THE number of planned operations being carried out on the NHS in Scotland fell in April amid warnings that workforce shortages are "limiting" recovery from the pandemic.
Public Health Scotland said there had been a "noticeable decrease" in the number of procedures being cancelled at short notice due to problems such as lack of beds, theatre space or staff absences, but noted that elective activity continues to lag behind pre-pandemic levels and had dipped in April.
Its report shows that 18,107 operations were carried out on NHS Scotland as a whole, compared to 24,894 in April 2019 - a difference of 27 per cent.
Excluding Lothian - which had been unable to provide data until recently - the report also shows a 22% month-on-month drop in the number of elective procedures performed from 19,591 in March to 15,292 in April.
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It comes after figures last week revealed that nearly 7000 people in Scotland who are on NHS waiting lists for an inpatient or day case procedure have been waiting for two years - something that was supposed to be virtually eradicated by September 2022.
In England - which has moved faster to clear backlogs using surgical hubs and more private hospital referrals - fewer than 600 patients are now facing such lengthy delays.
NHS bosses who were quizzed by MSPs on waiting times said the Covid pandemic had "exacerbated" existing problems.
Speaking at Holyrood's health and social care committee, Carol Potter, chief executive at NHS Fife, said it was "looking at a range of options to increase throughout in our elective capacity" including the use of digital pre-op assessment apps for patients and reviewing different ways of working for clinical teams.
She added: "Despite all that, we have got workforce challenges and that is a limiting factor and our capacity is struggling to keep up with demand.
"That is prevalent across all areas, so we have all got very detailed and robust forward plans about our ability to address waiting times going forward both in terms of the length of the wait and the size of the waiting list, but the challenges do remain and there are a number of specialties that are particularly stretched and some of that is down to workforce in those areas."
Calum Campbell, chief executive for NHS Lothian, said pressure on social care was also slowing the pace of recovery.
He added: "Our colleagues in social care are under significant pressure - that is limiting the capacity within the NHS and I think we have to accept that health and social care are so fundamentally linked, so if we could ease the burden on social care, from my perspective, that would be my biggest ask."
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It comes as the latest data on NHS workforce shows that there were more than 7,000 NHS vacancies by the end of March this year, including over 5,500 unfilled nursing and midwifery posts.
This is down from a peak of nearly 6,700 at the end of 2021, but the cost of filling rota gaps with bank and agency staff has soared amid inflation.
In the year to March 2023, NHS Scotland spent almost £170 million on agency nurses and midwives - up 91% year-on-year - plus £119.6m on locum doctors, up 17% year-on-year.
Eileen Mckenna, associate director for the Royal College of Nursing (RCN) Scotland, said: “Thousands of registered nurses are missing from teams across Scotland, impacting on the safety and quality of patient care and putting even more pressure on staff who are already working extra unpaid hours to cover gaps and going home feeling that they are unable to provide the quality of care they want.
“To fill these gaps in the nursing workforce, the reliance on agency staff has increased dramatically, costing a staggering £170m last year.
"While some investment in bank and agency nursing will always be needed to cover unexpected events and ensure safe patient care, it is not the solution to the workforce crisis and the huge increase in spend is simply not sustainable."
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Dr Joanna Bredski, deputy chair of the BMA’s Scottish Consultants Committee, said the NHS was "desperately short" of doctors.
She added: "It is little wonder that some doctors are choosing to leave their permanent posts and take up locum posts for a better work life balance and better pay.
"Filling posts permanently is proving to be a major challenge and the Scottish government must up the ante to improve this situation."
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