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Tag: NHS Lothian
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 24th 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.
‘Catastrophic failure’: Lothian MSP comments on A & E crisis
NHS Lothian has warned patients not to attend A&E unless their condition was life-threatening.
It comes after statistics published this week have revealed the worst weekly A&E statistics on record.
Chief executive of NHS Lothian, Calum Campbell, said a request has been submitted for mutual aid from other health boards after services became caught in the grip of a “perfect storm” caused by staffing and bed pressures, combined with high volumes of patients presenting with complex and serious cases.
Lothian list Labour MSP Foysol Choudhury said: “Patients in the Lothians are being put in danger due to the SNP’s catastrophic failure to support A&E services.’’
‘’Lives are on the line and the Health Secretary’s current strategy is clearly not dealing whatsoever with this crisis.’’
‘’ The NHS is under-resourced, under-staffed and under pressure, and the Scottish Government must fund the NHS properly so that people can access care and treatment at A&E when they need it.’’
“If action is not taken now, we risk a winter of chaos in A&E departments across the Lothians.
Local patients can access new cancer treatment
New prostate cancer treatment available at Edinburgh Cancer Centre is first in Scotland
Men in the South East of Scotland may now be able to access a new treatment for prostate cancer, which is available at the Edinburgh Cancer Centre, Western General Hospital.
The Edinburgh Cancer Centre (ECC) is the first in Scotland to offer High–dose-rate brachytherapy (HDR-BT) for treatment of prostate cancer.
It was successfully introduced by NHS Lothian earlier this year and is now being made available to suitable patients across the South East of Scotland.
Prostate cancer is the most common cancer among Scottish males affecting 1 in 10 men. With more than 3,000 men diagnosed every year this figure is only expected to increase.
But, with early detection and improved treatments, survival rates are also increasing. Radiotherapy is commonly used to cure prostate cancers and increasing the radiation dose in treatments has shown to improve long-term cancer control.
The HDR-BT service at the ECC offers an additional treatment approach to deal with aggressive but localised prostate cancer. It allows a higher dose of radiation to be targeted directly into the prostate gland in a safe and controlled way. This minimises radiation exposure to surrounding normal tissue and thereby reduces potential side effects.
The new treatment is being offered alongside existing radiotherapy treatments at the Edinburgh Cancer Centre, expanding the range of treatment options on offer.
Dr Aravindhan Sundaramurthy, Consultant Clinical Oncologist at the Edinburgh Cancer Centre explains: “We have been successfully delivering low-dose-rate brachytherapy (LDR-BT) for prostate cancer with over 1000 men throughout Scotland benefitting from the service. However, men with more advanced or aggressive disease would not be eligible for LDR-BT on its own.”
“The start of the new HDR-BT service opens a very important therapeutic option for men with high-risk prostate cancer features. It brings together the skills and expertise of staff across our radiotherapy, oncology and anaesthetic teams to deliver another treatment option.”
He said: “I would strongly encourage anyone who is offered this treatment to go for it. It was a very smooth process and the care I received from the NHS was absolutely first class. I was looked after every step of the way and I knew that I was in the best possible hands for my treatment.”
This HDR-BT service is a collaborative effort involving radiotherapy nursing, prostate clinical oncologists, anaesthetics, therapeutic radiographers and oncology physicists. It is currently being offered at the Edinburgh Cancer Centre for suitable patients within the South-east Scotland Cancer Network with an aim to expand the service to other patients across Scotland.
Anyone looking for more information about prostate cancer including details of common symptoms and testing can visit NHS Inform: www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer
New £6.2m Renal Dialysis Unit opens at the Western General
A new £6.2 million Renal Dialysis Unit has opened in Edinburgh serving patients from the north and west of the city. Located at the Western General Hospital, the state-of-the art facility is designed to meet projected rising demand for dialysis services, while being more comfortable and welcoming for patients.
It will ensure patients who need kidney dialysis have access to the latest equipment in modern, bright and spacious surroundings.
The new building replaces a smaller unit, which was over 30 years old, and very cramped. It has increased the number of dialysis stations from 9 to 12. Now up to 72 patients can be treated in the unit.
Dialysis involves filtering waste products and excess fluid from a patient’s blood when their kidneys stop working properly. The most common form of dialysis, haemodialysis, takes on average four hours per session and is typically carried out three times a week.
Dr Caroline Whitworth, Consultant Nephrologist explains: “Patients can expect to spend between 12 and 18 hours per week on dialysis so having a welcoming, peaceful and comfortable place to do dialysis is really important.
“We’re already seeing the positive impact this fantastic new facility is having on patients and staff. The clinical areas is as light and airy as possible, but also more peaceful, giving patients a much better experience. The unit will be a great benefit for patients for years to come.”
Bill Aitken, a renal patient, started experiencing symptoms of kidney failure in his early 30s. An avid football player he first noticed that something was wrong when his fitness started to deteriorate. He has been a patient with NHS Lothian for over 25 years. He says: “I’ve been in and out of treatment at both the Royal and the Western General. This feels light years away from the previous unit.
“It’s very nice and bright and has cracking views out the window to Edinburgh Castle and the Old Town. When we’re dialysing, we’re there for a long time so it makes a huge difference to be doing it in modern, pleasant surroundings.”
The Renal Dialysis Unit is one of several new projects at the Western General Hospital to transform services and create more space, comfort and privacy for patients. It was funded by NHS Lothian Capital Investment, constructed by Robertson Construction on behalf of RMF Health, and designed by HLM Architects.
David Cairns, regional managing director, Robertson Construction Central East, said: “The new renal unit is one of several projects we have delivered at the Western General Hospital, on behalf of RMF Health, over the last 2 years whilst the hospital has remained a live environment. We’re also progressing a number of other projects with RMF Health which will provide first class facilities for the hospital.”
The capital development team worked closely with NHS Lothian’s official charity, Edinburgh & Lothians Health Foundation, to integrate creative enhancements of the environment into the design, helping to ensure that the unit was not only clinically functional but also aesthetically pleasing.
Jane Ferguson, Director of Edinburgh & Lothians Health Foundation, explains: “The involvement of our Arts in Health and Wellbeing team from the start of this project really demonstrates the importance that NHS Lothian has placed on art and design as an essential part of their capital projects.
“They recognise how much of an impact the environment and surroundings can have on patient and staff wellbeing. We were delighted to work together to take forward creative and innovative ways to enhance the space, and I think the end result is a welcoming, restful environment which creates privacy, distraction and diversion while patients receive treatment.”
NHS Lothian warns of children flu vaccination letter mistake
Are you a parent or guardian of a 2-5 year old in Edinburgh, East Lothian or Midlothian? Check out this important update regarding flu vaccine appointments 
More information on the children’s flu vaccine is available here:
NHS Lothian: Please wait for Covid Vaccine Booster invite
Frontline health and social care workers and those aged 70+ are currently being invited forward for the COVID-19 Vaccine Booster to provide longer protection against coronavirus.
Others who are eligible for the vaccine will be invited forward soon.
Visit http://nhsinform.scot for more information.
Councillor George Gordon calls on citizens to get their flu vaccination
In the first week of the winter vaccination programme, 27,000 people have come forward to get their flu vaccine, which is a great response ((writes Edinburgh Integration Joint Board member and Forth Councillor GEORGE GORDON).
We’ve all seen the devastating effect the pandemic has had in the past 18 months so it’s really important we all play our part to limit the impact this winter.
This is a personal appeal to encourage everyone who’s eligible to get their flu vaccination this winter. COVID-19 has not gone away so it’s more important than ever to protect yourself by getting the vaccination and do your bit to ease the pressure on social care, GP surgeries and hospitals over winter.
Many of you will already have received a letter either with an appointment or asking you to book one online. I know there’s been an issue with the scheduling of some flu appointments via the national booking system.
This means some people’s appointments are not as local as would have been expected, and a few cases where people who are housebound have been asked to go to an appointment. I know how concerning this is for people who cannot travel.
If you have received a letter with an appointment that you are unable to attend, you can rearrange your appointment for a more local venue by going online at nhsinform.scot/flu-vaccine/invitations-and-appointments/rearrange-your-flu-vaccine-appointmen or ring the national flu vaccination helpline on 0800 030 8013 for help to re-book.
More local appointments are now available for people who find it difficult to travel. If you are housebound and normally get your flu jab at home then you will get it at home again this year, even if you’ve received an appointment letter.
It’s really good to see that so many people have been turning out to get their vaccinations. The Royal Highland Centre site experienced a slight delay in topping up vaccination stocks on Tuesday morning (5 October) due to the level of demand across other sites and some people were asked to return the following day.
This was resolved within an hour and I can assure you that we have good vaccine stocks in Edinburgh.
Across Scotland, GP surgeries are no longer responsible for flu vaccinations for their patients. Now, health and social care partnerships manage the flu programme. In Edinburgh we have a range of drive through and walk through clinics for adults which will open at weekends during October and November.
Edinburgh’s main site is in Lowland Hall at the Royal Highland Centre which is open seven days a week and easy to access by public transport (buses 100, 200 and 400). We also have small local clinics for people who can’t make their way to Ingliston.
Children have received a letter for their parents or carers about their vaccine. If it’s been six months since your second dose of the COVID vaccine, you may also get your COVID vaccine booster at the same time as your flu vaccine.
It’s a massive programme and this year there’s more people than ever eligible to get a vaccine which is great news. You can now get the vaccine if you’re over 50, pregnant, an unpaid carer, at risk because of an existing health condition, or because of the job that you do. You can check if you are eligible for a flu vaccine, or find more information, at nhsinform.scot/flu.
I’d really encourage you to take up that offer – go to your vaccination appointment if you have been given one or book an appointment on the online portal if you’ve been asked to do that.
Please don’t be in any doubt – flu is serious. Getting the vaccine will protect you, your family and friends, and also our vital NHS and social care services.
Some second dose appointments offered to teenagers in error
NHS Lothian has said that a number of second vaccination appointments have been mistakenly scheduled for 16 and 17-year-olds.
The health board said text message and appointment letters have been issued to the teenagers in Lothian which urge them to attend an appointment for a second dose of COVID vaccine, even though they may not be eligible.
At the moment, and in line with national guidance, 16 and 17-year-olds are only being offered one dose of the vaccine, unless they are clinically extremely vulnerable themselves, living with someone who is or are an unpaid carer.
However a data error has caused 2,500 text messages to be sent to teenagers in Lothian inviting them for a second dose. Many of those invitations may be entirely appropriate, but many will not.
As a result, a second text message has been issued urging the teenagers not to attend unless they are clinically extremely vulnerable themselves, living with someone who is or are an unpaid carer.
The situation is under investigation to establish what happened and how many letters may also have been sent via the national booking system to teenagers.
Pat Wynne, Director of Nursing Primary and Community Care, NHS Lothian, said: “I would like to apologise to all of those teenagers affected and for any confusion and inconvenience caused.
“All of those who received a text message have been contacted again with more information on what to do next. We don’t yet know how many letters have been issued, but we are investigating fully to establish what happened and how many people are affected.
“If you are eligible for a second dose – if you clinically extremely vulnerable yourself, living with someone else who is or are an unpaid carer – please double-check your appointment and make sure you receive that vital protection from a second dose.
“However we are really keen to make sure that other teenagers do not face a wasted journey to a vaccination centre or that they do not receive a second dose when it is currently not recommended for them.”