 diabetes enabling some patients to stop taking insulin is to be rolled out.

Scotland is the first country in the world to introduce this test which will be available from hospital diabetes centres from Monday (1 November).

Aimed to improve the accuracy of diagnosis of Type 1 diabetes, the routine testing of C-peptide allows doctors to work out how much insulin someone with diabetes is making themselves.

If C-peptide is present in significant amounts, then it may indicate that the person does not have Type 1 diabetes and that it may be possible to stop or reduce insulin treatment.

The roll-out follows a two year pilot study in NHS Lothian led by Diabetes and Endocrinology Consultant Professor Mark Strachan.

Public Health Minister Maree Todd said: “Diabetes is a clinical priority for this Government and we want to ensure that everyone living with diabetes in Scotland can access safe, effective and person-centred healthcare, treatment and support.

“Type 1 diabetes is a significant health challenge right across the world. I am proud that Scotland will be the first country to introduce this blood test which has the potential to have a significant positive impact on the lives of those people living with diabetes.”

Professor Mark Strachan said: “C-peptide helps diabetes specialists make a more accurate diagnosis of the cause of diabetes, and that means we can get people on the most appropriate treatment. In some instances, C-peptide testing allowed people to stop very long-standing insulin therapy; this can be life-transforming.

“If anyone has any concerns regarding their diabetes or wishes to know more about the new blood test, they should contact their diabetes clinical team who are best placed to provide specific advice and support based on their individual circumstances.”

There are approximately 315,000 people living with diabetes in Scotland.

The programme will be offered to people with a diagnosis of Type 1 diabetes of at least three years duration. C-peptide testing will be offered by hospital diabetes centres.