HEALTH MATTERS: We have many people waiting longer for operations than we would wish, says NHS Highland chief officer
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There has been a lot of coverage of our preparations for Covid-19 and how we responded to the virus in NHS Highland.
Although the numbers of people hospitalised with Covid-19 in our area were lower than some other health boards, we still had to take precautions, like screening every patient being admitted to our hospitals. This changed the way our hospital functioned.
There was a significant impact on our intensive care beds relative to the overall number of beds we have available. We needed to close wards and theatres and reassign beds and colleagues had to work flexibly across areas to make sure we could care for those affected by Covid-19.
Covid also means we have to keep patients further apart, carry out extra cleaning, and allow extra time to put on and take off PPE – all factors which reduce the space and time we have to treat people.
Fortunately, following this latest lockdown, we are now seeing a reduction in numbers of people across NHS Highland with Covid-19 and the vaccination programme is well under way.
So now comes ‘remobilisation’ – bringing back the services that couldn’t be continued at the height of the pandemic. We are working closely with Scottish Government and other partners to look at how we can step services back up safely. This will take time, and you will continue to see different ways of working as we try to help as many people as possible. This will include how we deliver our inpatient and outpatient services, with some utilising new delivery methods such as virtual consultations.
Key to remobilisation and heavily impacted are our surgical services, including orthopaedic surgery. The orthopaedic service has been particularly affected by the impact of the pandemic, as many of our theatre teams were deployed to support patients requiring intensive care and this significantly reduced available theatre capacity, meaning we could only deliver urgent surgery.
In addition, we needed to change the spacing and use of bed capacity and wards. This meant the ward normally reserved for elective orthopaedics was no longer available through the pandemic. As we remobilise we will apply our clinical prioritisation framework, ensuring early access for those requiring emergency, urgent and cancer services.
We know we now have many people waiting longer than we would wish for operations and understand how frustrating it can be to have to wait to access services and clinical treatment. We are working as rapidly as we can to progress reorganising the hospital to ensure dedicated beds for people awaiting surgery, including making joint replacements available. Additional operating will commence this month, and those with the most urgent clinical need will be prioritised.
It will take time to remobilise to our full capacity and to offer treatment to all patients waiting. To help address the increase in waiting times, we will be looking at all options to offer treatment as early as possible to those waiting.
To help increase capacity for patients recovering from surgery, we will be looking at ways to get people home from hospital with access to rehabilitation services or to a facility closer to home. This will allow us to protect the finite resources we have to deliver surgery and allow us to get to people more quickly on the waiting list.
We ask that you work with us at this challenging time for our health services; we are working hard to recover quickly, but it is not straightforward and will take time. To help keep patients informed, we will be writing directly to individuals that are waiting.
We also want to provide a more interactive arrangement to respond to questions that our patients may have. To help with this, we are introducing a central contact number to make access to updates and information easier for those waiting and also to support our front line clinical teams to focus on service delivery.
Further updates and information on remobilisation will be made publicly available as plans progress to address the impact the pandemic has had on our services.
• Katherine Sutton is chief officer (acute) at NHS Highland.
