The Scottish Government needs to be clearer about how long it will take the NHS to recover from the Covid-19 pandemic and to reform services.
The government's NHS recovery plan aims to reduce the healthcare backlog and change how services are delivered.
But the plan doesn't contain the detailed actions that would allow progress to be accurately measured. It also lacks robust modelling to understand demand on services and the NHS's capacity to meet that demand.Read the report in detail
|Dec 2019||Dec 2020||Dec 2021||Dec 2022|
|Percentage of A&E attendances seen within 4 hours||83.8%||86.3%||75.7%||62.1%|
|Average number of beds occupied each day due to delayed discharges||1,465||1,076||1,522||1,878|
|Number of people in hospital with Covid-19 (7-day average at end of Dec)||-||1,190||833||1,267|
|Number of calls made to NHS 24 111 service||-||-||182,200||217,989|
|NHS Inform website page views (core service, excludes Covid-19)||-||-||10.7m||12.4m|
More people are being added to waiting lists than are being removed from them. They are also waiting longer for treatment, including those suspected of having cancer.
Inpatient: a patient who lives in hospital while getting treatment
Outpatient: a patient who attends hospital for treatment without staying overnight
Note: Before October 2019, some patients waiting for a key diagnostic test were included in the new outpatient waiting list. From 1 October 2019, people waiting for these tests were no longer covered by this standard. This largely explains the pre-pandemic decrease in the outpatient waiting list towards the end of 2019.
Health boards continue to find it hard to recruit the doctors, nurses and other health professionals needed to make sure NHS services are sustainable in the long term.
There's been a 17 per cent rise in people who can't leave hospital because often the social care they need is not available.
Note: 1. Nursing agency and bank staff expenditure figures do not take into account inflation.
The Scottish Government, Public Health Scotland and NHS 24 launched an online waiting times platform for the public in 2022. It shows the median waiting time experienced by patients. But health boards told us that, taken in isolation, this information is not an accurate indication of waiting times.
The Scottish Government is moving ahead with the innovation and reform essential to NHS sustainability. There are early signs of progress, but it is too soon to gauge the impact of this work.
Ten new NTCs are planned and are expected to deliver 73 per cent of increases in NHS procedures, such as for hip replacements, by 2025. The first three were due to open in 2022 but have been delayed. And timescales for the remaining NTCs are unclear.
Some recruitment targets in the NHS recovery plan have been achieved but other key targets are at risk or have been missed.
Every NHS board is facing significant financial challenges. These include:
All these factors could limit investment in recovery.
the Scottish Government health budget in 2022/23
has been committed to NHS recovery
the Covid-19 funding in 2022/23 no longer covered by the UK Government
rise in cost of bank and agency nursing staff since 2017
rise in delayed discharge (October 2021 to October 2022)
fewer operations scheduled in 2022 than 2019
The Scottish Government has set out the big challenges facing the NHS.
But ministers have to prioritise which NHS aims can realistically be delivered and be more transparent about the progress they're making.
The government also needs to clearly explain to the public what level of service they can expect, including waiting times.Stephen Boyle Auditor General for Scotland