Recovering planned care in Scotland
03 June 2021
The health and social care system in Scotland is emerging from a period of significant operational pressures. On one side are new challenges on how planned care services with increased backlogs and record patient waiting lists should recover. One the other is the continuing need to be resilient against potential further waves of the virus and the roll out of the COVID-19 vaccination programme. Across the health and care system, staff are fatigued, having worked tirelessly throughout the pandemic to provide essential front-line services.
In May 2020, the Scottish Government published Re-mobilise, Recover, Re-design: the framework for NHS Scotland. This provides NHS Boards, together with partners across the health and social care system, the apparatus to safely and effectively re-mobilise services paused at the onset of the pandemic. Boards, along with their partners, have since developed and started implementing their Remobilisation Plans. In line with these, elective care was restarted in June 2020. However activity remains below pre-pandemic levels and waiting lists continue to increase.
The most recent data from March 2021 shows the number of patients waiting for an outpatient appointment in Scotland was up from December figures, and 14% higher than in the equivalent pre-pandemic quarter in March 2019. The waiting list for endoscopy, a diagnostic test for conditions such as cancer, had 33,444 patients on it at the end of March 2021, 43% more than the previous year. Of this number, 65% were waiting longer than six weeks, compared with 40% in March last year.
And these numbers don’t account for unseen demand across the system. Public attitude polling data from the past several months suggests that around 25% of the Scottish population may have been avoiding seeing their GP for health issues unrelated to COVID-19. This raises concerns about unknown and unmet demand for planned care across the system, and the risk of late presentation of conditions that will be more difficult and resource intensive to treat when they are uncovered.
Restoring elective activity levels will be critical for the health and care system to recover from the backlog of planned care, and mitigate the impact of the disruption to health and care services throughout the pandemic on longer term health outcomes.
In light of the complexity and scale of the challenge, we’ve set out a way of thinking it through with six key segments, each of which will be critical for managing the issue with a structured approach. These are outlined in our framework for restoration and recovery.