Non-urgent elective procedures in Lanarkshire still on hold as ICU numbers too high

NHS Lanarkshire has delayed the reintroduction of non-urgent elective procedures due to continuing high numbers in intensive care.

It was decided in January that non-urgent elective procedures would be temporarily postponed, along with a targeted range of outpatient appointments. A number of clinically urgent and priority procedures were not affected.

The move was to allow the health board to focus on Covid-19 inpatients and emergency care.

Treatments for urgent cancer care remained in place and all three acute sites continue to operate an emergency service for theatres and diagnostics.

The number of patients being treated in Lanarkshire hospitals with Covid-19 have now dropped to 102 as of yesterday, falling from a high of around 350 during the second half of January.

However, Covid ICU numbers remain high, peaking at 25 in late January and currently sitting at 10 as of Tuesday 9th March.

25 ICU beds are currently occupied including non-Covid patients, with 21 of these level-three patients who require advanced respiratory support and monitoring.

Judith Park, NHS Lanarkshire director of acute services, said:

"The number of Covid-19 patients in our hospitals is falling. However, ICU numbers remain stubbornly high for both Covid and non-Covid patients and there is still continued pressure on our resources. There are challenges to overcome before we are able to reintroduce non-urgent outpatient appointments and planned procedures but we will continue to review this on a weekly basis."

Dr Rory Mackenzie, University Hospital Monklands chief of medical services, added:

"One of the reasons ICU numbers aren’t falling as quickly as overall hospital numbers is because of a lag with the numbers due to patients spending a substantial amount of time in ICU. The length of stay is far greater than pre-Covid levels so beds are occupied for longer. As numbers fall, patients will still need to come to ICU.

"One of our patients recently spent 67 days in ICU – 61 of them on a ventilator – at University Hospital Hairmyres."

NHS boards yesterday reported 50 recently confirmed patients in ICU (for 28 days or less), a decrease of nine from the day before. This compares with around 220 in ICU at the peak in April 2020.

In addition, NHS boards reported 28 long stay Covid-19 patients in ICU (for more than 28 days), a decrease of one from the day before. This is 35.9% of all Covid-19 patients in ICU.

Judith said: "There are other challenges to consider such as availability and wellbeing of critical care staff, some of whom are redeployed, and we continue to have strict control measures in place such as physical distancing measures which impacts on ward space.

"We are also busy caring for patients who don’t have Covid, as highlighted in the high number of non-Covid patients we currently have in ICU.

"The safety of our patients and staff is of paramount importance and we continue to take all necessary action to ensure safe and effective patient care.

"The decision to postpone any appointment is not one that we take lightly and I apologise for the impact this will have on patients.

"Most patients will receive a text message confirming the postponement of their appointment.

"A small number of appointments will still go ahead as scheduled. Appointments will be prioritised based on clinical need and those patients who are deemed clinically urgent will be rebooked. Patients will receive a letter, text message or voice message giving details of their new appointment."

Maternity and neonatal clinics will continue as normal in the meantime. Appointments for urgent referrals, including cancer referrals, will also continue.

Judith added: "It is vitally important that everyone continues to follow the stay at home Scottish Government guidance to help save lives.

"The general measures to minimise the risk of Covid-19 remain the same – face coverings, avoid crowded places, clean your hands, two metre distance, self-isolate and go for a test if you have symptoms."

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