New funding alongside actions to increase productivity
First Minister Humza Yousaf has announced an initial £30 million of targeted investment for Q1 of the new financial year, as part of a £300 million plan over the next three years, to help reduce inpatient and day-case waiting lists.
Backed by planned additional investment, this targeted approach will help drive down waiting lists by an estimated 100,000 patients over three years.
Visiting the National Treatment Centre in Fife, one year on since its official opening, First Minister Humza Yousaf said: “As I set out last October, we are committed to accelerating treatment in our NHS and reducing inpatient and day-case waiting lists by an estimated 100,000 patients over the next three years, backed by planned investment of an extra £100 million annually.
“This initial investment of £30 million will target reductions to national backlogs that built up through the pandemic, including orthopaedic treatment, diagnostics for cancer referrals and patients with the longest waits.
“This is all part of our programme to drive up productivity and tackle waiting lists, supported by the Centre for Sustainable Delivery.
“Together, our actions will further enable NHS Scotland to maximise capacity, build greater resilience and deliver year-on-year reductions in the number of patients who have waited too long for treatment.”
The British Dental Association has said there can be no complacency from the Scottish Government on the crisis in NHS dentistry, following yesterday’s debate in the Scottish Parliament, in which MSPs raised the heart-breaking case of a single mother going without food to pay for care, with others travelling hundreds of miles for access or embarking on ‘DIY’ dentistry.
The BDA’s own recent surveys found 83% of dentist respondents in Scotland had treated patients that had performed some form of DIY dentistry since lockdown.
Some reforms to the discredited small margin/high volume system NHS dentists work to were rolled out in November 2023. This system has been in crisis for a generation but proved undeliverable during the pandemic. Facing soaring costs, some practices were left delivering some NHS treatments at a financial loss.
The BDA had been seeking a decisive break from this system, and a move to a patient-centred, prevention-focused model of care. The Scottish Government refused to break with the overall framework.
The BDA stress that this must be the beginning, not the end of the road for reform, and that access, outcomes and inequalities need to be closely monitored.
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said:“MSPs and patients across Scotland have sent a clear message: the Scottish Government cannot pretend it’s ‘Mission Accomplished’ on NHS dentistry.
“Recent reforms may ease problems, but Ministers can’t afford to take their eyes off the crisis in this service.”
The UK Health and Social Care Secretary has invited the devolved administration for talks to discuss lessons learnt and tackle waiting lists across the UK
The UK Government Health and Social Care Secretary Steve Barclay has written to the devolved administrations inviting them for talks about how all parts of the UK can work together to tackle long-term waiting lists in all parts of the UK.
NHS services across the UK are a devolved matter, but Prime Minister Rishi Sunak has made cutting waiting lists a priority across the UK. Although approaches taken across England, Scotland, Wales and Northern Ireland share many common features, significant variations in outcomes exist.
In Wales, more than 73,000 people are waiting over 77 weeks for treatment, and at least 21,600 people are waiting over 78 weeks for an outpatient, day case or inpatient appointment in Scotland. In England, waiting times for patients over 78 weeks have been virtually eliminated.
The Secretary of State is inviting health ministers from the devolved administrations to discuss what lessons can be learnt from the different approaches taken.
In England for example, NHS patients are offered a choice of provider at GP referral – NHS or independent sector – provided that it meets NHS costs and standards. And from October we will proactively notify patients waiting over 40 weeks for treatment of their right to choose to be treated elsewhere.
In his letter, the Secretary of State writes that he would be open to requests from the devolved administrations to allow patients in Wales and Scotland who are waiting for lengthy periods to choose to be treated at providers in England, NHS or independent sector – building on the current arrangements for cross-border healthcare.
The Secretary of State has also asked UK health ministers to discuss how health data can be made more comparable across the UK. Northern Ireland official counterparts have also been invited to the ministerial meeting.
Health and Social Care Secretary Steve Barclay said: “I hugely value being able to share knowledge and experiences on the joint challenges facing our healthcare systems. I want to support collaboration between our nations to share best practices, improve transparency and provide better accountability for patients.
“This will help to ensure we are joined up when it comes to cutting waiting lists – one of the government’s top five priorities – and will allow us to better work together to improve performance and get patients seen more quickly.”
The letter reads:
Dear Michael and Eluned,
Thank you for a constructive meeting last month.
As you know, the NHS is at the forefront of people’s minds, and the Prime Minister has made cutting waiting lists a priority to ensure people across the UK get the care they need more quickly. We must continue to take steps to support the NHS and reduce waiting times to ensure no part of the UK is left behind. I am therefore concerned by the variation in performance across NHS services.
As we look to address this issue, it is important that the UK Government and Devolved Administrations work together to ensure that no matter where you are in the country, citizens can access vital services quickly.
In England, we are delivering on the actions set out in the NHS’s Elective Recovery Implementation Plan published last February. Our target to virtually eliminate waits of longer than two years by July 2022 was achieved on time and waits for treatment of more than 78 weeks have been virtually eliminated. Although data is not collected on the same basis across the UK, recent figures show more than 73,000 people are waiting over 77 weeks for treatment in Wales, and at least 21,600 people are waiting over 78 weeks for an outpatient, daycase or inpatient appointment in Scotland.
Whilst there are common features across the approaches of England, Wales and Scotland, one area of difference relates to patient choice. In England, patients have the legal right to choose the provider for their first outpatient appointment (at the point of GP referral) for many healthcare services. Patients may choose to be treated free of charge at any provider – NHS or independent sector – provided they meet NHS standards and costs and hold a contract for the provision of services to the NHS. A Patients Association study has found that this can reduce a patient’s waiting time by up to 3 months.
From October, we will proactively notify patients in England who have been waiting over 40 weeks of their right to request to be treated at a different provider if clinically appropriate, again in the NHS or in the independent sector, provided they meet NHS standards and costs, and they hold a contract for the provision of services to the NHS.
The Secretaries of State for Scotland and Wales share my desire to see patients across the UK have the same rights when it comes to accessing treatment. I would therefore be happy to facilitate a Ministerial working group session (with NI official counterparts) to share how we are implementing this choice approach in England, and to share lessons on work across the UK to tackle the elective waiting list. I would also be open to considering any request from you for patients waiting for lengthy periods for treatment in Scotland and Wales to be able to choose from alternate providers in England – NHS or independent sector – in line with the approach we are taking here, and building on the existing arrangements for cross-border healthcare.
I also believe we need to work together to ensure that health data is more comparable across the UK. It is important that all our citizens can understand the performance of the health services they are receiving and that we can learn from what has been tried and tested in one part of the UK to improve services across the country. I welcome the work our respective teams have been doing to improve data comparability, for example through the Office for National Statistics’ work to improve key UK-wide health performance metrics.
I am very keen to see this work progress and ask for your continued support in prioritising this moving forward.
In the absence of Ministers in Northern Ireland, I am copying this letter to the Department of Health in Northern Ireland and the Secretary of State for Northern Ireland.
A new national digital dermatology programme will be launched to help speed up treatment and reduce waiting lists.
By capturing quality digital images of a patient’s skin concern when they visit their GP or primary care provider the programme will, where clinically appropriate, allow a senior dermatologist to triage, diagnose and assess some skin conditions without the need for patients to attend an appointment.
People will then either be treated by their GP, directed to a more suitable service for their skin concern like an acne clinic or be offered a face-to-face appointment at a dermatology clinic, with those who need it directly scheduled for treatment or surgery.
Dermatology is one of the biggest outpatient specialties with over 46,000 patients on the waiting list for a first appointment at the end of March 2023. This new programme, backed by £1.8 million of funding, could potentially reduce demand for outpatient dermatology appointments by up to 50 per cent with the potential for up to 90 percent of referrals across Scotland to include a digital image.
Health Secretary Michael Matheson said: “The Scottish Government is determined to reduce waiting times across all specialities, and we know that dermatology is one of the busiest when it comes to demand for outpatient appointments.This new programme will lead to a better and quicker service for patients – allowing clinicians to see patients in the right place sooner. It has the potential to significantly reduce waiting times.
“Innovation like this is vital for the future of our healthcare service and I am excited to see the real benefits that will come from programmes like this in the years to come.”
Fiona Macdonald, Consultant Dermatologist and Centre for Sustainable Delivery (CfSD) Clinical Lead for Dermatology said: “Managing referrals during the pandemic highlighted to Dermatologists how important a good quality image is to a Dermatology referral.
“It can help us prioritise the most urgent referrals, choose the right treatment pathway or offer advice to support care provided in Primary care”.
Dr Stuart Sutton, GP and clinical lead for primary and secondary care interface working, said: “Having a fast, effective and secure way for Primary Care teams to send images of our patient’s skin conditions to specialist colleagues will ensure more rapid and most appropriate advice and treatment is available – a picture provides a level of detail that cannot be conveyed in a traditional referral letter.”
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.”
Sarah Boyack MSP has highlighted the grim findings that more than 3 in 4 Dental Practices serving patients in Musselburgh are no longer accepting NHS Patients.
Following up on concerns of Musselburgh residents, Lothian MSP Sarah Boyack contacted practices serving the Musselburgh area to inquire whether they were accepting new NHS patients.
The findings also highlighted those that were accepting new patients had waiting lists of over six months on average.
Commenting Scottish Labour MSP Sarah Boyack said: “Patients in Musselburgh are being routinely let-down by the lack of NHS Dental provision.
“With more than three quarters of NHS Dentists unable to accept new patients, the people of Musselburgh have been left with a two-tiered system that routinely fails them.
“We are now seeing the devastating effects of the SNP mismanagement of our NHS, with patients spending months suffering unnecessarily whilst they are unable to see an NHS Dentists.
“This cannot carry on, The SNP must act now before more communities like Musselburgh are left without access to NHS services.”
Data collected by the office of Sarah Boyack MSP for the 20 closest practices to Musselburgh on 5/5/23:
We know everyone is busy, so this event is taking place online to fit in around family, work and life. It’ll only take 1 hour and will be informative.
Did you know Edinburgh North East Scouts has almost 100 young people on a waiting list to join?
And they need new helpers to support their 14 Scout Groups in Portobello, Craigentinny, Craigmillar, Duddingston, Calton, Joppa, Stockbridge, Pilrig, Broughton, Trinity, Leith, Newhaven, Wardie and Willowbrae.
Sign up for this event to find out about the exciting things the Scout Groups get up to and flexible volunteering opportunities.
Demand by young people to join Scouts in the Edinburgh North East area is good with youth waiting lists growing. However, they need new adult volunteers to reduce the waiting list and enable more local young people to benefit from Scouting.
Edinburgh North East Scouts is looking to the local community and organisations to help change the lives of local young people. They are appealing for help to reduce the youth waiting list and support 100 more young people to benefit from Scouts.
Scouts is only possible thanks to superstar volunteers – ordinary people, like you, making an extraordinary difference in young people’s lives. They are looking for new adult volunteers to assist their existing leader and executive team.
So please consider what you can do and if you know anyone who may be willing to get involved and ask them to come along to the event too. It is possible that they may consider a job share if that was of interest to you?
Scouting has a reputation for helping young people to develop resilience, a positive character, respect for others, good community skills, as well as physical and mental fitness. Can you help inspire the doers and give it a goers of the future?
FACT 1: There are 14 Scout Groups in the Edinburgh North East area and they all want to provide more Scouting to more local young children. FACT 2: You don’t need to have any specific skills or be Bear Grylls to lend a hand. FACT 3: They have a collective youth waiting list of almost 100. FACT 4: If you volunteer as a Leader to get involved now then they can look at how your child could get automatic entry into their preferred Scout Group. FACT 5: You don’t have to have previous Scouting experience to get involved.
As a District, they want to offer your child and other local children across the Edinburgh North East area the chance to participate in all the fun experiences and adventures they do in Scouting week to week such as, camping, fire-lighting, climbing and abseiling, and yes, learning how to tie and use knots (these will come in handy in later life!).
Are you passionate about seeing local young people succeed? Are you a team player with a positive, can-do attitude? Do you enjoy fun activities? Do you want to do more in your community?
Are you more of a ‘behind the scenes’ person? Do you have a skill or hobby you can share? Then this event is right up your street. Scouts has the opportunities – you just show up, get stuck in and make memories for life!
We all have the power to help young people to realise their potential. You don’t need to have been a Scout when you were younger.
You don’t even need to know how to put up a tent. Their door is open to people of all ages, genders, races and backgrounds, and they’re only able to change lives because people like you lend a hand.
There’s lots of ways you can get more involved with Scouts as a parent, carer or family member. From helping out occasionally on a family rota or as part of their Executive Committee to stepping up as a leader, their volunteering activities are as varied as you.
The good news is you shape what you do and the time you have to give. Scouts happens when a lot of us give a little … and no, you don’t have to be a Scout or outdoors expert to volunteer.
Most of their volunteers work directly with young people aged 6-18 through their Beaver, Cub and Explorer groups – helping young people gain skills for life through fun activities.
District Commissioner, Rob Whitelaw, said: “This isn’t a job application, and you certainly don’t have to be an adventurer like Bear Grylls to get involved with Scouting and in fact not many of our volunteers are!
“Do you have first aid knowledge? Are you good with numbers? Handy in the kitchen? Or are you a DIY whizz? We all have useful skills, and you can volunteer and help in many ways.
“Are you ready to inspire a generation of young people to experience fun, friendship and real adventure? The opportunities to volunteer with us are flexible. Think of something you’d like to do, and chances are it’s just what we require.
“Whatever your skills, experience and interests, we can find a role for you!”
Sign up for the online information evening on Tuesday 29th November at 7.30pm here:
Responding to Scottish Labour Leader Anas Sarwar raising his late constituent Anne Sinclair’s case at First Minister’s Questions this week, Foysol Choudhury MSP said:“I am grateful to Anas Sarwar for raising the case of Anne Sinclair with the First Minister.
“I raised the case with the First Minister in February and was told that the seven months of delays she had faced in her cancer diagnosis were ‘not at all acceptable’. I agreed with that assessment.
“Unfortunately Anne passed away this summer. Throughout her journey with cancer she was determined that I raise her story in the Parliament, find answers for the delays she faced, and fight so that nobody else was left in the same position. Her sons, who were in the gallery of the Scottish Parliament for FMQs today, have kindly given me permission to continue that fight on their mother’s behalf.
“Anne’s case starkly demonstrates the real people behind the numbers we hear every week in the Scottish Parliament. There are faces behind all the waiting lists, the people waiting in ambulances, and the people who cannot get the care they need. These are not just statistics, they are human beings who deserve dignity in their healthcare.
“Unfortunately Anne was let down, and her sons deserve answers and an apology for the delays in their mother’s diagnosis.
“I want to thank my office staff for pursuing what has often been an emotional case. We all want to see that Anne’s family can be assured that lessons are learned and nobody else will be left in the same position.”
The family of Anne Sinclair, 64 from Edinburgh, said:“We are happy that Foysol Choudhury MSP and Scottish Labour have continued to raise our late mother’s case at the Scottish Parliament.
“We do not wish for any other families to go through what our mum and our family have gone through. Our mum was a fighter and she would want her questions about her late diagnosis to be answered.”
“There were nearly 30,000 12-hour waits (measured from decision to admit to admission) in July 2022, that is more than 3.5 times the total number of 12-hour waits for the whole of 2019.
“This is only the Tip of the Iceberg as the true number of 12-hour waits, measured from time of arrival, is much higher. We urgently need transparency for the scale of the crisis, only then will everyone recognise the reality of the situation and begin to take critical action. We urge NHS England to commit to publishing this data (which is already collected by all Trusts) monthly with immediate effect.
“The crisis is escalating quickly, and health workers are seriously concerned about the quality of care being provided, especially as we exit summer and head into winter. The system is struggling to perform its central function: to deliver care safely and effectively.
“This is a whole-system problem and requires a whole-system approach. There must be total focus on promoting flow throughout the hospital and priority around our ability to provide an NHS that helps patients in an emergency.
“We must ensure patients are discharged in a timely way, so beds are freed and patients in A&Es are able to move through the system and be treated. Flow and discharge rely heavily on an effective social care service that has sufficient workforce – the government must get to grips with this.
“Across the UK we urgently need 13,000 beds to drive meaningful improvement: in Emergency Medicine in England there is a shortfall of 2,000-2,500 Consultants as well as widespread shortages of nurses, trainees, SAS doctors and junior and supporting staff.
“The social care workforce must also be bolstered, which can be achieved by giving these core workers a fair wage that respects and recognises the value of their role. Retention of all health and social care workers is vital, staff are burned out and exhausted, and some are considering their careers.
“We are seeing the sharp demise of the health service and we are seeing little to no political will to act on or acknowledge the crisis – neither of the leadership candidates seem to recognise the scale of the crisis at hand.
“Winter is looming, which will bring a wave of flu and covid and increased footfall in Emergency Departments, with the data as dire as it is today and the scale of patient harm already occurring, we dread to think how much worse things could get for patients.
In winter four-hour performance typically decreases while the number of 12-hour waits significantly increases. We may reach a point where only half of patients are seen or treated within four-hours and see an even higher number of 12-hour waits.”
There were 1,385,080 attendances at major Emergency Departments
There were 2,163,779 total attendances at all Emergency Care facilities
29,317 patients were delayed for 12 hours or more from decision to admit to admission, this is just over 3.5 times higher than the total number of 12-hour waits over the whole of 2019
This is the highest number of 12-hour waits on record
This is a one third increase compared to the previous month, June 2022, or an increase of over 7,000 12-hour waits
There have now been 150,014 12-hour waits (from decision to admit to admission) so far this year
Four-hour performance at major Emergency Departments was 57.0%, this is the worst four-hour performance on record
More than 2 in 5 patients were delayed by four-hours or more
Type 1 admissions stood at 358,284 (a daily average of 11,575
136,221patients spent more than four hours in an Emergency Department from decision to admit to admission (also referred to as ‘trolley waits’)
Over 8/10 NHS dental practices unable to offer appointments to new adult patients, in the most extensive survey of patient access ever undertaken
The British Dental Association has pressed government to step up and deliver urgent reform, as new research from the BBC underlines the scale of the access crisis facing NHS patients across the country.
Between May and July, BBC researchers reached out to every UK dental practice with an NHS contract to ask if they were taking on new patients. Working with the British Dental Association, the BBC identified 8,533 dental practices across the UK that were believed to hold NHS contracts and attempted to call them all.
The survey found:
In Scotland, 82% of NHS practices were not accepting new adult patients, 687 of 839.
Of those practices not taking on adults in Scotland, 39% (267) said they had an open waiting list, and 18% (124) said the wait time was a year or longer, or were unable to say how long it would be.
Out of 32 local authorities in Scotland, BBC researchers did not successfully reach any practices accepting new adult NHS patients in 9 (28%) local authorities.
In Scotland, 79% of NHS practices were not accepting new child patients, 663 of 839. Out of 32 local authorities in Scotland, BBC researchers did not successfully reach any practices accepting new child NHS patients in 7 (22%) local authorities.
Last month BDA Scotland warned the Scottish Government risked undermining the future sustainability of NHS dentistry, as they scaled down vital financial support for the service.
From April to June practices received a 1.7 multiplier to the fees paid to provide NHS care, a reflection of the unprecedented backlog practices have faced as they try to ‘live with Covid’ and the continued suppressed activity compared with pre-pandemic levels. This was cut down to 1.3 from July, following no discussion with the profession, leaving many dentists at risk of delivering some NHS treatments at a loss.
Official data suggests the total number of high street NHS dentists in Scotland has fallen by over 5% since the onset of Covid. The BDA has again urged the Scottish Government to, in the short term, develop a suitable interim funding package to support dentists and their teams as they work through the backlog, and begin work on a new, sustainable long-term model for NHS dentistry.
David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee, said:“The Scottish Government promised free NHS dentistry for all, but the public are now living with the harsh reality.
“You can’t run a health service on soundbites and slogans. Ministers need to take a long hard look at the evidence, and bring forward the reforms and resources we need to deliver for patients across Scotland.”
UK-wide 90% of NHS practices were not accepting new adult patients, 6,193 of 6,880.
Of those practices not taking on adults in the UK, 25% (1,572) said they had an open waiting list, and 17% (1,039) said the wait time was a year or longer, or were unable to say how long it would be.
Out of 217 local authorities in the UK, BBC researchers did not successfully reach any practices accepting new adult NHS patients in 77 (35%) local authorities.
80% of NHS practices were not accepting new child patients, 5,506 of 6,880. Of those practices not taking on children in the UK, 1,480 (27%) said they had an open waiting list, and 16% (902) said wait time was a year or longer, or were unable to say how long it would be.
Out of 217 local authorities in the UK, BBC researchers did not successfully reach any practices accepting new child NHS patients in 25 (12%) local authorities.
