Pressures facing the NHS - update: First Minister's speech -16 January 2023

Good morning and welcome.

I am joined by the Health Secretary and the Chief Medical Officer.

I’ll give a further brief update today on the pressures the NHS is facing and the steps we’re taking to alleviate those pressures.

The pressures continue to be severe and the NHS remains under significant strain. This reflects in part very high levels of Covid, flu and Strep A.

These short-term pressures – in addition to longer term challenges that the NHS has been facing since before the pandemic associated with changing demographics and increasing expectations of what healthcare can deliver - continue to make this one of the most difficult winters in the history of the NHS.

And while, and it is important to stress this point,  the majority of patients continue to receive excellent and timely care, the current pressures are having an adverse impact on too many.

That, of course, is despite the extraordinary efforts of staff across the whole health and care system– and once again, my thanks go to them for everything they are doing in extremely difficult circumstances.

Although pressures do remain severe, some of our latest management information suggests a slight easing in some areas.

For example the number of calls to NHS24 reduced in the past week.

And feedback from NHS Boards has been that the situation in accident and emergency is also stabilising and obviously we will see the weekly statistics published tomorrow morning.

That said, A&E waiting times for many are still far higher than they should be.

And that is caused, to a very significant extent, by the fact that hospitals remain very full. Despite some initial, very initial, indications of a very slight easing of some winter pressure in the past week, hospital occupancy is still very high at this stage.

In summary, therefore, pressure remains intense but we do hope to see a further easing of it in the weeks ahead – and of course we remain focussed on supporting the service to address these pressures.

I chaired another meeting of the cross-government resilience committee last Friday.

Actions remain focused on two key areas.

First – ensuring as much advice and support as possible is available to help people, where safe and appropriate, to avoid attendance at hospital.

The Ambulance Service “Hear and Treat” and ‘See & Treat’ initiatives, ‘Hospital at Home’, and the continued build-up of NHS 24 capacity are all important in this regard.

And, second, ensuring timely discharge from hospital of patients generally, but in particular, tackling delayed discharges.

The Health Secretary’s announcement last week of additional funding for health & care partnerships to secure available beds in care homes is important in that regard.

Of course, the use of care beds on an interim basis is not new – there are already around 600 beds being used for this purpose - but this additional funding will help create even more capacity.

Since that announcement was made, detailed guidance has been issued and Health and Care Partnerships have been working with individual care providers to identify available beds, and match them with patients as appropriate. The Resilience Committee will be receiving regular updates on progress.

In addition to securing additional care home capacity, I can confirm that health boards are being asked to review – before the end of January -  all discharge plans in acute and community hospitals to identify any patients who should be discharged more quickly and help resolve any issues that might be preventing their discharge from hospital.

I also indicated last week that guidance was being issued giving health boards the flexibility, during this period of intense pressure, to take action they consider necessary and appropriate to protect critical and life-saving care.

At present, three health boards – NHS Borders, NHS Ayrshire & Arran and NHS Greater Glasgow & Clyde - have temporarily paused non-urgent elective procedures in order to prioritise more urgent treatment for those who need it.

Now, pausing non-urgent electives, while sometimes, as is obvious, necessary for a short period, nevertheless lengthens waiting times for patients.

So I can confirm that the government is currently working with the Golden Jubilee and with other health boards to make additional capacity available for elective operations over the weeks to come, to minimise the knock on pressure on waiting times. That will include weekday and weekend capacity, and support specialities such as ophthalmology, orthopaedics and general surgery. 

Now the final development since last week that is, I think, worth briefly mentioning relates to NHS pay negotiations.

I am very pleased to say that – as a result of further discussions between the Health Secretary and  health trade unions last week – the prospect of any immediate strike action in NHS Scotland has been removed.

It is hard to overstate the importance of that. I don’t want NHS staff to feel the need to strike at any time, but the impact on patients and indeed on staff in this period of acute pressure would have been especially difficult.

I want to thank health trade unions for agreeing to move forward quickly now to discussion and, I hope, early agreement of next year’s pay deal.

Lastly, let me just round off with an appeal to the public –

For those eligible, please get your flu and Covid vaccines if you haven’t already.

To everyone - to help reduce the risk of getting and spreading infection – please remember as we all learned during the toughest times of the pandemic the importance of hand washing and good ventilation and please consider wearing a  face covering on public transport or in indoor public places, including healthcare settings like GP waiting rooms or hospitals.

So with these relatively brief comments, I will now move straight to questions.