Covid Scotland: 240,000 fewer operations on NHS since pandemic began

That compares against a total of 541,891 in the 21-month period from March 2018 until November 2019, suggesting that around 241,000 patients will have had planned operations such as hip replacements delayed since Covid began spreading in Scotland.

During the first lockdown, non-urgent elective operations were suspended across NHS Scotland to free up beds and staff in order to prioritise Covid admissions and emergency or urgent procedures, such as cancer surgery.

Although these gradually increased as restrictions were lifted and vaccines rolled out, the Delta wave during August and September and then the current Omicron wave both resulted in several health boards temporarily suspending non-urgent elective work again amid rocketing staff absences and associated bed shortages.

These were also exacerbated by increasing levels of delayed discharge linked to spiralling workforce shortages in care homes and community social care.

The figures detail, month-by-month, the number of surgeries being scheduled for NHS theatres as well as the number which were subsequently cancelled.

Between March 2020 and November 2021, a total of 326,467 elective surgeries were scheduled to take place, but 25,877 were cancelled.

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Operations can be cancelled for a number of reasons, including because patients are too unwell, because they no longer want to proceed, or due to unforeseen obstacles such as adverse weather which prevents a patient from travelling.

However, 7,126 (27.5%) of the procedures cancelled were called off for a "capacity or non-clinical reasons", which covers a range of factors such as a lack of available beds in intensive care, high-dependency units, or on general wards; staff absences or clinicians being diverted to deal with an unplanned emergency operation; a previous theatre session overrunning; or necessary equipment being unavailable or dirty.

For example, during March 2021 NHS Western Isles cancelled one in five planned operations as a result of "equipment failure at the start of a cataract list", while 22% of planned surgeries at Borders General Hospital in August 2021 were postponed "due to capacity constraints".

NHS Highland - which suspended all non-urgent orthopaedic procedures, such as hip and knee replacements, from December until the end of January - also cancelled one in five planned operations in July last year due to "an issue with the Eye Clinic".

As recently as November 2021, before the Omicron wave, the health board was still recording the highest cancellation rate in Scotland with one in 20 planned procedures being called off.

Delayed discharges reduced to 600 at the beginning of the pandemic, freeing up beds for Covid and other admissions. However, around 1500 hospital beds are now occupied by patients well enough to leave

The overall picture has improved substantially from the beginning of the pandemic - just 2,948 elective operations took place on the NHS in Scotland in April 2020, compared to nearly 19,000 in November last year - but turnover remains around a third lower than pre-pandemic levels, with new patients being added to waiting lists all the time.

By September 30 2021 - the most recent date for which data is available - there were 106,496 patients on a waiting list for an inpatient or day case procedure, up by nearly 21,000 in a year.

There were also 425,242 patients on an outpatient waiting list, up by more than 106,000 since September 2020.

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Since mid-January 2021, five independent hospitals in the private sector have been admitting clinically urgent patients from seven NHS health boards - Ayrshire and Arran, Fife, Forth Valley, Grampian, Greater Glasgow and Clyde, Lothian and Tayside - in order to reduce waiting times.

However, the PHS report does not detail how many people have been treated at private hospitals since this arrangement began.

Total hospital admissions, for all causes, fell substantially at the beginning of the pandemic and remained around 10 per cent below pre-pandemic levels by the November 2021

Scottish Labour health spokeswoman Jackie Baillie said: “We are deep in the midst of a full-blown NHS crisis, with lives now on the line due to the failures of the SNP government.

“Thousands of Scots are waiting in A&E departments and on ever-lengthening waiting lists for treatment – this is unacceptable.

“And the SNP’s repeated failure to support social care services has allowed the scandal of delayed discharge to rear its head again, leading to thousands of Scots being stranded in hospital due to lack of provision.

“NHS and social care staff have gone above and beyond but they have been badly failed by the SNP government.

“The Cabinet Secretary must get a grip of the situation – whilst the pandemic has made matters worse, the fact of the matter is that the SNP has failed our NHS staff, patients and carers since before the pandemic hit. Scotland deserves better.”

A spokeswoman for the Scottish Government said it was working with health boards "to get those who have had treatments or procedures postponed due to Covid-19 the care they need as quickly as possible".

She added: “Throughout the pandemic NHS Boards have ensured that urgent, maternity and vital cancer services continue as usual and have worked hard to ensure vital cancer care remains in place where clinically agreed. Despite challenges created by the pandemic our NHS still managed to carry out 633 operations on average per day during November 2021.

“Our NHS Recovery Plan sets out commitments over the next five years, backed by over £1 billion of funding, to support an increase in inpatient, daycase, and outpatient activity to address backlogs, which will be supported by the implementation of sustainable improvements and new models of care.”