Key parts of Scotland’s NHS are "seriously short-staffed" after a surge in both the number of Covid cases and medics forced to self-isolate, doctors’ leaders have warned as the Highlands’ largest hospital cancelled all non-urgent operations.
Dr Lewis Morrison, the British Medical Association (BMA) Scotland chairman, said NHS Highland’s decision to put Inverness’ Raigmore Hospital on “code black status” because it had no more capacity was "extremely concerning".
He said the drastic move "may be something of a warning light for much of our NHS" and reflected reports from members in other parts of Scotland about "just how overstretched" the health service is.
Jason Leitch, Scotland’s national clinical director, said the hospital was "the first to show this level of concern" and warned "we can turn the tap of elective surgery off" to prevent the NHS being overwhelmed.
NHS Highland cancelled all non-urgent elective surgery at Raigmore along with outpatient care with the exception of cancer, urgent and some other activities. It said its other hospitals and services were facing similar problems with staffing.
The health board said there had been a perfect storm with many staff off work for their annual summer leave, more being forced to self-isolate thanks to the virus and more than 100 daily cases being reported in the area.
Unprecedented levels of demand
More than 1,300 cases were recorded last month, around a fifth of the total the Highlands have reported since the start of the pandemic, including outbreaks in care homes.
The board said this had resulted in "unprecedented levels of demand" and there were long waits for care at Raigmore’s accident and emergency department.
The announcement came as it was alleged that a series of "miserable" health statistics demonstrated the SNP has failed to fully remobilise Scotland’s NHS after lockdown restrictions were eased.
Only 210,241 operations were carried out in hospital theatres between the start of the pandemic last year and May this year – fewer than half the average recorded over the same period in previous years.
With more people attending accident and emergency departments than at any time since the pandemic started, only 87 per cent were seen within the target time of four hours in May.
It also emerged that delayed discharges – hospital beds blocked by patients who were medically cleared to leave – have surged to the highest level since the Covid outbreak began.
Scotland last week recorded a daily record of 4,234 cases and its Covid rate was almost twice as high as England’s and four times that of Wales.
Scotland’s infection rate is now higher than England’s
A World Health Organisation report said Scotland had six of Europe’s top ten Covid hotspots. Although case numbers have since dropped again, hospitalisations have continued to increase.
Dr Boyd Peters, NHS Highland’s medical director, said: “We are doing all we can to safeguard services but we have had to make the difficult decision to cancel non-urgent work, which I know many will find upsetting and frustrating. We are very sorry that we have had to do this.
“Covid is on the increase again but what is different this time is that we are seeing more medical and surgical activity at the same time. We also have a high number of staff having to self-isolate."
Dr Morrison said: "The news to come out of NHS Highland is extremely concerning and is a stark reminder – if anyone needed it – of just how overstretched our NHS currently is – and has been, even pre-pandemic.
"There is growing pressure and demand across all services of our NHS, and some services are now seriously short-staffed."
Prof Leitch told BBC Radio Scotland that the rise in hospitalisations was "relatively predictable", coming between 10 days and two weeks after the surge in cases linked to the more transmissible Delta variant.
He added: "We need to get the case rate down and stop people needing hospitalised and Inverness is the first to show this level of concern."
Official figures published yesterday disclosed that 1,782 people attending accident and emergency departments in May had to wait more than eight hours for help and 407 people were not treated within 12 hours.
Meanwhile, the number of days hospital beds blocked by patients who were medically cleared to leave but had not been discharged reached 35,348 days in May. This was more than two-thirds higher than the same month last year.
Not fast enough
Annie Wells, the Scottish Tories’ Shadow Health Secretary, said: "While everyone understands the pressure our NHS is under due to Covid, it is clear the SNP’s NHS recovery plan simply isn’t moving fast enough.
“We have hundreds of thousands of patients either having vital operations delayed or cancelled and we have more and more patients not being able to be discharged back into their own communities quickly enough."
The Scottish Government said the NHS still managed to carry out 600 operations daily in May and more than eight out of ten people are seen at accident and emergency within four hours.
A spokesman said: "The Scottish Government is committed to produce the NHS Recovery plan within the first 100 days of this government which will set out in detail how we intend to meet our ambition of reducing waiting times."
He added: "Delayed discharge levels remain significantly below those seen before the pandemic, but an increase in hospital activity in recent months have resulted in more people needing care and support to be safely discharged home."