NHS Lothian, one of Scotland’s largest health boards, is confronting a projected funding shortfall of over £140 million by the end of the decade, officials have revealed.
The board stated that population growth and an ageing demographic – with the region expected to account for 40% of Scotland’s population rise in coming years – will place increasing demand on health and social care services. While the board managed to meet its budget this year by identifying £60 million in savings, a similar level of savings is anticipated for the coming year.
Maternity services at NHS Lothian are also under intense scrutiny following an unannounced inspection by Healthcare Improvement Scotland (HIS), which uncovered “serious concerns” regarding staffing shortages and a “culture of mistrust” at the Royal Infirmary of Edinburgh. Inspectors highlighted 26 areas where required standards were not met.
Scottish Health Secretary Neil Gray told MSPs last month he was “deeply disappointed and concerned by the findings in the report.” He noted that NHS Lothian had already invested £1.5 million in staffing and recruited 70 new midwives since June, with 30 now in post.
Gray added that he had “nearly lost” his wife during pregnancy due to “inaccurate assessments” carried out at the hospital.
The inspection reported delays of more than 24 hours for some women awaiting induction and accounts of women being left alone in triage rooms for extended periods. Incident reviews also revealed “evidence of medication errors involving student midwives.”
Donna Maclean, chief inspector at HIS, said: “During the course of this inspection, we escalated serious concerns within NHS Lothian to senior staff and the Scottish Government. These concerns related to culture, oversight of patient safety and staff wellbeing within Edinburgh Royal Infirmary maternity services.”
Professor Caroline Hiscox, chief executive of NHS Lothian, described the report as “concerning” and apologised to patients and their families. She confirmed that an improvement plan was ongoing, noting that “wider-ranging matters, such as staffing, recruitment and working culture within the department, will take time to resolve.”
She emphasised that “significant investment and improvements have already been made. More than 70 additional midwives have been recruited and will be in post by the end of December. Thirty of those are already in post and we are now fully compliant with healthcare safe staffing legislation. The other 42 have been recruited to provide additional resilience and to future-proof our maternity service.”
Prof Hiscox added: “I want to reiterate the apology we made to staff earlier in the year when they told us about their concerns over staffing numbers and about a working culture that was difficult, and where bad behaviours were tolerated. That is not acceptable in any workplace. We are grateful to HIS for their expertise and remain committed to working with them and other professional organisations to improve our service for our women, people who use the service and our teams.”
