“Staff faced increasingly difficult conditions, with huge numbers of patients facing long and dangerous waits throughout the system. We know these long waits are associated with patient harm and even patient deaths, it is increasingly distressing for staff and patients.
“Exit block – where patients are unable to be admitted to a bed because other patients are unable to be discharged – was the worst it has ever been, meaning the entire Emergency Care system has been gridlocked – like a traffic jam.
Patients spending far longer in Emergency Departments than they should be, often in inappropriate or inadequate areas, on trolleys in corridors, in small, cramped spaces with a lack of privacy and lack of dignity.
“We welcome the gravity with which the First Minister and the Cabinet Secretary are taking the current crisis in Emergency Care. We have had constructive meetings with the Cabinet Secretary and do feel that there is recognition of the root of the issues and a political will to tackle it.
“We especially welcome the focus on social care and the whole system capacity. It is critical that we sort out discharges, ensuring patients who are medically fit to leave are able to return home or to the community in a timely way. We must continue to focus on this to free up beds so we can increase flow throughout hospitals and admit patients from Emergency Departments into a bed on wards.
“While these are the right initiatives, the green shoots of hope are not translating to big enough or fast enough improvements. Without significantly increasing capacity across Scotland, we will continue to borrow from tomorrow to cover today.
“This means cancelling elective surgery so we can admit Emergency Care patients to a bed, but at the cost of further delaying what may be serious surgery for patients who have already waited for a long time. We should not be in a position where decisions like these need to be made.
“It is wrong for specialties to compete for beds for their patients. What is better is to increase the number of staffed beds throughout the system, where safely possible, so we do not need to compromise on which patients are able to be treated.”
Researchers from NHS Lothian and the University of Edinburgh have conducted a clinical study to investigate the extent to which cancer and cancer treatment affects COVID-19 immunity.
Blood samples were taken regularly from over 760 consenting patients, most from Southeast Scotland, who were receiving routine treatments for cancer.
The samples were then tested for signs of an immune response to COVID-19 using an antibody test.
The study is the largest of its kind in the world with the first patients being recruited in May 2020, just months after the United Kingdom experienced its first lockdown.
Dr Peter Hall, Consultant Medical Oncologist at Edinburgh Cancer Centre, said: “Treatments such as chemotherapy can affect the immune system, so it was really important for us to understand the effects of COVID-19 on people undergoing anti-cancer treatment.
“We now have a better understanding of how the virus affects these patients in the short and long-term, and to what extent the vaccine had an impact on their antibodies.
“It’s very reassuring to see that most cancer patients can go ahead with their treatments without fear of excessive risk from COVID-19, and that vaccination offers an effective means of protection.”
The study found that COVID-19 infection rates in patients with cancer largely mirrored those of their local population and that treatment type did not impact the rate of their antibody response.
It also concluded that vaccination was effective in protecting people with cancer from COVID-19.
Dr Hall continued: “More research is needed, but this was an important step in understanding how people receiving anti-cancer treatment are impacted by the virus.
“It’s also another example of NHS Lothian and the University of Edinburgh working collaboratively to understand how best to care for some of the most vulnerable patients.”
You can read the Scottish COVID Cancer Immunity Prevalence Study in full in The Oncologist.
As pupils and students return to school following the Christmas break, UKHSA is reminding people that winter illnesses continue to circulate at high levels.
Following simple steps can help protect children, minimise the spread of illness in education and childcare settings and protect wider communities.
Professor Susan Hopkins, Chief Medical Adviser at the UK Health Security Agency (UKHSA), said: “It’s important to minimise the spread of infection in schools and other education and childcare settings as much as possible. If your child is unwell and has a fever, they should stay home from school or nursery until they feel better and the fever has resolved.
“Helping children to learn about the importance of good hand hygiene is also key, so practice regular handwashing at home with soap and warm water. Catching coughs and sneezes in tissues then binning them is another simple way to help stop illness from spreading.
“Adults should also try to stay home when unwell and if you do have to go out, wear a face covering. When unwell don’t visit healthcare settings or visit vulnerable people unless urgent.
“Remember that flu vaccination is still available for all eligible groups and is the best protection against the virus. We have seen good uptake in older age groups but vaccination among young children remains low. Flu can be very unpleasant and in some cases can lead to more serious illness. Getting your child vaccinated protects them and others they come into contact with, and it’s still not too late.”
An increasing number of respiratory viruses in Lothian is heaping extra pressure on the hospital system.
Cases of Flu are surging and there are still high levels of COVID andRespiratory Syncytial Virus (RSV), as well as norovirus, causing hospitals and GPs in Lothian to be stretched beyond capacity.
Calum Campbell, Chief Executive, NHS Lothian, said the sector as a whole was already experiencing significant pressures because of an increase in emergency patients and large numbers of delayed discharge patients, before this latest increase in infection rates.
He added: “Our teams across the health and social care system are facing sustained and relentless challenge. The system is under horrendous pressure and the challenges our teams are facing are uncharted.
“We are experiencing more cases of infection – flu, COVID and RSV, as well as norovirus – than ever before.
“In order to maintain our patient flow through the hospital and retain beds for the most urgent of cases, we need to support people to go home quicker after their treatment and reduce any preventable admissions. That is where the public can help.
“Please take sensible precautions to prevent infection, especially if you have underlying health conditions or plan to be with those that do””
The Royal Infirmary of Edinburgh, St John’s Hospital, the Western General Hospital and the Royal Hospital for Children and Young People are all at full capacity.
Dona Milne, Director of Public Health and Health Policy, NHS Lothian, urged people to help reduce the spread of infections to protect themselves and the most vulnerable in their communities.
She said: “Although they can be mild infections for many, RSV and Flu can be extremely serious for some people causing them to require urgent hospital treatment. We have now reached extraordinary levels of flu in Scotland that we haven’t seen for many years.”
“We are asking anyone who has cold or flu like symptoms to help limit the spread of infection and reduce the chances of passing it to someone who will become very unwell.
“Stay at home if you feel unwell. And if you do have to go out, please wear a mask. People should also remember to wash their hands, and cough or sneeze into a tissue and bin it.”
People in Lothian are also being reminded to stock up their medicine cabinets with paracetamol and cold remedies so they can treat common illnesses at home.
Anyone who has cold type symptoms, such as a runny nose or mild cough, or who has a sore throat without a temperature and can eat and drink, is likely to have a viral illness and does not need to contact their GP. They should drink plenty of fluids and rest and get additional help and advice from NHS Inform or their local pharmacy.
The most up to date information on Strep A can be found at:
FESTIVE ARRANGEMENTS: Clinics will be closed from 24th to 27th December and again from 31st December to 3rd January. Please check individual clinics for additional information before arranging your visit.
Area
Site
Days
Drop-in times
East Lothian
Edington Cottage Hospital
Monday to Friday
Closed from 24th December to 8th January
8.30am – 4.30pm (Closed 10am to 10.30am and again from 12.30pm to 1.30pm)
East Lothian
Haddington Corn Exchange
Monday to Sunday
8.30am – 4.30pm(Closed 12pm – 1pm)
East Lothian
Musselburgh Primary Care Centre
Monday to Friday Closed from 24th December to 8th January
8.05am – 4.50pm (Closed 10am to 10.20am and again from 12.30pm to 1.15pm)
Edinburgh
Fort Kinnaird (SAS Bus – next to Currys)
Monday 19th – Friday 23rd December
9.30am – 4pm
Edinburgh
The Gyle
Monday to Sunday
9.30am – 6.30pm
Edinburgh
Ocean Terminal
Monday to Sunday
9am – 6.30pm
Edinburgh
Waverley Mall
Monday to Sunday
10am – 5.30pm
Midlothian
Gorebridge Leisure Centre
Wednesdays, Thursdays and Fridays
Closed Thursday 22nd December onwards, reopens Wednesday 4th January
‘Sticking our heads in the sand – or using the NHS as a political football to exchange snappy soundbites – will not cut it anymore‘
The number one “quick fix” priority for Scotland’s NHS as we move into 2023 must be the retention of our invaluable healthcare professionals, the chair of BMA Scotland said today (Wednesday, Dec 28th).
Dr Iain Kennedy said any plan for further recruitment, investment in the systems and aspirations of improvement will “fall flat on its face” unless there is a laser like focus on keeping the experienced staff our NHS already has.
Dr Kennedy, who was speaking as he delivered his annual festive message for doctors, added that the need for an open discussion on the NHS is now greater than ever.
His renewed call for a national conversation on the future of the health service comes as BMA Scotland shares more than 100 testimonies from doctors about what working in the NHS is like at the moment and their concerns for what the future holds.
Comments included:
“There have been a number of critical incidents in the last six months involving unsafe staffing levels. The acuity of the workload has increased. Patients are generally getting sicker and more complex, but we have less resources or time to care for them. It’s hard to keep them safe. I wouldn’t want to be an inpatient at the moment, and hope everyone in my family remains well for the foreseeable.”
“It feels unsafe – because it is. It’s not safe for patients, and it’s not safe for staff either. I have gone from being a passionate committed GP to being a shadow of my former working self. I want to leave the profession and I am devastated by this.”
“Things are very bad. Chemotherapy can only be delivered four weeks after seeing a consultant because of a chemotherapy nurse shortage. Radiotherapy preparation scans can only be done two weeks after seeing a consultant because of lack of radiotherapy staff/physicists – and it’s another two or more weeks before radiotherapy can actually be delivered.”
Dr Kennedy said: “The NHS is haemorrhaging crucial staff – staff who we urgently need now more than ever before – and the government must step up to stop it. They can talk as much as they want about recruitment of staff, of investment in the system or of plans for improvement, but every single one will fall flat on its face unless there is a laser like focus on keeping the staff we have.
“That is why the retention of healthcare professionals – keeping them in the service – needs to be the number one priority in terms of the quick fixes to help us just make it through this winter with the NHS in Scotland somehow intact.
“I desperately want to be optimistic and forward looking, to set out some hope for the future – for the medical profession that I am so proud to be a part of, and the Scottish health service that I am equally proud to work in.
“But it’s not easy to find that indication of a brighter future – especially after reading the, frankly, harrowing comments from some of my NHS colleagues about what they are experiencing day in, day out. No one working in the health service would give me any credibility if I gave an upbeat description of the way our NHS will, or can, get better and how the working conditions of those caring for the people of Scotland will miraculously improve.
“All the statistics tell us that it’s a desperate state of affairs. Things are as bad, or worse, than they have ever been. Winter is a meaningless term now – this entire year has been winter.
“But looking beyond the statistics, looking at the people behind the statistics, the picture being painted is even more grim and concerning. The experiences my colleagues have shared speak louder than anything I could say, and anything any official stats could imply.
“We face crises across workload, workforce, working conditions, pay and pensions – all of these are hitting efforts to retain doctors, which we are already short of across both primary and secondary care. Hospitals have too many vacancies – indeed the current vacancy rate for consultants alone is 14.32% – and GP practices are falling over, with the Scottish Government not even close to being on target to deliver their promised 800 additional GPs by 2027.
“In the face of everything else pay and pensions are – incredibly – fairly quick fix issues. The government can make a decision to improve pay for NHS workers. And the UK Government can finally once and for all sort out the pension taxation issues that penalise senior doctors across primary and secondary care and force them to cut hours or face massive and unexpected bills.
“These two things will make a difference in staff retention – junior doctors will feel more valued and be more likely to stay in the NHS instead of looking to move abroad where they will be paid more and have a better work life balance.
“Senior doctors will be less likely to reduce their hours and more likely to work waiting list initiatives if they know they won’t receive a huge tax bill for doing so. We are beyond crisis point now – urgent action is needed to save our NHS and that simply must focus on investing in the workforce.
“Looking beyond that, of course we need to finally get a proper long-term workforce plan in place. But even more fundamentally we need, as a whole society, to grasp the nettle, face up to hard truths that have been brushed under the carpet for too long, and have a proper grown up, depoliticised national conversation about the future of the NHS in Scotland.
“Sticking our heads in the sand – or using the NHS as a political football to exchange snappy soundbites – will not cut it anymore.
“It’s clear we need to reflect on what we ask of our NHS and the levels of funding we, as a country, are prepared to provide to meet those asks, and to ensure the health service stays true to its founding principles and remains free at the point of delivery. The current approach of pushing insufficient resources harder and harder, then blaming staff when standards fall has failed and is failing patients every single day. I know doctors across Scotland are suffering moral injury as a result.
“Let’s stop putting healthcare workers in the impossible and insidious position of having to constantly be apologising and being the bearer of bad news.
“We need politicians on all sides to be brave and act – by bringing us together and finally actually properly talking about a plan for a future NHS we can all confidently get behind. And a better NHS will be better not just for Scotland’s doctors, but for the many people who rely on it for care.”
Humza Yousaf must be sacked for ‘dangerous negligence’, Scottish Labour MSP Sarah Boyack has said, as the party revealed that the number of patients waiting over 12 hours to be seen in Accident and Emergency in Lothian has soared.
Statistics have shown that, in the year from November 2021 to October 2022, a shocking 15,936 people in NHS Lothian spent more than 12 hours in A&E waiting to be seen – despite an SNP government commitment to see 95% of patients within four hours.
This figure has spiralled in recent years, with the number of people waiting more than 12 hours now around 18 times higher than the same period in 2018/19.
With A&E services in disarray and the situation only worsening throughout the winter, Scottish Labour is warning that lives will be lost due to the SNP-created A&E crisis.
Scottish Labour MSP Sarah Boyack said: “The facts are plain for all to see – NHS Lothian’s A&E services have been plunged into a deadly freefall by Humza Yousaf’s dangerous negligence.
“Despite the efforts of hardworking staff, the number of patients spending a shocking 12 hours waiting in A&E has soared this year.
“The SNP’s mismanagement of our NHS is putting lives at risk – we urgently need a real plan to put a stop to this chaos and protect services in Lothian.”
The Scottish Conservatives are also calling for Yousaf’s sacking. A spokesperson said: “With each passing week, Humza Yousaf continues to preside over complete chaos in our A&E departments.
“His tenure as Health Secretary has been nothing short of a disaster and Nicola Sturgeon must sack him immediately.”
Number of A&E patients waiting more than 12 hours:
Those eligible for the free COVID-19 and flu vaccinations are being urged to get their jabs as winter sets in and hospitalisations increase.
The reminder comes as Public Health Scotland (PHS) data shows in the week ending 11 December 2022, there were on average 735 patients in hospital with COVID-19, an 18.2% increase from the previous week.
Admissions for flu are also on this rise with the highest hospital admission rate noted in patients aged less than one year old (18.5 per 100,000). Parents and carers are encouraged to get their children vaccinated as soon as possible if they haven’t done so already. The flu vaccine for children is a painless nasal spray which will help protect them and reduce the risk of them spreading the virus to more vulnerable people.
The vaccines are safe, effective and offer the best protection to those most at risk of serious illness from COVID-19 and flu while also helping to protect the NHS at this, the busiest time of year.
Adults over 50 are entitled to get both free vaccines and further information on eligibility for each jab is available on the NHS Inform website.
Health Secretary Humza Yousaf said: “Uptake for the winter vaccine programme is very encouraging with Scotland delivering more jabs per head of the population among over 50’s than any other UK nation. However, the number of hospitalisations from both COVID-19 and flu are on the rise.
“The vaccines help to prevent serious illness and the need for hospital treatment freeing up capacity as we move into what could be the most challenging winter in the history of our health and care service.
“We are concerned that flu-related hospital admissions have been rising, with admission rates highest among very young children, and we urge parents and carers to get their children vaccinated with the painless nasal spray offered to this group.
“As well as protecting the child, the vaccine helps to reduce the risk of children spreading flu to family and friends who are more vulnerable, which is especially important at this time of year when families are getting together more.”
Police Scotland’s national rollout of the opioid reversal treatment, Naloxone, is reaching officers the length and breadth of the country.
Around 3,000 kits have been issued throughout Edinburgh, Highland and Islands, Dundee and Forth Valley divisions in recent weeks, where operational officers are now being trained and equipped.
The deliveries mark the completion of roll-outs to operational officers up to and including the rank of Inspector in both Highland & Islands and Forth Valley, while officers in Edinburgh, Ayrshire and North East divisions will be supplied with kits for the first time.
Police Scotland successfully piloted the carriage and use of Naloxone by its officers last year as part of a public health approach to addressing the country’s drug death rates, which are the highest in Europe.
Officers in four areas (Falkirk, Grangemouth & Stirling; Dundee City; Glasgow East, Caithness, and local custody suites) began carrying the single use intra-nasal sprays in March 2021.
Since then it has been used in at least 95 incidents by officers, with positive outcomes on all but four occasions. In three of the four incidents, officers suspected the individual was already deceased, however, they administered Naloxone to give the casualty every possible chance at recovery. In the fourth instance the individual did not regain consciousness and later died in hospital.
Nearly 4,000 officers are now both trained and equipped with Naloxone, or are due to undertake online training in the coming weeks.
All operational officers are expected to receive personal issue kits in early 2023. Probationary constables will also be trained in the use of Naloxone during their initial training at Police Scotland Headquarters, Tulliallan.
Assistant Chief Constable Gary Ritchie (Partnerships, Preventions and Community Wellbeing) said: “The national roll-out of Naloxone comes following a robust, independent evaluation of our test of change. As our officers are so often the first on the scene of a critical incident, it is right we equip them with this additional first aid resource, which can be used safely and with no adverse effects.
“We are working closely with partners to ensure adequate expertise is accessible to people who have received Naloxone from our officers. This includes the ambulance service as well as health colleagues who are best placed to provide additional support.
“Our approach to drugs in Scotland remains twofold. We are committed to protecting the most vulnerable people in society in times of crisis, and Naloxone helps us to do this. However, we remain resolutely determined to do all we can to stop illegal drugs reaching our villages, towns and cities in the first place. We continue to use all available resources to bring those involved in serious and organised crime to justice, and to safeguard Scotland’s communities.”
The circumstances in which Naloxone has been administered by Police Scotland officers have included incidents where officers have discovered unconscious casualties while on patrol, or been alerted to an overdose by a member of the public. Other incidents have involved people in police custody, during police public order incidents and the execution of a search warrant. Naloxone has also been administered to people intending to complete suicide.
More information about the carriage of Naloxone by Police Scotland officers can be found here.
Know how to stay on top of prescriptions – festive advice from NHS 24.
NHS 24 are advising people in Scotland to check their prescription medication and ensure they have enough to last throughout the festive holidays.
Dr John McAnaw, a pharmacist and NHS 24’s Associate Clinical Director, explains why it’s essential that people put health at the top of their festive ‘to-do’ list,
‘Over the holidays every year, NHS 24 receives thousands of calls from the public who have run out of essential prescribed medication. This can obviously be a very stressful situation for most people, however, by being organised and ordering any required prescriptions in advance, this would avoid this scenario and ensure that the 111 service can help more people who require urgent healthcare advice.
‘Due to both Christmas and Hogmanay falling on a weekend this year, many pharmacies and healthcare providers will be closed for a period of four days on each occasion. Therefore it is so important that people plan ahead, order only what they need and pick it up in plenty of time before these holidays.
‘To ensure you have all medication you require, please check what medication you already have and order any additional supplies you need by Friday 16th December. This will give both your GP practice and pharmacy time to process requests at what is already a very busy time of year for them.’
Dr McAnaw’s advice is part of a NHS Scotland national health campaign ‘Healthy Know How.’ The campaign provides advice on how to stay well and enjoy the festivities, avoiding the need to get medical help over the holidays.
Tips include:
Know how to stay on top of prescriptions. Order only what is needed and pick them up in plenty of time before the festive holidays.
Know how to be prepared for common illnesses. Ensure you have some remedies in the house.
Know how to check symptoms if you do become unwell. NHS inform’s symptom checkers can give you all the health advice you need online.
Know how to get the right care, in the right place. Further medical advice can be found during the week by contacting your GP, pharmacist, dentist or optometrist. For out of hours or during holiday closures call NHS 24 on 111.
More details on the Healthy Know How campaign can be found here –
