Date lodged: 28 August 2018
To ask the Scottish Government whether it will provide an update on any progress being made in reducing waiting times for orthopaedic appointments and treatment in NHS Lothian.
Answered by: Jeane Freeman 25 September 2018
I recognise the waiting times for orthopaedics in NHS Lothian are very much below the level I require, with patients experiencing exceptionally long waits to be seen and treated. NHS Lothian has received £3.7 million as part of the £25 million initially issued to Boards from the £50 million announced at the end of May. The Board are using £500,000 of this funding, plus £1.5 million from Access Support funding to improve waiting time performance for orthopaedics. The further £25 million funding will be issued to NHS Boards shortly
NHS Lothian recognise the issue of growing demand and has undertaken significant work to redesign the musculoskeletal pathway in the community, first for lower back pain through the development of an integrated back pain pathway, and now a foot and ankle and upper limb integrated community pathway. The foot and ankle and upper limb musclosketal allied health professional community pathways has reduced orthopaedic demand by 2,700. They have also redesigned their arthroplasty service to provide a service better aligned to realistic medicine which reduces the number of return appointments. These initiatives have created more additional new outpatient capacity. This combined work has effectively reduced acute orthopaedic demand, and increased service efficiency and productivity - as result of the changes the Board now have 810 more new outpatient capacity which has brought the outpatient service into balance.
The Board are also taking action to reduce the number of cancelled elective orthopaedic operations caused by long stays of hip fracture patients by providing
- Additional Occupational Therapy resource - enable patients to be returned home quicker.
- Additional resource for orthopaedic supported discharge and orthopaedic rehabilitation - to reduce delayed discharges
- Enhanced AHP resource in Midlothian IJB - enable faster flow of patients from Edinburgh Royal Infirmary to rehabilitation
The Board will also make use of the independent healthcare sector to see and treat between an estimated 580-690 of the longest waiting outpatients.
I will be raising the issue of waiting time performance with the Chairs of all Boards at their next meeting.