EFFORTS to clear waiting list backlogs and ramp up NHS activity are being jeopardised by the slow rollout of surgical hubs, according to internal Government documents.

Officials warned that a number of the planned national treatment centres (NTCs) are making "limited progress and may take until 2027 to deliver".

The sites are intended to provide dedicated capacity for elective procedures such as hip and knee replacements.

Officials also sound the alarm over an expected shortage of anaesthetists, stating that "this category represents the area of greatest risk". 

They add that this shortfall "may still be addressed via international recruitment options".

READ MORE: The rising cost of agency spending in the NHS - and why it matters 

The concerns are outlined in an Assurance and Action Plan (AAP) report, which was obtained by Scottish Labour following a freedom of information request.

It notes that there is a risk the extra capacity created by the NTCs "may be used to simply replace ‘lost capacity’ created within health boards due to Covid constraints", adding that it "will be crucial that NHS boards urgently restore and build on their pre-Covid treatment capacities".

The Herald:

More than three years on from the first lockdown, NHS Scotland is continuing to carry out around 10 per cent fewer planned operations each month than it was in 2019.

There are nearly 7000 patients still on waiting lists for an inpatient or day case procedure who have been waiting over two years, something that was supposed to be virtually eradicated by September last year.

NHS England has already reduced the number of patients with two-year waits to less than 600, and 18-month waiters to around 10,700 compared to 17,000 in Scotland.

READ MORE: In the NHS recovery drive, is England outperforming Scotland? 

The Scottish Government's original NHS Recovery Plan, published in August 2021 - prior to the Omicron wave - envisioned that the NTCs would be delivering 40,000 elective procedures by 2025/26 on top of an extra 15,500 via existing NHS sites.

That would mean elective inpatient and day case activity was 20 per cent higher than the pre-pandemic average.

However, several sites including Fife, Forth Valley and Highland opened later than planned, and timescales are slipping for other regions.

The NHS Grampian hub, initially scheduled for 2025, is now unlikely to be operational before October 2027, with the NHS Lanarkshire hub pushed back from 2026 to 2028.

The Tayside and Lothian NTCs - both earmarked for 2025 - now have forecast opening dates respectively of December 2026 and December 2027.

The Herald: The original targets for increased activity set out in the 2021 NHS Recovery PlanThe original targets for increased activity set out in the 2021 NHS Recovery Plan (Image: Scottish Government)

These projects were rated as 'red' in the AAP report, meaning that "successful delivery appears to be unachievable" and "there are major issues which, at this stage, do not appear to be manageable or resolvable".

The new Edinburgh Eye Pavilion, due to open in June 2027 as a dedicated cataracts and ophthalmology service, is also rated red.

READ MORE: NHS Scotland waiting lists grow as key targets missed

Internal Scottish Government correspondence, also obtained by Scottish Labour, shows that then-Health Secretary Humza Yousaf had requested a figure from officials on how much extra capacity the NTCs would create this year.

The request was made in February 2023, shortly after the publication of a damning Audit Scotland report which warned that the NHS recovery was off track.

Officials advised Mr Yousaf against using such a figure because "projections included in the NHS Recovery Plan have dropped significantly”.

The Herald: First Minister Humza Yousaf, in his previous capacity as health secretary, was advised against using figures publicly on how much extra capacity NTCs were expected to provide this yearFirst Minister Humza Yousaf, in his previous capacity as health secretary, was advised against using figures publicly on how much extra capacity NTCs were expected to provide this year (Image: Archive)

A Cabinet Secretary briefing dated March 8 also cautioned that there was “no [revenue] funding source” for the NTCs not yet in construction.

Scottish Labour health spokeswoman Jackie Baillie said: “Not content with crashing our health service, the SNP is now failing to deliver the modest ‘recovery plan’ that it promised to implement.

“Our NHS doesn’t just need a recovery plan from the pandemic – it needs a recovery plan from Humza Yousaf.”

A Scottish Government spokesman said elective activity for inpatient procedures and outpatient clinics was now the highest since the beginning of the Covid pandemic. 

He added: “There has also been a continued reduction in long waits over 18 months for outpatients, as well as a significant reduction in long waits over two years since targets were announced last July. 

“There are still unacceptable waits in some specialities, but we remain committed to delivering sustained improvements and year on year reductions through maximising capacity across Scotland and the redesign of services of care.

“The National Treatment Centres will provide significant additional capacity for orthopaedics, ophthalmic and diagnostic treatment. 

"We have already opened two National Treatment Centres this year, with the First Minister visiting Highland NTC this week, and there are two further centres opening later this year.”