NHS Scotland: Three year op waits up from 560 to nearly 1600

It is the first time that Public Health Scotland has disclosed data specifically relating to three year waits.

Backlogs are worst in NHS Grampian and Lanarkshire, where 696 and 281 patients respectively have been waiting over three years to be admitted for treatment.

Scotland-wide, the bulk of three-year waits relate to procedures in general surgery (352), which may include operations such as a gallbladder removal or hernia repair; ear, nose and throat (316); orthopaedics (252); and gynaecology (155).

READ MORE: What's really going on behind the England-Scotland waiting list divide? 

It comes after a row in August when UK Health Secretary Steve Barclay suggested that the devolved governments in Scotland and Wales should consider referring long-wait patients to England for faster NHS treatment as part of the national drive to clear waiting list backlogs.

In England, the number of two-year waits had already reduced to 314 by the end of June. 

The Scottish Government previously pledged to eradicate two-year waits "in most specialties" for inpatient and day case treatment - procedures which require an admission to hospital - by the end of September 2022, with 18-month waits supposed to be all but gone by the end of this month.

The two-year wait target was missed and the 18-month target is not on track.

According to PHS, by the end of June this year there were still 6,831 two-year waits on inpatient and day case lists for NHS Scotland - down from 9,535 a year ago - and 17,201 waits in excess of 18 months, a reduction of just 3.5% year-on-year.

The PHS report also shows a year-on-year increase in the number of patients who have been waiting over a year - from 34,458 to 36,628 - as the overall size of the waiting list continues to climb.

By the end of June it exceeded 149,000 compared to an average of around 77,600 in the year before the Covid pandemic led to severe restrictions on planned care.

READ MORE: Hundreds of hospital wards closed due to Covid outbreaks 

Dame Jackie Baillie, Scottish Labour's health spokeswoman said the crisis was "spiralling out of control".

She added: “Record waiting lists have soared again, leaving thousands of Scots stuck languishing in limbo for more than a year – but catch-up efforts haven’t worked."

Dr Sandesh Gulhane, health spokesman for the Scottish Conservatives, said the scale of the problem was "scarcely believable". 

He added: "Ministers must focus relentlessly on tackling this backlog because, as well as adding to patients’ suffering, it increases the strain on primary care."

While elective activity has increased year-on-year, PHS noted that admissions remain "markedly down" - by 17% - against the pre-pandemic average.

The overall size of the waiting list has nearly doubled from around 77,000 before the pandemic to around 149,000. More than half (57 per cent) of people are being treated within 12 weeks, but there has also been a huge increase in very long-waits. Health boards have to balance clearing backlogs and dealing with new referrals which may be more clinically urgent (Image: PHS)

Health boards have been trying to balance growing demand from new referrals against the impetus to clear backlogs, which has resulted in them "diverting capacity to longer waiting patients that are less clinically urgent".

The median wait time from consultant referral to treatment was 63 days for patients admitted between April and June, but one in ten patients had waited 473 days or longer.

Separate data for July show that 317 planned procedures were cancelled due to "non-clinical/capacity" reasons, such as staff and bed shortages.

READ MORE: Covid lockdowns left behind a 'pandemic of frailty' among the elderly, expert warns 

Delayed discharge also rose in July, with 1,897 patients typically stuck in hospital for 23 days longer than necessary.

The 9% increase in delayed discharges compared to June is likely to reflect staff absences in social care for example due to summer holidays, but could also reflect a sharp increase in Covid rates since the beginning of July.

Delayed discharge numbers rose in July (Image: PHS)

Patients cannot be discharged from hospital into care homes if they test positive for Covid, nor can care homes accept new admissions if they are experiencing a Covid outbreak.

Meanwhile, NHS workforce statistics show that nursing and midwifery vacancies have climbed to more than 5,600 with consultant vacancies up by 15% on the previous quarter, leaving over 500 posts unfilled.

A spokesman for the Scottish Government said it has increased capacity through the creation of new National Treatment Centres and is investing £1 billion in the NHS recovery plan.

He said: "We are working with NHS Boards to reduce long waits, which have been exacerbated by the impacts of the global pandemic."