RCEM: ‘We must not normalise crisis’

Accident and Emergency

We must not normalise crisis or celebrate small improvements – our patients and our members deserve more.’ That is the response of the Royal College of Emergency Medicine to the latest A&E performance data.

Yesterday (14 December 2023) two sets of data published by NHS England, have been released: the latest Urgent and Emergency Care (UEC) Daily Situation Reports 2023-24 (also known as Winter Sitrep); and monthly A&E performance figures for November 2023.

While there have been some small signs of improvement in certain areas the overall situation remails extremely challenging with A&E departments declaring critical incidents this week, clinicians describing things as the worst they have experienced and ambulance chiefs expressing serious concerns about the pressure their service is under.

The most recent Winter UEC Sitrep data which covers the period 4-10 December 2023 paints a worrying picture with bed occupancy running dangerously high at almost 95% (the level considered ‘safe‘ is 85%) and two-thirds of ambulances not meeting the 15-minute target to hand over patients.

There was a small uplift in the number of beds available within hospitals, but these do not appear to have helped to ease pressure elsewhere in the system, and there remain thousands of patients, who are well enough to go home, but have not been discharged – occupying beds which are needed for other people.

The November performance data reveals that last month more than 144,000 people who visited an A&E within the month were there for more than 12 hours – the target is four hours.

Reacting to these figures, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “While the data suggest a marginal improvement compared to last year, it’s just deja-vu and we must not allow this permacrisis to become accepted as ‘normal’.

“Ambulances are queueing outside A&Es, Trusts are declaring critical incidents, patients are facing dangerously long waits in overcrowded and uncomfortable A&Es. Conditions are intense and difficult for staff, and the experience of patients is distressing and undignified.

“Clinicians are doing their very best, despite the circumstances, to deliver optimal and compassionate care, and mitigate any potential risks to patients but it is taking its toll on them too.

“It is welcome to see small increases in bed numbers, but it is not enough and patients continue to endure long waits.

“Significant and urgent action is required now to address these issues – this is what our members and their patients need and deserve.”

Data in detail:

The latest Urgent and Emergency Care Winter sitrep data for week ending 10 December (week 4 of publication for 2023/24) published today by NHS England show:

  • Bed occupancy levels at Trusts with a major A&E (Type 1 acute Trust) was 94.9%.
  • There were 99,497 beds open at Trusts with a major A&E, 1,521 more than the same week last year.
  • The Government promised that by winter 2023/24 there would be 5,000 more beds open when compared to October 2022 (97,287). For this week, there was an increase of 2,210 Type 1 beds compared with October 2022.
  • On average, one third of ambulance handovers involved a delay of over 30 minutes, while only one third of patients arriving at A&E were handed over within 15 minutes as per national guidance.
  • On average, 46,929 patients occupied a bed for more than seven days at a Trust with a major A&E.
  • On average, 384 beds were general and acute beds were occupied by patients with flu.
  • On average, 12,927 patients remained in hospital while no longer who were ready to be discharged.
  • There was an average of 49,020 daily staff absences at Trusts with a major A&E.
  • This is 7,547 fewer than the same week last year.

Published today (14 December 2023) by NHS England, the latest A&E performance figures for November 2023 show:

  • There were 1,385,701 attendances to major A&Es (Type 1 EDs) in November 2023.
    This is a 1.97% decrease compared with the previous month.
  • In November 2023, 144,085 patients waited 12-hours or more from their time of arrival. This accounts for 10.9% of all major A&E attendances in November. This means that more than one in 10 patients waited 12-hours or more.
  • The four-hour target at major A&Es stood at 55.4%, this is the fourth worst four-hour performance on record and the lowest so far in 2023.The aggregate four-hour target stood at 69.7%, the lowest so far in 2023. This is 6.3 percentage points lower than the Government’s intermediary threshold target of 76% to be hit by March 2024.
  • 42,854 patients waited 12 hours or more from decision to admit (DTA) to admission. This is a 4% decrease when compared to the previous month. It is a 13.2% increase when compared with November 2022.
  • Beds data for October 2023 show bed occupancy stood at 94.8%.
  • Data show there were 98,844 Type 1 General & Acute beds available.  This is an increase of 1,473 beds from October 2023 (97,371). And an increase of 1,636 beds from November 2022 (97,208).
  • Since it was announced in January 2023 that 5,000 new beds would be made available by winter 2023/24 compared with October 2022 (when there was 97,287 beds available), there has been an increase of 1,557 beds.
  • There were 396,755 emergency admissions at major A&Es. This is a 1.19% decrease since the previous month (401,523). This is the second highest number of admissions so far in 2023.

Health and Social Care Secretary sets out priorities for system in England

Victoria Atkins aims to make health and social care system faster, simpler and fairer for patients

  • Health and Social Care Secretary sets out intention to make the system faster, simpler and fairer for patients
  • Victoria Atkins thanks staff for a week of delivery, in which two manifesto commitments were met

Health and Social Care Secretary Victoria Atkins has thanked health, social care and research staff for delivering on patients’ priorities, as she set out her commitment to make the health and social care system faster, simpler and fairer for patients.

The Secretary of State has paid tribute to NHS, social care and research staff for their hard work in a week the government delivered 50,000 additional nursesdelivered 50 million more GP appointments – both manifesto commitments – and rolled out lifesaving HIV opt-out testing to 46 areas across England.

Her words came days after pharmacies across the country began offering new contraceptive services and additional blood pressure checks, and after a breakthrough in talks to end consultant strikes, which saw the British Medical Association Consultants committee agree to put an offer on contract reform to its members.

Health and Social Care Secretary, Victoria Atkins, said: “Since joining the department, I have been bowled over by the way health and social care staff just keep on delivering for patients. The important milestones we’ve reached this week – reaching 50,000 additional nurses and 50 million more GP appointments – demonstrate real progress. 

“I have spent the past few weeks meeting doctors, nurses, GPs, pharmacists and other health workers and heard wonderful stories about how they have gone above and beyond to deliver outstanding care for patients and cut waiting lists.

“But I have also heard about their frustrations and where they feel they are not able to deliver the best possible care or where prevention or early intervention could have made a real difference. That is why I am committed to making health and social care services faster, simpler and fairer.

“We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do. But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”

The Health and Social Care Secretary has committed to making health and social care services:

  • Faster for patients, by making it easier to get treatment locally, improving A&E performance and cutting waiting lists
  • Simpler for patients, with joined up, integrated care, and simpler for staff, by reducing bureaucracy and giving them the latest technology to free up their time to care for patients
  • Fairer, ensuring children are protected from health harms, that health outcomes are not determined by where you live, that government supports older people to maintain their independence for longer, and that government delivers a more productive NHS that is fairer for taxpayers.

She added that she would continue to work with the NHS to manage the ongoing winter pressures. The government prepared for winter earlier than ever before and data released by the NHS on Thursday shows the government is making good progress.

Compared to the same time last year, ambulance handover delays have fallen by 28%, thousands more 111 calls are being answered within 60 seconds, and there were nearly 1,500 more hospital beds available.

The Secretary of State said: “We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do.

“But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”

The Health and Social Care Secretary was appointed on 13 November. She has now set out her priorities in a week in which the government and NHS hit a number of major delivery milestones:

  • NHS England data published on Thursday showed there were 51,245 additional nurses in September 2023 compared to 2019 – hitting the government’s manifesto commitment to recruit an additional 50,000 nurses six months early.
  • NHS England data also showed that for the year to October 2023, there were 51 million additional general practice appointments delivered when compared to October 2019, meeting another manifesto commitment.
  • On Monday the government announced that it had put forward an offer that will modernise the consultant contract and reform consultants’ pay structure, paving the way to end consultant strikes. The British Medical Association and Hospital Consultants and Specialists Association will put the deal to their memberships in the coming weeks. 
  • On Wednesday the Secretary of State announced funding for a research project to evaluate the rollout of the hugely successful HIV opt-out testing programme to 46 new sites across England.
  • On Friday 1 December pharmacies across England began offering the new contraceptive services announced recently as part of Pharmacy First. This is part of the NHS and government’s Primary Care Recovery Plan, announced by the head of the NHS and the Prime Minister in May, which committed to making it quicker and easier for millions of people to access healthcare on their high street.

RCEM Scotland calls for urgent increase in bed numbers amid warning of ‘devastating winter’

Latest data show that more than 4,000 patients faced 12-hour delays in Scottish A&Es as RCEM calls on the Scottish government to increase bed numbers and avoid ‘devastating winter’.

Monthly A&E performance figures for Scotland for September 2023 published by the Scottish government show:

  • In September 2023, there were 113,864 attendances at major A&Es in Scotland.
  • 66.50 % of patients were seen within four-hours at major A&Es (Type 1 EDs)
    • 38,114 (33.5%) patients waited over four-hours in major Emergency Departments, this is a 1.7% increase from the previous month and a 2.3% decrease from September 2022.
    • This is a decrease of 1.4 percentage points from the previous month.
    • The number waiting more than four-hours has increased by 145.5% compared with September 2019 (15,526).
  • 11,788 (10.4%) patients waited eight-hours or more in an Emergency Department
    • This is an increase of 1.1 percentage points from the previous month, and a 1.5 percentage point decrease compared with September 2022.
    • The number waiting more than eight-hours has increased by more than eight times (701%) compared with September 2019 (1471).
  • 4263 (3.7%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred.
    • This figure has increased by 0.4 percentage points from the previous month. And has decreased by 1 percentage point compared with September 2022.
    • The number waiting more than 12-hours has increased by 14 times (1307%) compared with 2019 (303).
  • There were 1,811 beds occupied due to delayed discharges, the second most for any September on record.

Commenting on these data, RCEM Scotland Vice President, Dr John-Paul Loughrey said: “As we head into winter, we expect many people to attend A&Es with a multitude of conditions and illnesses, and many of them will require admission to hospital for further care.

“It is vital that with this clear expectation comes the necessary winter planning to resource A&Es, and support both clinicians and their patients through the colder months.

“We are concerned that the Scottish government’s winter plan fell short of delivering what is needed ahead of what will likely be a difficult period for emergency care.

We desperately need to see an increase in bed numbers. This will help to reduce the dangerously high levels of bed occupancy, reduce long and dangerous delays in A&Es, and help to ensure patients are admitted to a bed more promptly.

“We continue to engage with the Cabinet Secretary and his team in good faith and raise the concerns of our members.

“To avoid what could be a devastating winter, we again urge the Scottish government to heed our calls to adopt our priorities to #ResuscitateEmergencyCare.”

The data come as figures obtained through Freedom of Information requests revealed that nearly 4,000 people faced 24 hour waits in Scotland A&Es in the six months up to June this year.

As Dr Loughrey said: “24 hours in A&E belongs on TV, not in daily reality for patients and staff”.

British Psychological Society: Access to mental health and wellbeing support for NHS and social care staff has become a national lottery

Access to staff mental health and wellbeing services has become a postcode lottery for NHS and social care workers, after funding was cut for the NHS Staff Mental Health and Wellbeing Hubs in March this year.

This World Mental Health Day, the British Psychological Society (BPS) is calling for all NHS and social care staff to have equal access to dedicated evidence-based mental health and wellbeing support at work, wherever they live in the country. 

With 17 hubs already closed or closing across England*, struggling staff in those areas are unable to access the dedicated support that’s still provided in localities that have retained a hub.

And, despite a limited injection of short term funding from NHS England to provide one hub per NHS region, which would offer a drastically reduced service for vast catchment areas, this arrangement is yet to be operational.

Some hubs report not having received this vital funding.

With less than six months of this financial year remaining, time is running out for staff who need to access help now. Yet, the need for dedicated mental health support for health and care staff could not be more stark.

The latest NHS statistics show anxiety, stress, depression, or other psychiatric illnesses was the most reported reason for sickness absence in May 2023, accounting for over 502,570 full time equivalent days lost and 26.4 per cent of all sickness absence.

Last year, more than 6 million full time equivalent days were lost in the NHS for mental health reasons. 

The BPS’s own research found mental health, stress, and work-related stress was behind nearly one-third(30 per cent or 500,021 FTE days)* of social care staff sickness absence in 114 councils in England last year.

With the NHS Workforce Plan placing responsibility for investment in staff mental health and wellbeing provision with integrated care systems from April 2024, local health and care leaders will make crucial decisions about their staff mental health and wellbeing services, including the hubs, in the next few months.

To date, just one integrated care board has confirmed continued long term funding for its dedicated staff mental health and wellbeing service, and 41 boards are yet to make a decision about the future of their provision from April 2024.

The BPS is urging health and care leaders to make funding for staff mental health and wellbeing support a key long-term priority in their budgets.

Dr Roman Raczka, BPS President-Elect and chair of the Division of Clinical Psychology, said: “NHS and social care staff have the right to be cared for by their employer, as they care for us.

“If and when they need help with their mental health, they have a right to parity of access to the same support services as their colleagues in a neighbouring area.

“The NHS and local authorities have a duty of care to their employees, and it simply isn’t good enough that where you live and work should have a bearing on the level of mental health support on offer if you’re struggling.”

This year’s theme for World Mental Health Day is ‘Mental health is a universal human right’.

Government and NHS to help tackle killer heart condition

Health and Social Care Secretary Steve Barclay has announced measures to tackle aortic dissection, a heart condition that kills 2,000 people every year

  • Aortic dissection takes the lives of 2,000 people a year in Britain
  • Government and NHS England to look at ways to tackle condition
  • Health Secretary pledges to build on strong work already being done

Secretary of State for Health and Social Care, Steve Barclay, has unveiled measures to tackle aortic dissection, a life-threatening heart condition that kills 2,000 people every year.

Speaking at a research event to mark Aortic Dissection Awareness Day, the Health Secretary announced the formation of an NHS working group that will bring together clinical experts and charities, to improve diagnosis and treatment of the condition.

The group will review the whole patient experience when it comes to aortic dissections, and pinpoint opportunities for future improvement, including the potential benefits of genetic testing.

Secretary of State for Health and Social Care, Steve Barclay said: “Aortic dissection can be a devastating condition and every year it takes the lives of more people than die on our roads, yet awareness is low. Changing that will save lives.

“Developing a holistic approach, from identifying those potentially at risk to providing first class follow-up care, will be life-changing for patients and I’m delighted to be able to build on the good work we’re already doing in this area.

“I also want to pay tribute to the tireless work of my colleague Pauline Latham whose campaigning to improve aortic dissection care has kept this issue on the agenda.”

The Health Secretary has asked for the working group to report back with options within six months, and aortic dissection charities will input into the work.

Pauline Latham MP, who tragically lost her son to an undiagnosed aortic dissection in 2018, has been a leading voice in campaigning to improve the lives of sufferers and their families, and met with the Secretary of State earlier this year to discuss ways to improve aortic dissection care.

Pauline Latham MP said: “In the wake of losing my son Ben to a missed diagnosis of aortic dissection, I couldn’t sit back and let other families suffer the way we have. That’s why Graham Cooper, Catherine Fowler and I started The Aortic Dissection Charitable Trust.

“We’ve been pushing hard – asking tough questions in Parliament, meeting with health ministers, and I’m thrilled to say, we have NHS England and the Department for Health and Social Care on board.

“This will bring in standardised care, genetic screening, and specialised nurses to not only save lives but improve quality of life for everyone affected by this condition. It’s our heartfelt mission to turn tragedy into a safer future for all.”

The announcement builds on the progress made on aortic dissection in recent years. NHS England adjusted 111 and 999’s triage systems to better recognise chest pains caused by aortic dissections and is rolling out the Aortic Dissection Acute Toolkit across the regions to speed up diagnosis and improve patient outcomes, while The Royal College of Emergency Medicine has also published a best-practice guide to improve diagnosis in emergency departments.

The Department of Health and Social Care is also funding dedicated research into aortic dissection through the National Institute for Health and Care Research, as part of an annual £50 million investment in cardiovascular disease research.

Researchers are developing a tool to help people at genetic risk of aortic dissection decide if they want screening and, if necessary, preventative treatment and this is just one of the many exciting research projects under way across the country.

The remit of the working group will be to:

  • continue to monitor and support the implementation of the acute Aortic Dissection toolkit which has already been produced by NHS England and is currently being rolled out to NHS providers
  • review the whole aortic dissection patient pathway and identify areas for improvement including the elective pathway
  • explore the evidence and options for genetic screening including potential cohorts for screening
  • scope the clinical skills and workforce requirements to support aortic dissection pathway improvement

Over two-thirds of patients in Scotland say recent NHS changes do NOT benefit them

  • Almost half of respondents desire more same-day appointments (49%)
  • Almost two-thirds (61%) would like to see prioritisation systems to help with hospital backlogs
  • Almost one in five (19%) have seen benefits from the addition of more over-the-phone appointments

Recent research has shown a deepening public concern about NHS services, as only 10% of people in Britain believe ministers are tackling the NHS’s many problems in the right way.

With this in mind and following rising waiting times and growing pressure on the NHS from strike action, healthcare management consultancy, Acumentice, surveyed 1,000 UK adults to explore the public’s opinion of the current healthcare system and how it could be improved in the future.²

Over two-thirds (68%) of patients in Scotland do not believe that any recent NHS changes have benefitted them personally. In particular, text availability with doctors for advice appears to have been the least popular initiative in the region, with no respondents acknowledging the benefit.

In contrast, the survey suggests the most impactful NHS offering for Scotland was the addition of more over-the-phone appointments, with almost one in five (19%) professing they have seen the most advantage to their care from this out of all recent NHS changes.

When questioned about which changes Scotland would like to see from the NHS to improve their experience, the most popular suggestions were: the ability to book appointments online and/or in the NHS app (54%), more same-day appointments (49%) and the option to book double appointments for multiple concerns (41%). 

In addition, over 6 in 10 (61%) respondents felt that using prioritisation systems to ensure that patients with the most urgent needs are seen first would help the backlog of patients waiting for hospital treatment. 

Looking at average perception across the whole of the UK, the survey suggests people desire an updated approach to accessing NHS health services to improve service and efficiency, with a remarkable half of respondents (50%) saying that none of the recent changes already made by the NHS has benefitted them.

Respondents from Wales, in particular (68%), found the least benefit from recent initiatives, while Yorkshire and the Humber were the areas least critical of recent changes (38%). 

Nationally, when asked what they would like to see implemented by the NHS to improve experience, the biggest priority across the UK was A&E waiting times, with nearly half of the respondents (47%) looking for shorter waiting times, followed by an increase in same-day appointment availability (46%) and more flexibility when booking future appointments over the phone (44%).

Interestingly, more than one in four (27%) respondents would like to see the introduction of fines and consequences for cancelled or no-show appointments in a bid to improve the availability of bookings.

Stephen Hall, Director of Consulting Services at Acumentice and former Executive Director for Performance and Planning across Kingston Hospital NHS Foundation Trust and Hounslow and Richmond Community Healthcare NHS Trust, commented on the findings: “This research indicates that, despite recent changes to the NHS, people in the UK believe it has not been successful and have little faith in the future.

“They feel that the approach to NHS care has not changed much in the past and that there is a need for more investment in digital innovation and data-driven healthcare.

“The outcome is that there is undoubtedly scope for a serious debate regarding access to data and analytics within the NHS as it undergoes a period of significant change. It’s also hugely important that digital transformation support plays an increasing role in ensuring these programmes deliver the benefits they should.”

You can find the full study here: https://acumentice.com/the-future-of-healthcare-survey-through-the-public-eye/ 

The shape of things to come? UK Government boosts use of private sector to cut NHS waits

Thirteen new community diagnostic centres are opening across England to deliver more than 742,000 additional scans, tests and checks a year

  • The Elective Recovery Taskforce – formed last year to identify ways to cut waiting times – publishes plan to maximise independent sector capacity to treat NHS patients more quickly
  • Measures include better use of data to help the NHS identify potential opportunities for the independent sector to support patient care, and expanding training opportunities for staff

Thirteen new community diagnostic centres (CDCs) – including eight independently run CDCs – are being launched across England as part of UK government plans to use the independent sector to cut NHS waiting lists, Health and Social Care Secretary Steve Barclay will announce today.

Five of these independent sector-led CDCs will operate in the South West of England, with permanent sites fully opening in 2024 in Redruth, Bristol, Torbay, Yeovil and Weston Super Mare. Additional diagnostic testing capacity is already being rolled out in the region via the use of mobile diagnostic facilities, to provide additional diagnostic services while these sites are constructed.

Three others will open in Southend, Northampton and South Birmingham – with the former commencing activity from November and the latter two from December. These independently run CDCs will help to make it easier for patients to receive checks closer to home and will remain free at the point of use for patients. This adds to the four CDCs run by the independent sector that are already operational in Brighton, North Solihull, Oxford, and Salford.

Five more NHS-run centres will also open across the country, delivering on our ambition to open up to 160 across the country by 2025, backed by £2.3 billion. These will be in Hornchurch, Skegness, Lincoln, Nottingham and Stoke-on-Trent.

Health and Social Care Secretary, Steve Barclay, said: “We must use every available resource to deliver life-saving checks to ease pressure on the NHS.

“By making use of the available capacity in the independent sector, and enabling patients to access this diagnostic capacity free at the point of need, we can offer patients a wider choice of venues to receive treatment and in doing so diagnose major illnesses quicker and start treatments sooner.

“The Elective Recovery Taskforce has identified additional diagnostic capacity that is available in the independent sector which we will now use more widely to enable patients to access the care they need quicker.”

As well as being more convenient for patients, CDCs drive efficiency across the NHS by shielding elective diagnostic services from wider hospital pressures.

The government has also set out a range of new measures to unlock spare capacity within the independent healthcare sector. This comes following actions from the Elective Recovery Taskforce which was established last December.

Chaired by Health Minister Will Quince and made up of academics and experts from the NHS and independent sector, the taskforce looked for ways to go further to bust the Covid backlogs and reduce waiting times for patients.

The measures include a commitment to using data on independent sector providers to identify where they have capacity to take on more NHS patients to help clear the backlog and increasing the use of the independent sector in training junior NHS staff.

These thirteen new CDCs will provide capacity for more than 742,000 extra tests a year once all are fully operational, bolstering access to care.

Independent sector led centres will function like NHS-run CDCs, but staff will be employed by the independent sector, which also owns the buildings. The South West network will be run by InHealth, a specialist provider of diagnostic tests which has worked with hospitals and commissioners across the health service for more than 30 years. By utilising independent sector staff, the NHS will be able to keep pace with rising demand in the region and deliver a high number of tests for patients.

There are currently 114 CDCs open across the country, which have delivered an additional 4.6 million tests, checks and scans since July 2021. Alongside this, significant progress has already been made to cut waiting lists, with 18-month and two-year waits virtually eliminated.

Health Minister and Elective Recovery Taskforce Chair, Will Quince, said: “We have already made significant progress in bringing down waiting lists, with 18 month waits virtually eliminated.

“I chaired the Elective Recovery Taskforce to turbocharge these efforts and help patients get the treatment they need.

“These actions will bolster capacity across the country and give patients more choice over where and when they are treated.”

The taskforce aims to form strong local relationships between NHS organisations and the independent sector. This will help to support improved training opportunities for junior doctors through first-hand experience of procedures. This follows the NHS Long-Term Workforce Plan which will deliver the biggest training expansion in NHS history and recruit and retain hundreds of thousands more staff over the next 15 years.

The department has also published its response to a consultation on a new procurement system known as the Provider Selection Regime, which will give commissioners of healthcare services more flexibility when selecting NHS and independent sector healthcare providers. This is intended to remove unnecessary levels of competitive tendering and barriers to integrating care, which will help to promote collaboration across the NHS and wider healthcare system.

NHS England will evaluate the independent sector’s impact on healthcare capacity and has already begun publishing regular monthly data on independent sector use, showing its contribution to tackling the backlog.

NHS England National Clinical Director for Elective Care, Stella Vig, said: “Hardworking staff across the NHS have made significant progress towards recovering elective care, and it is testament to their efforts that widespread innovative measures are already being rolled out to transform our services and bring down the longest waits for patients.

“Alongside this, we have increased our use of the independent sector by more than a third since April 2021  – carrying out 90,000 appointments and procedures every week, including more than 10,000 diagnostic tests – and independent providers will continue to play a key role as we work towards the next milestone in our recovery plan, as well as the additional one stop shops announced today as part of NHS England’s rollout of community diagnostic centres.

“As this report details, we have already made significant progress in this area, including operating mutual aid systems across both the NHS and independent sector, and by expanding My Planned Care to make it easier for patients to choose where they receive care.”

David Hare, Chief Executive of IHPN, who sat on the Taskforce, said: “The publication of this report is good news for patients. This is a real, significant step forward to unlocking more of the capital, capacity and capability of the independent sector.

“Today’s report builds on the Prime Minister’s recent welcome announcements about how the government is committed to providing patients with better choice over who provides their NHS care, as well as positive changes in how services are procured, which can help add overall capacity and speed up waiting times for NHS patients.

“The report’s commitment to open further independent sector-led Community Diagnostic Centres is also good news for patients, deploying some of the private capital that is available to build new facilities and to help ensure that more NHS patients can get the tests and scans that they need.”

Rachel Power, Chief Executive of the Patients Association, said: “We are advocates of patients having choice and welcome today’s announcement. In particular, the news that GPs will tell patients, at the point of referral, of options for treatment other than the local hospital or clinic.

“Patients in England already have a right to choose where they are treated but not all patients are aware of this right or exercise it. Our expectation is that once GPs offer patients a choice of where to receive treatment, more and more patients will choose to travel further to receive treatment if that means shorter waits.”

Justin Ash, CEO of Spire Healthcare, said: “The best way to cut waiting times for patients is for the independent sector to be fully integrated as part of the solution, and to offer patient choice.

“We welcome the Elective Recovery Taskforce’s recognition of this and are pleased that it has recommended some bold and far-reaching steps to encourage collaboration, promote patient choice and engage the independent sector to help deliver the NHS Long Term Workforce Plan.

“The Taskforce’s work will genuinely benefit patients, who’ll be able to choose where they can receive treatment most quickly, regardless of whether that’s at an NHS or an independent sector hospital.”

This builds on previous work to give patients greater choice. At the point of referral (for example, at a GP appointment), patients will be actively offered a list of providers which are clinically appropriate for their condition.

This will be a minimum of five providers where possible. And by October 2023, all patients waiting over 40 weeks who have not had a first outpatient appointment booked or where a decision to treat has been made but the patient does not have a date for their treatment will be able to initiate a request to transfer to another provider and receive treatment more quickly.

Last month, the Health and Social Care Secretary also convened ministers, clinical leaders and health experts for the NHS Recovery Summit to collaborate and drive forward ideas to help cut waiting lists and improve care for patients.

Working together? Partnership agreed on National Care Service

Scottish Government, NHS and Councils to share accountability for services

The Scottish Government has reached an initial agreement with local government and the NHS about accountability arrangements for the National Care Service (NCS).

The agreement aims to establish who will be responsible for people’s care once the NCS is established.  Overall legal accountability will be shared between Scottish Government, the NHS and local government.

Staff will continue to be employed by local authorities, and councils will still be responsible for assets like buildings and the delivery of services.

New governance arrangements will be introduced to ensure consistently high levels of service across the country, while building the flexibility to meet varying community needs at a local level.

Social Care Minister Maree Todd said: “The Scottish Government has been working closely with Local Government to find a consensus on the National Care Service (Scotland) Bill, which will allow us to deliver on the urgent improvements needed to strengthen the delivery of integrated health and social care for people.  

“This partnership between the Scottish Government, Local Government and the NHS helps establish where responsibility for people’s care will sit under the National Care Service. The detail of how this will work at a local level will be developed in the coming months and we will continue to update parliament on this work, along with the results of our ongoing co-design events taking place across the country, after the summer recess.”

COSLA’s Health and Social Care Spokesperson, Councillor Paul Kelly, said: “Further improving the experiences of people accessing and working in social care and social work services must rest on an effective partnership between Scottish Government and Local Government.

“Combining shared national accountability with local expertise ensures the right balance of further improvement across Scotland, whilst rightly reflecting the diverse needs of local communities.

“We know too that successful change is driven by the valuable staff who deliver services. We hope by setting out the continued role of local authorities in delivering social care and social work functions, and staff remaining employed within councils, we offer comfort and stability to the Local Government workforce.

“In recognising this important first step, we know there is still more to do. As we progress forward, we are committed to continuing to work closely with people in receipt of support and partners to design a system that ensures individuals and communities always experience high quality care and support.”

The consensus follows the Verity House agreement on closer cooperation between Scottish Government and local government signed last month.

Scotland’s Health Secretary marks 75th anniversary of the NHS

Staff thanked for their efforts and dedication

Health Secretary Michael Matheson has paid tribute to the staff who have helped deliver the NHS throughout its 75 year existence.

Mr Matheson praised the extraordinary efforts of those involved with the service, particularly in the recent years of the pandemic. He also expressed his gratitude to those whose spirit of innovation has helped the NHS adapt over the years.

He said: “We are fortunate beyond words to have a National Health Service free at the point of need for every single one of us. Looking around the globe, it is clear that what we accept as a basic human right is not enjoyed by the majority of the world’s population.

“On this day, the 75th anniversary of our NHS, I cannot express enough how grateful I am to the people who have delivered this extraordinary service through all these years.

Working in the NHS has not always been easy – particularly during the covid pandemic, but along with their colleagues in social care, NHS staff worked in tremendously difficult circumstances to care for those who needed them. Together they saved countless lives and their contribution will never be forgotten.

“From the world’s first ‘test tube baby’, through to robotic surgery, and then vaccinations and treatments for Covid-19 being rolled out at incredible pace – our health service has always been ready to adapt to new technologies and scientific developments.

“That spirit of innovation will be ever more crucial in the years to come, as the NHS and social care face new and different challenges, and it’s something we are determined to harness here in Scotland.

“With the continued support of people across the country, and the unwavering dedication of NHS staff, I have no doubt the NHS will be celebrating many more anniversaries in the years to come.”

‘National Emergency’: Boyack demands action as waiting lists soar

Scottish Labour MSP Sarah Boyack has branded Humza Yousaf’s time as Health Secretary “catastrophic” as new figures reveal NHS waiting lists in Lothian soaring on his watch.

At the end of March, as Humza Yousaf departed as Health Secretary, there were 123,481 people in Lothian on an NHS waiting list.

This is a shocking 25 per cent increase since the same point in 2021, shortly after Humza Yousaf took over the role.

Across Scotland waiting lists are at a record high, with around 1 in every 7 Scots currently on an NHS waiting list.

Scottish Labour branded this a “national emergency” and called for the Scottish Government to support NHS Lothian and implement a real NHS catch-up plan.

Commenting, Scottish Labour MSP Sarah Boyack said “People in Lothian have been badly let down by this incompetent SNP government and their disastrous stewardship of our NHS.

“It should worry us all that First Minister Humza Yousaf left behind such a catastrophic legacy as Health Secretary.

“Despite the tireless efforts of NHS staff, record numbers of Scots are stuck languishing on NHS waiting list, including more than 120,000 people in Lothian.  

“Blame for this national emergency lies squarely with Humza Yousaf and his failed NHS recovery plan, which saw waiting lists in NHS Lothian spiral by 25% after the pandemic.   

“The SNP government must support NHS Lothian and deliver a real catch-up plan to help it recover from the damage inflicted by both the pandemic and by this disastrous government.”