THE Scottish Government has been accused of "quietly dropping" key targets from its NHS recovery plan amid a slower than expected increase in activity.
A progress report on NHS re-mobilisation published last week made no reference to previous aims of increasing inpatient and day case procedures by 10 per cent in the current year, and 55,500 by 2025/26, above pre-pandemic levels.
Previous targets for increased outpatient and diagnostic capacity were also omitted.
A Scottish Government spokesman insisted that the targets remain.
The report said the Government remains "absolutely committed" to the Recovery Plan, first published in August 2021, but added that it is "important too that we can adapt, update and refine our plans and our services as our national circumstances evolve".
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It noted that the Omicron variant - first detected in November last year - had "led to inpatient numbers higher than we had ever seen before, and since then, our health boards have had to respond to waves on an almost quarterly basis".
Before Covid, Scotland's NHS carried out around 270,000 planned inpatient and day case procedures per year.
The original five-year plan envisioned a sliding scale of increasing elective activity, climbing from an extra 27,500 procedures during 2022/23 to 55,500 by 2025/26 - equivalent to 10% and 20% gains respectively on pre-Covid turnover.
However, between April and the end of August this year, the number of elective operations carried out - 94,807 - was 25% lower than the same five-month period in 2019.
There were signs of improvement by August as activity returned to its highest levels since February 2020, but the deficit remained 16% - equivalent to 4000 fewer planned surgeries.
Tuesday's progress report compares performance against 2021 only, noting that "recovery and reform of planned care in the last year has been directly impacted by the need to pause activity to allow boards to respond to the various waves of Covid-19".
It describes a 7.8% increase in scheduled operations during April to June this year, compared to July to September 2021, as "significant progress".
A major plank in the recovery plan was the rollout of a national network of elective hubs, known as National Treatment Centres (NTCs), dedicated to providing diagnostic scans and surgery such as hip replacements separate from the main acute hospitals.
Three - in Fife, Forth Valley, and Inverness - were due to launch in 2022, but will not be up and running before Spring next year, followed in "late summer" by an expanded orthopaedics, endoscopy and general surgery service at the Golden Jubilee Hospital.
Combined, the four centres - mainly focused on orthopaedics and ophthalmology - are initially projected to provide "over 12,250 additional procedures, dependent on workforce", according to the updated recovery plan.
The original target for 2022/23 onwards was 15,500.
Opening dates for the remaining NTCs in Tayside, Grampian, Lanarkshire, Lothian, and Ayrshire and Arran - originally earmarked for 2025 or 2026 - are now subject to "ongoing business case development".
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Key to delivering the NTCs is the recruitment of 1,500 additional clinical and non-clinical staff by 2026.
Progress against this target is unclear, with Tuesday's report stating only that the Scottish Government remains "committed" to it and is "supporting health boards to utilise a range of recruitment and retention options to meet this requirement".
On outpatient activity, the original recovery plan promised 58,000 additional appointments in 2022/23 rising to 140,000 more than the pre-pandemic average by 2025/26.
However, between April and the end of June this year, just under 302,000 new outpatient appointments took place - 18% below the average per quarter in 2019.
Again the updated recovery report compares performance against 2021 instead, noting a 7% increase in outpatient activity compared to April to June last year.
It adds that activity in this area "continues to be impacted by an increase in unscheduled care, and high levels of staff absence".
On diagnostics - such as CT scans, MRI, and endoscopy - the original recovery plan set "ambitious but achievable" goals of 78,000 extra diagnostic tests in 2022/23, rising to 90,000 by 2025/26.
The progress report notes that a combination of six mobile MRI and five mobile CT scanners, plus five additional endoscopy rooms, had boosted capacity for diagnostic procedures by 12,000 by April.
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It also cites Colon Capsule Endoscopy - introduced in 2020 to help detect bowel cancer - for delivering 2,500 screenings since April 2021, while cytosponge - used instead of endoscopy to detect those at risk of oesophageal cancer - is reported to have been used in 4,700 patients since its introduction in September 2020, including 3,000 in the year to April 2022.
However, this still appears to leave the Government at least 60,000 short of it original 2022/23 target.
Labour Jackie Baillie said: “It’s plain for all to see that the SNP’s so-called NHS recovery plan is not worth the paper it is written on.
“Workforce shortages and delays to the opening of the SNP’s flagship national treatment centres demonstrates once again this Government’s record of failure.
“Thousands of patients are falling through the cracks and lives will be lost if action is not taken now.”
Scottish Conservative Shadow Health Secretary Dr Sandesh Gulhane MSP: “[Humza Yousaf] has quietly dropped these targets because he’s come nowhere near to meeting them.
“On his watch the NHS has lurched from crisis to crisis and his winter plan doesn’t inspire confidence that we’ll avoid a catastrophic situation across our health service in the coming months."
A Scottish Government spokesman said: "The increased capacity targets for planned care set out in the NHS Recovery Plan remain.
"The Recovery Plan also identified key risk, such as high levels of uncertainty on to the future trajectory of Covid-19 and its potential for increased Covid related pressures on the system, and mitigations."
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