Western General makes significant strides in reducing the environmental harm caused by theatre gases

NHS Lothian’s Western General Hospital has significantly reduced its carbon emissions thanks to a team of environmentally conscious anaesthetists.

By replacing the use of one medical gas alone with an eco-friendlier alternative, the Department of Anaesthetic’s carbon footprint has decreased by over 125 tonnes annually.

Anaesthetic gases have a significant impact on the environment and account for around 5% of the overall carbon footprint of health services.

Desflurane and Nitrous Oxide are two of the most environmentally harmful gases used in operating theatres, with Desflurane having a global warming potential 2,500 times greater than carbon dioxide.

The team at the Western stopped using Desflurane in April 2022, switching to eco-friendlier alternatives, which reduced the carbon emissions of their anaesthetic gases by 73%.

Dr Matthew Royds, Clinical Director of Anaesthetics & Theatres at the Western, said: “Operating theatres are significant contributors to the carbon emissions generated by healthcare. A lot of this is due to the gases and techniques which have long been used in anaesthesia.

“Our team feel that, as professionals, we have a moral obligation to find more sustainable alternatives, while continuing to deliver the same high level of patient care.

“It is incredibly rewarding to see the real and measurable reduction in our environmental impact, which has been achieved through a passionate team effort and a long-term commitment to more sustainable practices, which will ultimately benefit us all.”

Withdrawing desflurane is the first action of the Scottish Government’s National Green Theatres Programme, part of the NHS Scotland Climate Emergency and Sustainability strategy.

Carbon emissions due to Nitrous Oxide at the Western last year were also less than 25% of previous levels due to a change in the way this is used and delivered.

In the next two years, the aim is to reduce these emissions to zero at the Western, with piped Nitrous Oxide at two other Lothian hospitals awaiting decommissioning.

Jane Hopton, Programme Director and Sustainability Lead for NHS Lothian, said: “The changes being driven by Dr Royds and his colleagues are essential if we are to achieve our Net Zero goals.

“The support and commitment of the staff in anaesthetics and theatres has a had huge impact on making this work a success, as well as creating financial and environmental savings for NHS Lothian without compromising patient care.

“In the Royal Infirmary and St John’s hospitals, the teams have also been hard at work to safely reduce the environmental impact of these gases.

“In late 2021, St John’s became the first hospital in Scotland to use a new technology during labour which breaks down exhaled Nitrous Oxide into harmless Nitrogen and Oxygen.

“We are proud to support the increasing number of professionals across NHS Lothian who are taking action to reduce the impact of health care on the environment.”

Briggs: NHS Lothian A&E Waiting Times showing no sign of improving

Date ↓% within 4 hours
19 March 202360
20 March 202261.5
21 March 202184.1
22 March 202094.6
24 March 201986.6

Scottish Conservative and Unionist MSP for Lothian Miles Briggs said: “The figures are an embarrassment for Humza Yousaf and are indicative of the extent to which he failed in his role as Heath Secretary.

“It is completely unacceptable that in the space of 3 years the percentage seen withing 4 hours dropped almost 35% from 94.6% to 60% in Lothian.

“Despite being well into the swing of Spring, the figures for Lothian are now worse than at the peak winter times.

“In taking his eye off the ball and doing his best to appease the independence hardliners during the leadership contest, Lothian and Scotland’s figures have deteriorated further.

While as Health Secretary he was clearly unable to find a solution to the mess he created, one of his first priorities as the new First Minister must be to get on top of the situation and find someone who can clear up the disaster that he presided over.”

Edinburgh embraces Day of Action

NATIONAL SUPPORTED INTERNSHIP DAY

A new government-backed national day of action will be marked today (Monday 27 March) to boost the number of people with a learning disability or autism spectrum condition in employment.

Led by the charity DFN Project SEARCH, the first-ever National Supported Internship Day showcases the tremendous contribution young adults with Special Educational Needs and Disability (SEND) can make to the workforce.

In Edinburgh, the City of Edinburgh Council, NHS Lothian and Virgin Hotels will hold a series of events throughout the week, including a celebration for newly graduated interns. Young people will take over the city’s Project SEARCH social media channel on Monday to share what they are getting up to on their supported internships. 

Employers in all sectors are also being called upon to redouble efforts to employ young adults with SEND and come together to challenge the everyday misconceptions that all too often unfairly shape their life opportunities. 

Councillor Mandy Watt, Depute Leader of the City of Edinburgh Council, said: “Training and employment chances were pulled from under young people’s feet because of Covid. So, one of our biggest priorities in the aftermath of the pandemic has been to improve opportunities and outcomes for our young people, including those with complex needs.

“I’m proud of the inspiring and talented group of graduates we’ve nurtured. Many have held internships with us while others have been supported by NHS Lothian and Virgin Hotels.

“This day of action, I want to call on other Edinburgh-based employers to follow suit. We require a variety of placements every year to ensure we’re able to provide a full range of experiences to our young people and interested organisations should get in touch with Edinburgh Project Search.

“These are ten-week work placements beginning in September and the benefits are life-changing. They give special young people the same opportunities as their peers and space to shine.

“The placements can unlock confidence, build CV skills and be the difference between someone choosing to enter the workforce or feeling unable to. Plus, employers may well find their intern is exactly the type of person they’ve been looking for to expand their talent pool.”

Luke Baillie has been taking part in the programme and has a placement at Edinburgh’s bus station. He said: “Project SEARCH gives us the chance to get real work experience, build our CV and prepare for employment.

“It allows us to build our confidence and learn skills we otherwise wouldn’t be able to access. It changes our lives.

Adam Gray, Regional Director of People, Scotland at Virgin Hotels Edinburgh, said: “At Virgin Hotels, our teammates are fundamental to our success. It is important to us that our teammates reflect the guests that we welcome to our hotels, inclusive of everyone.

“Being a host business with DFN Project Search Edinburgh is something we are incredibly passionate about and proud to be the first privately owned organisation to do so.

“National Supported Internship Day is a great way to shine a light on the incredible talents of the interns of the 2022/2023 Cohort, and showcase the positive impact that supported internships have on business, organisations and also the local community.”

Most recent figures show that just 4.1% of young adults with a learning disability and/or autism in Scotland enter secure paid employment following education, compared to 80% of their peers. 

Supported internships – work-based study programmes for 16 to 29-year-olds with SEND – dramatically change the employment outcomes for those who take part.  DFN Project SEARCH figures show that 70% of people who complete their supported internships achieve this and successfully remain in employment.

Having meaningful paid employment is known to improve health and wellbeing and is central to individual identity and social status. If given the correct support and opportunities, young adults with SEND can thrive in a wide variety of jobs.

Minister for Children, Families and Wellbeing, Claire Coutinho said: “Supported Internships provide brilliant support to young people with EHC plans, equipping them with the skills they need to have fulfilling and successful careers.

“This is why we are boosting investment for the internships by doubling their numbers, and through the extra £3m the Chancellor announced last week we’ll explore ways to extend this programme to young people with SEND and without an EHC plan.  

“Ensuring successful transitions into adulthood is a central part of our SEND and AP Improvement Plan, through which we will make sure all children and young people have the support they needed, no matter where they live or what school they go to.”

David Forbes Nixon, Founder and Executive Chair of DFN Project SEARCH, said: “We created National Supported Internships Day to give every young adult with a learning disability the same opportunities as anyone else to transition from education to employment.  

“There is often a fear factor among employers of getting it wrong in hiring young adults with a learning disability, but it doesn’t need to be like that. It makes good business sense to explore the wealth of untapped potential among this group of enthusiastic and capable young people.

“They are keen, ambitious, and have an array of talent to offer employers.”

NHS Lothian releases results of research into transmission of COVID-19 from hospitals into care homes

Scientists in NHS Lothian have helped to develop national infection controls after studying COVID-19 transmission between hospitals and care homes.

The teams found that 99 per cent of patients discharged from hospital into care homes during the first wave of the pandemic did not introduce COVID-19 into care homes.

The study, conducted with the University of Edinburgh, focused on patients in Lothian discharged from hospital into 130 care homes from 1st March 2020 to 31st May 2020. 

Of the 787 discharges in this time, the researchers found that the majority – a total of 776 – did not introduce COVID-19 into care homes as a result of their hospital stay.

Forty-one of the discharged patients had a positive COVID-19 test within two weeks of leaving hospital and genome sequencing was used to identify if these cases could be linked.

The study found that 30 patients likely contracted this in the care home or from the community.

The results of 10 patients were inconclusive and one patient was confirmed to have contracted COVID-19 during their stay in hospital.

Very sadly, this patient later passed away and a number of residents in their care home subsequently contracted COVID-19.

Dona Milne, Director of Public Health and Health Policy, NHS Lothian, said: “This study has shown that 99 per cent of hospital discharges didn’t introduce COVID-19 cases into Lothian care homes during the first wave of the pandemic.

“However, we’re able to say with certainty that one care home outbreak in this time originated from us. We are deeply saddened by this, and our heartfelt apologies and condolences are with the families and loved ones of those affected.

“We began testing symptomatic care home residents very early in the pandemic, so it’s been really important for us to use this information to find out what we can learn about how the virus was contracted and spread and how this linked to our hospitals.”

Before the nation went into its first lockdown when testing wasn’t widely available, NHS Lothian built capacity into its labs specifically to PCR test those who were symptomatic in hospitals and care homes.

Because of this early testing of symptomatic patients, in-depth data was available to the research team to enable them to genome sequence the transmission of the virus as part of the study.

Dr Kate Templeton, Head of Molecular Diagnostics for NHS Lothian who led the study, said: “Testing was a priority for us from the beginning and we were the first health board in Scotland to build capacity in our labs specifically for care home residents.

“This early testing has enabled us to genome sequence the virus and track where this was acquired and how this spread, leading to the creation of an outbreak methodology which has informed best practice at both Scotland and UK-level.

“This methodology not only has applications to COVID-19 but other viruses too and has been vital in learning lessons around infection control. It also clearly shows that the protection of the most vulnerable in society needs to involve not just health authorities but the community too.”

You can read the study in full here.

North Edinburgh residents invited to No Smoking Day event in Pilton

Health charity ASH Scotland is urging North Edinburgh residents to attend an event organised by the Pilton Community Health Project (PCHP) on No Smoking Day tomorrow (Wednesday 8 March).

People who smoke and attend the event in PCHP’s Community Hub at 73 Boswall Parkway between 12 midday and 1pm will have the opportunity to speak with representatives from the charity and NHS Lothian’s Quit Your Way service, which provides person-centred support to help stop smoking attempts.

Sheila Duffy, Chief Executive of ASH Scotland said: “Our charity’s theme for No Smoking Day is ‘Quit and Win’ and, through our campaigning and engagement at this event hosted by Pilton Community Health Project, we look forward to encouraging more people in NorthEdinburgh to make attempts to quit smoking to benefit their health, wellbeing and personal finances.”

Dawn Anderson, Director of PCHP said: “We are delighted to support our Community Wellbeing partnerASH Scotland with its No Smoking Day campaign and encourage people who smoke, their families, friends and neighbours to come along, share some lunch, and tell their stories about smoking, quitting or trying to quit.  They will also have the chance to get some personalised advice from the experts about the best way for them to stop.

“The informal event will include lunch and those who take part will also receive a small gift card to thank them for sharing their experiences. We hope people who have already given up smoking will also come along and offer support to those starting out on their quit journey.”

If you live in North Edinburgh and would like to register for the event contact PCHP on 0131 551 1571 or email Dawn Anderson on dawnanderson@pchp.org.uk .

Anyone who has the goal of giving up smoking but unable to attend the event can contact a Quit Your Way adviser by calling the free helpline on 0800 848484 or create a quit plan at www.quityourway.scot

Award-winning Long Covid support service extended

An innovative project to provide much-needed support to Long Covid patients has been extended to Midlothian.

Chest Heart & Stroke Scotland has worked with NHS Lothian, Pogo Digital Healthcare, patients and GPs to develop the individualised and easy-to-use Long Covid Pathway.

The pathway was piloted in Edinburgh in 2022, involving 36 GP practices and 173 patients, with plans to roll out across Edinburgh and the Lothians by the end of 2023.

GPs can refer patients directly into the pathway, which provides people with bespoke digital advice and also connects them to a CHSS nurse-led helpline and peer support.

The digital aspect of the service, the award-winning ‘MyTailoredTalks’, helps people manage their condition day-to-day while providing feedback to their GP to help with ongoing care.

Jane-Claire Judson, Chief Executive of Chest, Heart & Stroke Scotland, commented: “In Scotland, 94,000 people have been living with Long Covid for over a year. We know that people living with the condition feel scared, abandoned and left behind.

“Our Long Covid Support Pathway allows us to better support people living with the condition in Edinburgh and Lothian. Its success means we hope to see it rolled out across the country, helping more people with Long Covid to live their lives to the full.”

Professor Tim Walsh, Director of Innovation for NHS Lothian, said: “It’s been really important for us to bring together expertise from a range of organisations to better improve the support available for people with Long Covid.

“We know living with this can be really challenging and patients with Long Covid need support that can be individualised and available on demand, and we’re proud to have worked with our partners to have developed such support in Lothian.”

The Midlothian Health & Social Care Partnership Long Covid Project Team has welcomed the roll-out.. A spokesperson commented: “During the pilot phase, this pathway empowered people to make a successful transition after diagnosis towards self-management of Long Covid through effective and targeted self-management resources.

“GP practitioners in Midlothian are looking forward to utilising the pathway, which will remove travel barriers while still providing person-centered support and reducing demand on services. The combination of written, video and telephone support will provide people in Midlothian access to the most appropriate support for them.

“Importantly, support and self-management resources provided by MyTailoredTalks and CHSS are fed back to the referring GP without them needing to seek out this information. The pathway will enable people in Midlothian living with Long Covid to self-manage their symptoms and access up-to-date and validated information relevant to their needs.”

None of this would have been possible without NHS Lothian Charity, which has invested £120,000 in the platform so far.

Jane Ferguson, Director of NHS Lothian Charity, said: “As the official charity of NHS Lothian, we have a key role to play in supporting NHS Lothian to take forward innovative projects that help improve the health and wellbeing of communities.

“Thanks to generous donations to our COVID-19 appeal, we were able to provide initial funding for ‘MyTailoredTalks’ and are delighted to see this now being extended to Midlothian.

“This has been a great example of partners coming together from across the sector to put in place innovative solutions that support our communities dealing with the effects of Long Covid.”

Pogo Studio designed MyTailoredTalks, which recently won the Technology Enabled Independent Living Award at the Digital Health and Care Awards 2023.

Jack Francis, Managing Director of Pogo Studio, said: “This has been a fantastic, collaborative partnership to bring our expertise in technology to, and we have learnt hugely from working with NHS Lothian, Chest Heart & Stroke Scotland and people living with Long Covid.

“Long Covid continues to be a huge issue across Scotland and so we’re delighted that our work so far is demonstrating that MyTailoredTalks can help to support people in their recovery.”

Improving children’s health

Almost £600,000 funding to help prevent childhood obesity

Children up to the age of five and their families are being given the tools to develop healthy habits through six projects aimed at preventing childhood obesity and reducing health inequalities.

Almost £600,000 is going to programmes such as JumpStart Tots – run by NHS Ayrshire & Arran – which has already seen a number of young children and families in the area benefit from this healthy weight programme.

The funding is part of the Scottish Government’s commitment to ensure all children have the best start in life and the projects support the ambition to halve childhood obesity in Scotland by 2030.

This builds on the range of actions being taken as a result of the 2018 Diet and Healthy Weight Delivery Plan to ensure everyone eats well and has a healthy weight.

Public Health Minister Maree Todd said: “On World Obesity Day we reiterate the importance of improving health and reducing health inequalities across Scotland.

“We want Scotland to be the best place in the world for a child to grow up and we know good nutrition and physical activity is crucial for children’s health and development.

“These projects are crucial to our bold ambition to halve childhood obesity in Scotland by 2030. They tackle inequalities working with families and communities to encourage healthy eating and offering support for those experiencing food insecurity.

“We will continue to support local partners to develop these ambitious and effective plans to help prevent and reduce childhood obesity, alongside policies such as our Diet and Healthy Weight Delivery Plan and Best Start Foods payment, which are central to our commitment to ensure everyone in Scotland has access to healthy, nutritious food.”

Consultant Dietitian in Public Health Nutrition for NHS Ayrshire& Arran, Dr Ruth Campbell said: “The continued early years funding from Scottish Government has enabled NHS Ayrshire & Arran to extend the Jumpstart Tots programme to more families across Ayrshire.

“Jumpstart Tots is an interactive healthy lifestyle programme which offers families with children aged between two and five, a minimum of eight one hour sessions that are planned to suit each individual family’s needs.

“Local parents feedback has been that the Jumpstart Tots programme has helped them make changes that their whole family has been able to benefit from as a result of finding out more about the food they eat.”

Projects receiving funding are:

NHS Ayrshire & Arran: JumpStart Tots – £53,769

NHS Lanarkshire: ‘Little n Lively’ programme in partnership with Healthy Valleys – £150,000

NHS Greater Glasgow & Clyde: ‘Thrive Under Five’ programme – £305,448

NHS Grampian: Training and support for a group of multi-agency professionals across Aberdeenshire to deliver the HENRY approach – £17,028

NHS Lothian and NHS Fife:  Continued delivery of HENRY core training to early years workforce  – £57,000 (£48,500 for Lothian, £8,500 for Fife)

NHS Lothian: Improving and increasing weaning support £10,000

The Scottish Government published the Diet and Healthy Weight Delivery Plan in July 2018.

No Smoking Day lunch at PCHP

Its #NoSmokingDay next week! Pilton Community Health Project would love to hear your stories of quitting, trying to quit, successfully quitting …. call us on 0131 551 1571 or email Dawn on dawnanderson@pchp.org.uk to book in for lunch with us and @ASHScotland @QYWLothian @NHS_Lothian

Thank you vouchers too!

NHS Lothian publishes new annual Public Health report

NHS Lothian has released a new annual report which looks to provide an in-depth analysis into the health of Lothian.

The report, from NHS Lothian’s Director of Public Health, seeks to outline health and social inequalities, as well as their current and predicted impact on mental and physical wellbeing.

Public Health specialists work to protect and enhance the health of everyone in Lothian, informing local and national policy to improve outcomes for both the individual and community.

Dona Milne, Director of Public Health for NHS Lothian, said: “Understanding our population as it is now and how this is predicted to look is vital to reduce inequalities and improve health outcomes for everyone in Lothian.

“This report highlights and reaffirms what the evidence tells us about the socio-economic factors impacting health the most. When designing and delivering health and social care, we must be able to understand and address those wider factors which lead to poorer outcomes for people.”

The new report brings together evidence and research from a variety of sources, addressing systemic inequalities and the impact of recent seismic events such as the COVID-19 pandemic.

The report also predicts population trends and the expected health impact of the cost-of-living crisis and increasing child poverty on those already living in more deprived communities.

Dona continued: “We are endeavouring to share this report widely with partners to help inform the collaborative work we need to do to make long-lasting and meaningful changes to public health in Lothian.

“With the cost-of-living crisis and increasing child poverty expected to exacerbate pre-existing inequalities, it’s more important than ever to understand what is needed as part of a whole system approach to ensuring better health outcomes for all.”

Jane Ferguson, Director of NHS Lothian Charity, said: “As the official charity of NHS Lothian, we have a key role to play in supporting Public Health in their work to reduce health inequalities and prevent ill health in all our communities.

“Through our strategic partnership with the health board, we have provided five years of funding for income maximisation services that can be accessed by patients and their families to help mitigate against both the immediate impact of the current cost-of-living crisis and the ongoing impacts of poverty on overall physical and mental health.

“We will continue to work closely together to support Public Health to tackle health inequalities that exist as a result of poverty so that we can improve the health and wellbeing of people across Edinburgh and the Lothians, now and in the future.”

You can read the report in full on NHS Lothian’s website.

Getting better: NHS Lothian moved to Stage 2 for paediatric audiology

NHS Lothian will move to Stage 2 of NHS Scotland’s national performance framework for paediatric audiology following improvements.

The health board has made significant progress, completing almost 81% of the recommendations outlined by the British Academy of Audiology (BAA) following an independent review of services in 2021. This includes improvements in governance and culture.

As part of the Stage 2 escalation level, robust measures will remain in place, ensuring that Scottish Government officials continue to provide direct support to NHS Lothian.

Health Secretary Humza Yousaf said: “The de-escalation of NHS Lothian to Stage 2 for paediatric audiology is a positive step forward and highlights the significant progress the board has made towards the BAA’s recommendations.

“I would like to thank all staff at the board for their hard work to implement robust and sustainable changes, to continue to improve the service and to deliver high quality patient care. I want to ensure families across Scotland are assured their child is getting the best possible audiology support.

“We will work closely with and support the board over the coming months as it continues to provide high quality services. A wider Independent review of audiology services in Scotland is on-going and due to report to the Scottish Government this Spring.”

NHS Lothian was moved to escalation Stage 3 in December 2021 on the NHS Board Performance Escalation Framework for Paediatric Audiology.

An independent audit and governance review into the Paediatric Audiology service at NHS Lothian was established following the Scottish Public Services Ombudsman Investigative report into Child A’s audiology care at the health board. Following that publication, the BAA was commissioned by NHS Lothian to help fulfil recommendations from that report.

The decision on a board’s Stage 3 Escalated position sits with the Director General for Health and Social Care.

The BAA report and recommendations is here.