Update on Action to Maintain Critical Health Services
NHS Forth Valley is to postpone a number of non-urgent operations over the next few weeks to help reduce pressure across the Forth Valley Royal Hospital site and free up staff to support critical health services. The action is being taken in response to a significant increase in Covid-19 infections which has resulted in high numbers of staff absences and added to existing service pressures.
This is the first time the Health Board has taken the decision to postpone planned operations since non-urgent health services were restarted in August 2020. Since then, staff have worked tirelessly to maintain the delivery of a wide range of planned surgery, day case procedures and outpatient clinics alongside emergency and urgent care. However, a recent rise in the number of staff having to self-isolate, along with capacity pressures, means that some non-urgent operations are now being postponed for a four-to-six week period. Everything possible will be done to reschedule the postponed operations as quickly as possible with the aim of giving any patients affected a new date for their surgery no later than 6 weeks after their original date.
This temporary measure will help protect vital emergency, cancer care and other critical health services as it will free up staff to support essential health services and provide cover for areas experiencing significant staff shortages due to Covid-19. It will also free up capacity to deal with an anticipated increase in the numbers of patients who may require to be admitted to hospital with coronavirus related illnesses whilst helping to maintain vital services for patients with other serious illnesses and injuries who require urgent care and treatment.
Over the last few months, health services across Forth Valley have come under increasing pressure due to a high number of patients requiring inpatient care for both non-Covid and Covid related health conditions. Local social care and care home services across Forth Valley are also facing significant staffing pressures along with increasing demand for home care, particularly for people with complex needs. This means that some patients who are clinically well enough to leave hospital can often face delays in returning home or moving to a local care home. This reduces the number of beds available for new admissions and means some patients have to wait for longer periods in the Emergency Department for a suitable bed to become available. Over the last few weeks, the rapid spread of the Omicron variant has led to record numbers of Covid-19 infections with very high levels in Forth Valley and the rest of Central Scotland adding to existing service pressures.
Cathie Cowan, Chief Executive of NHS Forth Valley, said that staff had worked hard to try to avoid taking this action but that it was necessary to protect critical health services. She explained: “Increasing capacity and Covid related staffing pressures are placing additional strain on already over-stretched local health and care services and we expect these pressures to intensify over the next few weeks. We have therefore taken the difficult decision to postpone some non-urgent operations in order to maintain critical health services. This will free up staff to support areas experiencing significant staffing shortages and increase the number of inpatient beds available to ensure patients who are seriously unwell can continue to receive the vital care they need.
“I know that this decision will be very disappointing and I would like to apologise to local patients who have had their operation postponed. Everything possible will be done to reschedule the operations affected as quickly as possible and we also plan to review capacity on a weekly basis so that we can restart activity sooner if it is possible to do so.”
Work is also continuing with partners and local voluntary organisations to reduce delays for the many patients in local hospitals across Forth Valley who are well enough to leave but are experiencing delays in being discharged. This includes identifying alternative, more suitable, accommodation and facilities where people can stay on a temporary basis while they wait for a package of care or a place in a local care home.
A number of actions have been taken over the last three months to try to reduce pressure on local health and care services. This included opening additional inpatient beds and treatment areas and recruiting additional healthcare support workers to support care at home services. NHS Forth Valley has also invested in the expansion of the local Hospital @ Home team to support more local people in their own homes. However, despite extensive efforts, the number of patients experiencing delays in being discharged from Forth Valley Royal and local community hospitals remains very high.
The Emergency Department at Forth Valley Royal Hospital is continuing to see high numbers of seriously unwell patients requiring to be admitted to hospital for treatment. Many of these patients have to stay for longer periods of time due to the severity of their health conditions which is adding to pressures on inpatient capacity during the busy winter period. The recent rise in levels of coronavirus infections, along with the impact of other respiratory and winter-related illnesses, is likely to lead to a further increase in the number of patients requiring acute hospital care over the coming weeks. Unlike many other NHS Boards, NHS Forth Valley only has one Emergency Department which is therefore the only site used to calculate our performance against the 4-hour access standard. Work continues to improve our performance against this standard as part of wider plans to improve capacity and flow across our local health and care system.
Local people can help relieve pressure on local health services by not attending the Emergency Department if they have a minor injury or illness. They should call NHS24 on 111 first for advice, day or night. They can arrange a telephone or video consultation with a local healthcare professional who can organise a priority appointment at our Minor Injuries Unit or Urgent Care Centre for patients who need to be seen so that they don’t need to wait when they attend.
Local pharmacists are able to provide healthcare advice and treatment and, as part of the Pharmacy First service, can provide free medication without the need for a prescription for many common healthcare conditions. Local GP practices across Forth Valley remain open and continue to offer telephone, video and face-to-face appointments and home visits, where appropriate. You can also arrange an appointment directly with other healthcare professionals, such as mental health nurses, physiotherapists, and advanced nurse practitioners, who are now working alongside GPs as part of the wider practice team.