NHS Lothian has been forced to postpone all non-urgent elective procedures and outpatient appointments amid staff shortages and rising patient demand.
The health board said increased levels of general staff sickness, annual leave, and self-isolation led to a “significant reduction” in nurses and midwives during June and July.
These shortages, combined with rising numbers of patients, led to longer waiting times, especially in the emergency department, and caused non-urgent elective surgery and outpatient appointments to be postponed.
On Friday, the health board outlined a range of measures to mitigate the pressure being faced across the community and acute hospital sectors.
Around 460 new nurses are expected to start over the next two months, while extra admin and domestic support has been enlisted to allow clinical staff the time they need to work with patients.
The new starts will join an increased number of health support workers who have formed special “bed-busting” teams to ensure that patient transfers are facilitated and that beds are made ready.
Extra staffing and new pathways will take time to bed in, so shorter-term measures are being put in place to ensure that staff can continue to deliver patient-centred care for those who need it most.
On a day-to-day basis, staffing levels will be monitored routinely and decisions will be taken at “safety huddles” in relation to how best to deploy staff across a site, partnership or on pan-Lothian basis.
Staff are being offered extra shifts, if they choose, to help maintain the required mix of skills and experience, and wards which have fewer numbers of hospital patients are being merged to maximise safety and staffing.
Non-urgent outpatient appointments and elective procedures have also been postponed so that clinic and theatre staff can be redeployed to the areas where staffing is needed most.
The move comes two days after NHS Borders cancelled all scheduled routine operations until the end of next week due to pressure on services.
Professor Alex McMahon, nurse director at NHS Lothian, said: “We are doing everything possible to mitigate the additional pressures we are facing, however we have to be realistic.
“These challenges will not disappear overnight. We continue to work through appointments that have already been rescheduled in recent months and to see people who may have delayed seeking treatment because of Covid-19. This will take time.
“We also continue to be restricted in the number of people we can see each day because of the enhanced infection control measures in place. Covid is still with us.”
All those who live in the region are being urged ‘to do their bit’ to support the NHS.
Professor McMahon added: “The pandemic has taught us to reconsider ‘normal’ and teams across Lothian are investigating ways of streamlining services and working smarter to ensure we can continue to deliver the best possible care for our patients.
“However, everyone has a part to play and we are asking people to remember that the way we access urgent care has changed.
“If you think you need to visit A&E, but it’s not life-threatening, or you think you need to visit a minor injury unit, call NHS 24 on 111 first, day or night.
“NHS 24 will direct you to the right care in the right place, and NHS Lothian is working with NHS 24 to provide appointments for minor injury assessments to reduce the length of time spent waiting in busy hospital waiting rooms.
“It is important too to remember that there is self-care information on NHS Inform, and local pharmacies, GPs or dental practices or opticians might be the most appropriate route to treatment and care.
“If it is an emergency always call 999 or go to your local A&E.”