Tag: NHS

Scottish Government commits extra funding to tackle delayed discharge from hospitals

Humza Yousaf: “This winter is likely to be the most challenging in the history of the NHS”

The Scottish Government is investing an additional £10 million to help patients avoid a hospital stay wherever possible – and to prevent delayed discharge for inpatients.

This is part of a range of actions included in the £300 million winter package of funding to health and social care services, and outlined in the health and social care winter plan, to take the pressure off hospitals and frontline staff.

Two new programmes – Interface Care and Discharge without Delay – will support NHS Boards to explore alternatives to hospital inpatient care where appropriate, and improve the discharge process for those who do need to be admitted to hospital.

Interface Care, backed by an additional £6 million this financial year, will deliver safe, high-quality care as an alternative to hospital admission, or will support early hospital discharge. The programme will be implemented by early winter.

Discharge without Delay, supported with a further £4 million, will improve pathways through hospital settings, reducing inpatient length of stay and building bed capacity. Working with patients, families and/or carers, it will ensure patients are treated in their home where appropriate.

Health Secretary Humza Yousaf said: “This winter is likely to be the most challenging in the history of the NHS, and it’s important we take urgent action to ensure our hospitals and emergency frontline staff are not overwhelmed. That’s why these actions to improve the discharge process, and redirect patients who don’t need to be in hospital, are so important.

“I am confident that through our collective investment in people, capacity and systems to deliver the right care in the right setting, we can improve outcomes for those of us who need to use our health and social care services.”

The Scottish Government has invested more than £80 million this year to support the reduction in waiting times for people having elective procedures, which has been impacted by the pandemic. To minimise delays for those patients waiting on urgent hospital treatment within four weeks, including cancer patients, extra capacity is being provided through private hospitals over the winter period.

Discharge without Delay launches this month, with four early adopter sites to test the approach, with the aim of rolling the programme out nationally across all sites over the next 10 weeks.

The Interface Care Programme launched this month in two pathfinder sites – NHS Greater Glasgow and Clyde and NHS Tayside. Roll out across all boards is planned over the winter.

Register your defibrillator to help save lives across Scotland

The Circuit: Charities and health organisations urge people to register their defibrillators on database to help save lives  

A new campaign has been launched across Scotland to urge defibrillator owners to register their devices on a national database to help save more lives from cardiac arrests.

Leading charities and health organisations have come together calling for defibrillators to be registered on The Circuit – The national defibrillator network, which connects defibrillators to NHS ambulance services across the UK, so that in those crucial moments after a cardiac arrest they can be accessed quickly to help save lives.

  • There are around 3,200 out-of-hospital cardiac arrests every year in Scotland, but only one in ten people survive.
  • Every minute that passes without CPR or defibrillation reduces the chances of survival by up to 10 per cent in some instances, but immediate CPR and defibrillation can more than double the chances of survival.
  • It’s estimated that public-access defibrillators (PADs) are used in less than one in ten out-of-hospital cardiac arrests across the UK – often because 999 call handlers aren’t always aware that a defibrillator is available nearby because the ambulance service hasn’t been told about it. If they don’t know it is there, they can’t direct someone at the scene to retrieve it while waiting for the ambulance to arrive. 

To help save more lives, The British Heart Foundation (BHF), Resuscitation Council UK (RCUK) St John Ambulance and Association of Ambulance Chief Executives (AACE), are urging people who look after defibrillators in places such as offices, communities, shopping centres and leisure centres, as well as in public places, to register them on The Circuit.

James Jopling, Head of BHF Scotland, said: ““Every second counts when someone has a cardiac arrest and, alongside CPR, prompt use of a defibrillator is critical in giving them the best chance of survival.

“To put it simply, knowing where the nearest defibrillator is could be the difference between life and death.

“The Circuit is pioneering technology which will help emergency services direct bystanders more quickly to a defibrillator when someone collapses with a cardiac arrest. But for The Circuit to save lives, it is vital that unregistered defibrillators are put on the system. If you, or somebody you know is a defibrillator guardian, then we urge you to register your device on The Circuit. You could help save a life.”

Pauline Howie, Chief Executive of the Scottish Ambulance Service, said: “When someone calls 999 to report a cardiac arrest, the call handlers in our control rooms are trained to provide the location of the nearest registered defibrillator within 500m of the call. 

“Studies show that using a defibrillator within three minutes of collapse, along with starting CPR, can greatly increase chances of survival.  

“This swift action can make a real difference, and The Circuit is a vital tool in helping increase bystander action to help someone in cardiac arrest. Over the last five years, the Save a Life for Scotland (SALFS) partnership which includes SAS, the Scottish Government and the Scottish Fire and Rescue Service has equipped over 640,000 people with CPR skills, and the survival rate after an out-of-hospital cardiac arrest has doubled to one in ten people. 

“However, there’s more we can do, and to help save even more lives, we would urge everyone to register the defibrillators that they are responsible for on The Circuit, so that they can be easily located and accessed when needed.”  

Dr James Cant, Chief Executive Officer at Resuscitation Council UK, said: “A cardiac arrest can happen to anyone, anywhere, at any time. Not only is defibrillator use a crucial step in the Chain of Survival, the presence of defibrillators in public places can help raise awareness and stimulate people to think about what they would do in an emergency. 

“Survival depends on all links in the Chain of Survival being carried out quickly. This means early recognition and calling for help, early CPR, early defibrillation and post resuscitation care – and The Circuit plays a vital role in giving people their best chance of surviving a sudden cardiac arrest.”

While the 14 UK ambulance services have previously had their own regional databases, The Circuit will eventually replace these with a new national database that lets the ambulance services see defibrillators across the UK once it has been rolled out. This will allow them to direct people to the nearest defibrillator when somebody is having a cardiac arrest, wherever they are.

The Circuit, which is already live in 12 of the 14 ambulance service regions across the UK[1] and will become nationwide soon, could help to save thousands of lives – but it is vital that as many defibrillators as possible are registered on the database for it to work effectively. 

It’s free to register your defibrillator onto The Circuit, and you only have to do it once. You can also register multiple defibrillators if you are the guardian to more than one.

Visit TheCircuit.UK for more information or to register your defibrillator. 

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.” 

RCM warn of midwife exodus as maternity staffing crisis grows

Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system, according to a new survey of its members by the Royal College of Midwives (RCM).  

The College is warning of a ‘midwife exodus’ as it publishes the results of its annual member experiences of work survey. Over half of midwives surveyed said they were considering leaving their job as a midwife with 57% saying they would leave the NHS in the next year. 

Of those midwives who either have left or were considering leaving, more than eight out of 10 were concerned about staffing levels and two-thirds were not satisfied with the quality of care they are currently able to deliver.  

Alarmingly, the highest level of dissatisfaction among those surveyed came from midwives who had only worked for five years or less in the NHS. This will have a significantly detrimental impact on workforce planning and, says the RCM, the ability of maternity services across the country to provide acceptable levels of safe, quality care. 

The RCM’s General Secretary and Chief Executive, Gill Walton, said: “Every midwife and maternity support worker goes to work to provide safe, quality care. That so many feel that understaffing means they are unable to do so is deeply worrying.

“What these numbers suggest is a midwife exodus, which will leave already-struggling services on their knees. Quite rightly, there is a strong focus on improving maternity safety, but there is a risk that the Government is ignoring the essential ingredient to that: having the right staff, in the right place.  

“Investment and programmes to improve safety in maternity services hang in the balance here, because without adequate numbers of staff with are fighting a losing battle. Every safety report cites understaffing as an issue that is comprising the delivery of safe care, but when are the Government going to take note?

“We are calling on the Government to listen to those best advised and work with us to improve retention and recruitment. All NHS organisations must urgently review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.” 

A report published by NHS Digital in July revealed the number of NHS midwives working in England in May had fallen by almost 300 in just two months. This is the fastest fall for these two months for any of the years listed in the NHS report, which goes back to 20 years say the RCM.  

Burnout among midwives and all maternity staff is higher than ever, particularly after COVID-19 which saw an increase in sickness absence adding to a pre-existing shortage of 2,000 midwives in England alone.

Last week leaked results of an NHS national staff survey showed a sharp drop in those who believe their health and wellbeing is being supported by their employer. This is echoed in the RCM survey, with over half of respondents saying that they did not feel valued by their employer.

Almost all (92%) of midwives and maternity support workers (MSW) said that they did not feel their work was valued by the current Government.

 

Gill added: “Not a day goes by that we don’t hear of a maternity service having to close temporarily, suspend services or divert women to other maternity units just because there simply aren’t enough midwives. This can’t continue because we know it compromises safety and means women don’t always get the safe positive pregnancy and birth experience that they should.  

“It’s also having a shocking impact on maternity staff themselves. A shortage of midwives has undoubtedly worsened rates of physical and mental burnout among our members. Morale among staff is low and has been worsened by the recent pay award in England.  

“Sadly, this survey shows that many midwives and MSWs have had enough. They are feeling very fragile and are simply at breaking point. Enormous demands are being made on midwives and the services they work for, yet investment in these services from the Government remains inadequate to provide the safe, high-quality care that women deserve.

“We have previously advised the Government on what can be done to begin to address this situation which hasn’t happened overnight. Prior to the pandemic the RCM has voiced concerns and solutions to the recruitment and retention issues faced by UK maternity services, and we are happy to do that again, but we are now sadly at crisis point.

“That is today we are again calling on the Government and NHS Employers to take action immediate to keep midwives in midwifery before it’s too late.” 

Additional £5.4 billion for NHS COVID-19 response in England over next six months

Includes £1 billion to help tackle COVID-19 backlogs, delivering routine surgery and treatments for patients

The NHS will receive an extra £5.4 billion over the next six months to support its response to COVID-19 and help tackle waiting lists, the Prime Minister and Health and Social Care Secretary Sajid Javid have announced.

The funding will immediately go towards supporting the NHS to manage the immediate pressures of the pandemic. This includes an extra £1 billion to help tackle the COVID-19 backlog, £2.8 billion to cover related costs such as enhanced infection control measures to keep staff and patients safe from the virus and £478 million to continue the hospital discharge programme, freeing up beds.

The additional £5.4 billion brings the government’s total investment to health services for COVID-19 so far this year to over £34 billion, with £2 billion in total for the NHS to tackle the elective backlog.

Prime Minister Boris Johnson said: “The NHS was there for us during the pandemic – but treating Covid patients has created huge backlogs.

“This funding will go straight to the frontline, to provide more patients with the treatments they need but aren’t getting quickly enough.

“We will continue to make sure our NHS has what it needs to bust the Covid backlogs and help the health service build back better from the worst pandemic in a century.”

Health and Social Care Secretary Sajid Javid said: “The NHS has been phenomenal as it has faced one of the biggest challenges in its history.

“Today’s additional £5.4 billion funding over the next 6 months is critical to ensuring the health service has what it needs to manage the ongoing pandemic and helping to tackle waiting lists.

“We know waiting lists will get worse before they get better as people come forward for help, and I want to reassure you the NHS is open, and we are doing what we can to support the NHS to deliver routine operations and treatment to patients across the country.”

Amanda Pritchard, NHS chief executive, said: “This funding provides welcome certainty for the NHS, which has pulled out all the stops to restore services, while caring for thousands of seriously ill Covid patients requiring hospital treatment during the toughest summer on record.

“This additional investment will enable the NHS to deliver more checks, scans and procedures as well as helping to deal with the ongoing costs and pressures of the pandemic as the NHS heads in to winter.”

The UK Government has been clear that the NHS will ‘get what it needs’ to recover its usual services and deliver quality care to patients.

The waiting list for routine operations and treatments such as hip replacements and eye cataract surgery could potentially increase to as high as 13 million. While today’s extra £1 billion funding will go some way to help reduce this number, waiting lists will rise before they improve as more people who didn’t seek care over the pandemic come forward.

£478 million of this new funding has been dedicated to continue the hospital discharge programme so staff can ensure patients leave hospital as quickly and as safely as possible, with the right community or at-home support.

This will free up thousands of extra beds and staff time to help the NHS recover services. The government has also invested £500 million in capital funding for extra theatre capacity and productivity-boosting technology, to increase the number of surgeries able to take place.

This funding is for England only. The devolved administrations will receive up to £1 billion in Barnett consequentials in 2021-22. The final amount will be confirmed and allocated at Supplementary Estimates 2021-22.

On top of this funding, the NHS recently launched a £160 million initiative to tackle waiting lists. This is looking to accelerate the recovery of routine treatments and operations by trialling new ways of working, including a high-volume cataract service, one stop testing facilities where people can get tests done quickly and efficiently, to speed up the time to treatment, greater access to specialist advice for GPs and pop-up clinics so patients can be seen and discharged closer to home.

The UK government is ‘committed to delivering the greatest hospital building programme in a generation with 40 new hospitals by 2030’, backed by an initial £3.7 billion.

Yesterday’s announcement is in addition to the £3 billion announced at Spending Review 2020 to support the NHS.

First Minister Nicola Sturgeon is expected to announce a further £2.5 billion increase in NHS spending in Scotland when she lays out her Programme for Government later today.

“Shocking”: Ambulance handover delays are threatening patient safety, experts warn

A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020.

The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day.

One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with seven per cent reporting the longest stay to be more than 48 hours.

Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK.

“Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options.

“We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now.

“The data is stark, and this is August. Our members are really worried about what may come in autumn and winter. We have a duty to our patients and staff. Currently there is extremely high demand – for a number of reasons – but demand is not the whole picture.

“Demand presents a challenge because of the limitations of hospital space, workforce shortages, difficulties arranging quick ambulance handovers, smooth care and safe discharge of patients from wards, and a lack of services and alternatives to admission, particularly in the evenings and at weekends.

“The health service entered the pandemic short of staff, with less beds, and underprepared. Throughout the pandemic these shortages have been felt, but with demand higher than ever before, and with a workforce that is burned out, these shortages are felt more acutely than ever.”

Commenting on the increase in ambulance handover delays, Tracy Nicholls, Chief Executive of the College of Paramedics, said: “The College of Paramedics’ members also speak passionately about the potential for harm to those patients who, as a consequence of these lengthy ambulance handover delays, can wait an unacceptably long time for help. It is deeply concerning.

“Like the Royal College of Emergency Medicine, we recognise that all partners are working exceptionally hard to manage this situation and current demand. The reality is, however, that unless effective actions are taken now to ease the system pressures, more and more patients will face these delays as we head into another difficult winter, and both paramedics and ambulance clinicians across the UK will face the brunt of any further increase in demand.

“We urge NHS leadership to take action now to mitigate this risk wherever possible and protect both patients and our collective workforce from the inevitable pressure that we face if nothing is done.”

The survey also found that over 80% of respondents had little or no confidence in their organisation’s ability to safely and effectively manage the current or predicted combination of pressures as we head into winter.

Dr Higginson continued: “The final response that found an overwhelming lack of confidence signals something deeply troubling.

“The College has consistently warned of the upcoming winter and ongoing pressures. It is time we saw leadership and an equivalent response. There must be a comprehensive plan for the current demand and upcoming winter that include short- and long-term solutions to tackle these serious challenges.

“If ambulance services and Emergency Departments cannot cope with ongoing pressures, then it is patients and the workforce looking after them who will suffer. The winter could lead the health service into a serious crisis. Patients and staff must have assurance that they, their Emergency Department and their hospital will get what they need to manage.”

Programme for Government: Record investment to ‘transform’ Scotland’s NHS

FM to confirm £2.5 billion increase in spending

Record investment to ensure Scotland’s NHS is ready to meet changing patient demands and the impact of the Coronavirus (COVID-19) pandemic will be at the heart of the 2021/22 Programme for Government (PFG) this week.

The PfG will confirm plans to introduce an unprecedented increase in frontline health spending of 20% over the current Parliament.

The first rise will be confirmed in the 2022/23 budget being published later this year and will provide additional funding of at least £2.5 billion by 2026/27.

The PfG will be set out by First Minister Nicola Sturgeon in the Scottish Parliament tomorrow (Tuesday 7 September), and will also include measures to drive a green, fair economic recovery, create a land of opportunity for our children and young people, and achieve a just transition to net zero.

It will also confirm plans to introduce legislation in the coming year to establish a new National Care Service in Scotland by the end of the current Parliament, transforming the way health and social care services are provided. 

The First Minister said: “We owe our health and social care services, and the extraordinary staff who kept them running in the toughest of years, our immense gratitude.

“As we emerge from the pandemic, we will strengthen and improve our health and social care system so that everyone gets the care they need, while recognising and repaying the efforts of staff given the toll the pandemic has had on them.

“We are already investing record amounts in out NHS, but this 20% increase will help transform the way we deliver services and ensure the system is ready to meet the challenges which still lie ahead.

“Our recent NHS recovery plan set out measures to establish a network of cancer diagnostic centres, refurbish NHS facilities across Scotland and make unprecedented investment in mental health services.

“The creation of a National Care Service will also mark the biggest reform of health and social care since the creation of the NHS and will help ensure every patient’s care journey is focused on the individual.

“Recovery from COVID-19 across all of society is the Scottish Government’s first and most pressing priority and I am determined that this Programme for Government will allow our health service to continue managing COVID-19 and our longer term population health challenges.”

Primary care funding will go up by 25% over the course of this parliament, with half of all frontline health spending invested in community health services.

The PfG will also confirm plans to invest £29 million to provide an additional 78,000 diagnostic procedures, as well as increasing inpatient and day case activity by 10% in 2022/23 and outpatient activity by 10% by 2025/26.

The first £50 million, of the planned £250 million increased investment to tackle the drugs death emergency, will also be provided.

New clinics introduced to provide COVID jabs for newly arrived asylum seekers

A vaccination clinic has been set up in Glasgow to provide COVID vaccinations for newly arrived asylum seekers.

The clinic, which welcomed the first vaccination patients to its base in Govan last Friday, is part of the Asylum Health Bridging Team which provides a range of health services to some of Scotland’s most vulnerable communities.

Craig Davidson, a senior nurse within the team, helped to administer the first vaccines at the clinic. He said: “People have been really positive about getting access to the vaccine – to protect them and the wider community. We want to make sure that asylum seekers get the same access to health care and the COVID vaccine as the rest of the population.”

The clinic is targeting asylum seekers who have recently arrived in Glasgow, in the four to six week window where the team can offer assistance before patients’ asylum journey progresses. An initial health assessment can take up to 90 minutes, looking at physical illnesses and conditions and to provide mental health and trauma support.

The team also support people who may have been victims of trafficking and women who may have been subject to abuse or FGM. After the initial assessment is over, patients are invited back to the clinic for the COVID vaccination, with accommodation provider Mears, arranging transport.

Craig added: “It’s about building trust. We support them through the traumatic experience they have been through and at least 95% have been through a traumatic journey just to get to the UK.”

The clinic was the brainchild of Stewart Curtis, team leader at the service. While asylum seekers already established in accommodation were targeted as part of earlier COVID vaccination outreach programmes, or able to access their jab through community clinics, Stewart recognised that not everyone could do the same.

Stewart said: “The people we are seeing don’t know the community, they don’t know where to go. I wouldn’t even try to imagine what some of our service users have left behind and what some of them have gone through just to get here.

“We’re the first point of NHS contact for them. We are that friendly face and space, somewhere they feel comfortable and we can have the vaccination clinic here, where people know us and feel they are in a safe and supportive environment.”

Stewart said his team have welcomed the opportunity to add the vaccine to the range of support services on offer.

He added: “I know the positive impact my staff are having on each individual’s life that comes through the door – that makes me really proud.”

Craig has also seen the benefits. He said: “I began my nursing career in May 2020, in the middle of the pandemic. I used to work in a ward treating patients who had COVID and dealing with a high level of death and trauma was, for me, really hard.

“It’s great to see this side with people who are so pleased to get the vaccine in the knowledge that it will protect them and the wider community.”

Lowest ever levels of A&E performance show NHS ‘near boiling point’

‘the reality is that the NHS is really struggling’

Responding to the latest set of performance figures released by NHS England for July 2021, President of the Royal College of Emergency Medicine, Dr Katherine Henderson, said: “The NHS has been running hot for months now and these figures show we are nearly at boiling point.

“We are worried that the public think that things are getting back to normal on the virtual eve of a further reduction in restrictions, and messages from the centre that says things are OK are disingenuous – the reality is that the health service is really struggling.

“Four-hour performance has sunk to its lowest ever level, we have levels of 12 hour waits we would usually associate with winter, and July saw the second highest ever number of attendances across emergency care units. Yet there is no sign of rescue ahead of winter. Despite our calls for action, crowding is back with us and is compromising patient care.”

Performance figures for Emergency Care for the NHS in England in July 2021 showed that:

  • there were 1,431,499 attendances at major Emergency Departments – the second highest on record
  • 67.7% of patients waited less than four hours from arrival to admission, transfer, or discharge in Type 1 EDs – the lowest percentage on record
  • the number of patients waiting more than four hours after a decision to admit them stood at 89,768 – this is a 30% increase compared to June 2021 (66,619) and is the third highest ever
  • the number of patients waiting more than 12 hours after a decision to admit them stood at 2,215 – by far the highest July figure on record (second highest is 451 from July 2019).

Dr Henderson said: “The NHS was in a pretty dreadful state going into the pandemic – we were seeing record waits across the board, due to insufficient resourcing – but the sheer determination of an overstretched workforce, combined with a ‘whatever it takes’ approach, got us through.

“The problems that were with us before the pandemic have not gone away. Not only do they remain but are now much worse due to the impact of Covid, as these figures make crystal clear.

“The ambulance service saw thehighest ever number of ambulance callouts for life threatening conditions in July, and we saw ‘trolley waits’ in hospitals go up by 30% on the previous month. This means there have been delays offloading ambulances and patients have experienced long waits to be seen and moved to a bed if they need admission.

“Emergency Departments are very, very busy.

“There has also been a steady rise in Covid presentations and even though numbers are still low all the infection risk concerns remain in hospitals, further depleting capacity. Staff have had no let up and are worried about what the winter will be like if this is where we are in the summer.

“Demand is driven by multiple factors – difficulties accessing primary care, complications of chronic conditions, new presentations of significant illness and waiting list patients with on-going symptoms and no sign of getting their care sorted any time soon.

“NHSE recommends patients to access help via 111 but unless the system is responsive and clinically supported and other options available that advice too often defaults to go to the Emergency Department. Local health systems must ensure adequate urgent care facilities for their communities, letting Emergency Department have capacity to treat the seriously ill and injured.

“The other side of this is problems with supply – we do not have enough staff, beds, or equipment. There is still no plan for social care, which has a huge impact on the NHS. These have been issues for some time, but on top of this is the growing waiting list for elective care, staff absence due to a combination of leave and necessary self-isolation, and an even lower bed capacity due to infection prevention control measures.

“We fear for what winter may hold; we know it will be worse than now but a heavy flu season, another potential Covid surge and an understandable desire not to cancel elective care this winter could cripple us and put patient safety at risk.

“NHS Trusts must do all that they can to wring out every drop of capacity ahead of winter and the Department of Health and Social Care must extend ‘discharge to assess’, which made a significant difference freeing up beds during the pandemic. There has been a sustained rise in the number of patients experience long stays in hospital, and this funding is critical to freeing beds and maintaining flow in hospitals.

“We also need clarity in terms of performance – we are currently in a performance vacuum with Trusts uncertain about what they need to focus on. Implementing some of the metrics proposed by the Clinical Review of Standards is vital ahead of winter. We need to operationalise the metric of a maximum of a 12 hour stay from point of arrival. This will be a small step to reducing exit block, and allow timely ambulance offloads.

“While the NHS rollout of the vaccine has been an incredible success, parliament must not take its eyes off the ball regarding the state of the NHS. This autumn’s spending review – one which has not been put out to consultation – is an opportunity for the government to further signal it’s ‘peace time’ commitment to NHS funding and help prevent the NHS from boiling over this winter.”

The situation in Scotland is also giving cause for alarm. Lothian MSP, Miles Briggs is ‘very concerned’ A&E waiting times aren’t showing signs of improvement.

Miles Briggs MSP said: “NHS Lothian is in desperate need of an injection of funds to alleviate pressure on services. 

“Years of chronic underfunding and a global pandemic has left staff on their knees, struggling to meet the increased numbers of patients attending A&E. 

“SNP Ministers must take responsibility for allowing the situation to get to this point and immediately fund NHS Lothian properly to start getting services back to normal.”

https://www.publichealthscotland.scot/publications/nhs-performs-weekly-update-of-emergency-department-activity-and-waiting-time-statistics/nhs-performs-weekly-update-of-emergency-department-activity-and-waiting-time-statistics-week-ending-1-august-2021/

3% pay rise for Scotland’s NHS medical and dental staff

The Scottish Government has announced a 3% uplift for NHS medical and dental staff, in recognition of their efforts during the pandemic.

This is in line with the recommendation of the independent UK Review Body on Doctors’ and Dentists’ Remuneration.

The pay uplift will be backdated to 1 April 2021.

Health Secretary Humza Yousaf said: “This pay award is in recognition of an exceptional year for all of our NHS workers and reflects the immense value we place on the continued hard work and dedication of medical and dental staff.

“This announcement means that our senior medical staff will continue to be the best paid in the UK. As well as rewarding them for their efforts during the pandemic, it will help to ensure that NHS Scotland remains an attractive employment option for medical and dental staff.”

The announcement covers three main staff groups not covered by the Agenda for Change pay deal  – NHS Scotland Medical and Dental (M&D) staff; General Medical Practitioners (GMPs) and General Dental Practitioners (GDPs). 

Agenda for Change employees have already been awarded a deal providing minimum pay uplifts of 4% to all but the highest-earning staff.

Dentists: Government must apply full pay award

The British Dental Association has called on the Scottish Government to confirm that the recently announced 3% pay award for dentists will be applied to practitioners’ overall remuneration package to avoid front line staff potentially being left out of pocket and practices struggling to invest to improve care. 

Historically in Scotland the recommended uplift has not applied to all dentists allowances and payments, meaning the overall awards often fall short of the pay review body’s recommendations.

Last year the Scottish Government did not apply the recommended 2.8% uplift to practice allowances – which make up around 16% of practice income – leaving an overall increase of less than the review body’s recommendations. The BDA estimates that the net award for that year was around 2.3%.

While one-off support to fund improvements in ventilation has been offered by the Scottish Government, NHS dentists do not routinely receive capital investment. These earnings serve to fund all improvements in equipment, training, and facilities for NHS practices.

Scottish Government officials have stated they will provide details of how the package will operate in due course. The BDA is calling for the 3% uplift to be applied to the full remuneration package.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “The Scottish Government’s announcement has left key questions unanswered. 

“This uplift will do little to correct a decade of austerity, and not all of this increase may actually reach dentists, who rely on their earnings to invest in their practices.

“In the recent election, Ministers put dentistry front and centre in their pitch for government. If they are going to deliver on their promises they shouldn’t be short-changing front line practitioners.”