NHS Scotland waiting lists: £30m of £300m spent one year on

He said the extra investment would see £100m a year spent on cutting wait lists, with a target to get 100,000 patients treated and off the waiting lists by 2026.

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However, figures obtained by the Herald show that just £30m from the £300m fund has been allocated to health boards so far, and year-on-year the size of the inpatient/day case lists has actually increased - including waits in excess of one and two years. 

The number waiting for an outpatient appointment is also up.

In April this year, the Scottish Government announced that it had handed health boards £30m as a "first instalment" from its £300m waiting list fund.

Health boards were allocated sums based on the extra elective workload they promised to take on and complete.

A breakdown of the spending, provided to the Herald under freedom of information, shows that a majority - £7.16m - went towards orthopaedics - with imaging and endoscopy departments involved in diagnostics getting £6.9m and £5.74m respectively.

Cancer, dermatology, ophthalmology and ear, nose and throat (ENT) shared a total of £7.75m, with the remainder spread between various specialties such as general surgery, gynaecology, urology and cardiology.

In total, the investment should enable an extra 12,000 outpatient appointments, around 12,000 inpatient operations, and over 40,000 diagnostic procedures.

The Scottish Government said it is monitoring progress but that additional funding will only be released to each health board "once they have carried out and delivered the procedures outlined in their bid for funding".

It is understood that progress has been slower than expected because acute hospitals are struggling to free up the extra beds, theatre space, and staffing resources needed to plough through additional planned surgeries or diagnostic procedures.

Between June 2023 and June 2024 - the most recent month for which data is available - the total size of the inpatient-day case waiting list in NHS Scotland went from 149,643 to 155,558.

This included an increase in patients waiting in excess of one year, from 36,437 to 37,972, and over two years from 7,052 to 7,146.

Mr Mike McKirdy, a breast cancer surgeon and president of the Royal College of Physicians and Surgeons of Glasgow (RCPSG), said that while nearly 60% of patients undergo operations within 12 weeks of referral, clinicians - who "have the solutions as to how things can be done more efficiently" - should be "empowered" to work with hospital management colleagues to develop new ways of tackling the backlogs. 

With construction of new National Treatment Centres in Livingston, Aberdeen, Perth, Ayr and Cumbernauld indefinitely suspended, he added that it was time to rethink how the £300m is being spent. 

Mr McKirdy said: "What's really needed is to look at what can we do with the facilities we have - how do we get them working, and how do we get the throughput we require?

"Perhaps that means taking theatres that have been mothballed or not thought to be fit for purpose and getting them organised, or getting spaces in outpatients organised so that more patients can be seen?

"I've been a consultant in the Clyde part of NHS Greater Glasgow and Clyde since 1997. In that time, we have opened one new operating theatre.

"We've opened no new outpatient facilities. The facilities that we have in outpatients are exactly the same as when I went to work as a registrar in Paisley in 1990.

"We have no increased the number of rooms where we can do colonoscopy and endoscopy in Clyde since 1986."

Simon Barker, deputy chair of the BMA’s Scottish Council, said there was simply "no flex in the system" to ramp up elective activity. 

He said: “Multiple factors are impacting the ability to tackle waiting lists; infrastructure renewal is long overdue in some areas – which means the facilities to provide sterile operating equipment are frequently breaking down in some Boards, and building/equipment maintenance backlogs are not being addressed leaving some operating theatres unusable.

“There is a shortage of doctors across the NHS exacerbating long wait times and backlogs faced by many patients.

"This means theatre staffing is a struggle and there is an urgent need to do more to recruit and retain staff.

"Consequently, surgeons are having to constantly firefight and prioritise emergency cases."

RCPSG president Mr McKirdy said clinicians should be more directly involved in planning initiatives to drive down backlogs (Image: RCPSG)

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh (RCPE), said it was "concerned" to hear that "very little of the extra investment pledged to reduce waiting lists has reached health boards".

Prof Elder called on the Scottish Government to "redouble its efforts" to tackle the most severe workforce shortages, adding that record levels of delayed discharges within hospitals was "another major concern" limiting access to inpatient wards.

He added: "We hope that the Scottish Government can work with boards, and show a degree of flexibility, in order to get this funding distributed in the rest of this financial year and in the following two years. 

“Many patients are waiting too long for treatments and procedures in Scotland, and this should be addressed urgently."

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Scottish Labour's health spokeswoman, Jackie Baillie, said the SNP had made “big promises with no plan for delivery".

She said: “The SNP should follow the UK Labour government’s ambitious plans to drive down waiting lists by expanding capacity at evenings and weekends, as well as dealing with challenges such as delayed discharge and workforce shortages."

Scottish Conservative health spokesman Dr Sandesh Gulhane, a GP in Glasgow, called on the SNP to "stop dithering and get this money that they promised out to the frontline now".

He said his party would cut backlogs "by introducing ‘Super Saturdays’ and twinning theatres to reduce the wait times between operations" - an initiative piloted in some parts of NHS England.

Then-First Minister Humza Yousaf visits the National Treatment Centre in Fife on April 1 2024 as £30m was released to tackle waiting list backlogs (Image: PA)

A spokesman for the Scottish Government said: “£30 million has been allocated to health boards in 2024-25 to tackle waiting lists.

"We are working closely with Boards to monitor progress and funding is only provided to each health board once they have carried out and delivered the procedures outlined in their bid for funding.

“Through this funding, significant activity is already underway which will see around 12,000 new outpatient appointments, around 12,000 inpatient procedures and over 40,000 diagnostic procedures delivered.

“We are determined to reduce waiting times and continue to work with all boards to maximise current resources and productivity.

"Future funding for commitments will be considered as part of the 2025-26 budget process that will allocate resources to the Government’s priorities of the day.”