An insight into the recovery of ‘crucial’ NHS services across Scotland shows many are yet to fully reopen, more than four years after they first closed due to COVID-19.

NHS health boards, responding to a series of Freedom of Information requests submitted by the Scottish Conservatives, say several of their services continue to operate at a reduced capacity – with some still completely unavailable to patients in certain NHS board areas.

NHS Fife has revealed that its older adult day hospitals and GP open access services for X-rays have not resumed at all since closing due to the pandemic.

The health board says its older adult day hospitals in Central and West Fife were not reopened as the ‘service structure changed’. This involved service redesign to offer develop older adult community mental health teams.

However, NHS Fife adds that recommencement of some older adult service group work is in the planning stages depending on staff training availability.

Additionally, Fife’s face-to-face parenthood education support within women’s services remains shut. 

NHS Greater Glasgow and Clyde said all of its services were affected in some way by the pandemic, adding that any services no longer in operation have been modified through service redesign.

Services at the minor injuries unit at Ladyhome Hospital in NHS Lanarkshire have also not resumed and neither have hydrotherapy services in NHS Borders.

Published in 2021, Scotland’s NHS recovery plan outlines the government’s commitments to reduce high waiting times, address the workforce crisis and improve overall activity and delivery of services.

While emails released by the Scottish government to healthandcare.scot in 2022 revealed haste to finalise the NHS recovery plan, with weekend and late-night revisions, the plan’s delivery has since been criticised.

Earlier this year, Audit Scotland called for transformation across NHS Scotland in the face of increasing demand, with its report detailing that hospital activity has been ‘outpaced’ by rising need.

NHS Lanarkshire notes in its response that difficulties with resuming Ladyhome Hospital’s minor injuries unit stem from challenges in recruiting required nursing staff.

Responding to the NHS review, health leaders said it painted a ‘bleak picture’, with BMA Scotland’s Chair warning that the government’s recovery plan was inadequate and staff are exhausted.

Now, these FOI responses reveal that although some services have resumed, others are operating at reduced capacity, while some health boards could not provide this information relating to service recovery from the pandemic.

NHS Western Isles says that, while its dental services have not returned to normal, all other services which were shut due to the pandemic are now ‘business as usual or well on the way to full recovery’.

NHS Dumfries and Galloway, NHS Lothian and NHS Orkney did not provide information about their service closures.

Scottish Conservative shadow health secretary, Dr Sandesh Gulhane MSP said these “damning revelations” highlight the failure of Scotland’s NHS recovery plan:

“It is astonishing that many crucial healthcare services across Scotland are still not up and running, four years after COVID-19 hit our NHS. 

“We see the deadly delays patients are suffering at A&E, thousands of operations being cancelled each month and one in seven Scots languishing on a waiting list.

“It is simply unacceptable that some services are still not operating at all and that will be having a deeply damaging impact on patients’ health, which I see first-hand as GP.”

NHS Ayrshire and Arran says most of their paused services – including long term condition reviews, addiction reviews for those on opiate substitution therapy – have resumed.

Meanwhile, it says its follow up reviews for those recently admitted have not yet resumed – stating that it is currently reviewing its admission process.

The health board adds that some services like the way referrals were triaged will not return to pre-pandemic delivery as assessments revealed changes led to an improvement in deliver.

In terms of mental health support, NHS Ayrshire and Arran said neurodevelopmental assessments with CAMHS were put on hold during the pandemic but reinstated as quickly as possible.

No other mental health services in Ayrshire and Arran were paused.

Audit Scotland’s report said that despite a number of strategies and plan to deliver on healthcare, many areas of the government’s recovery plan remain ‘behind schedule’ and there is ‘no overall vision’ for NHS Scotland.

Since then, Neil Gray has said a range of “immediate and longer-term reforms” to the NHS are being taken forward by government, stating in February that he will set out a vision for future NHS reform in the coming weeks.

healthandcare.scot asked the Scottish government for comment on these FOI releases and an update on its NHS reform plans.

A Scottish government spokesperson said:

“An initial investment of £30m, the first instalment of a £300m investment over three years, will target reductions to pandemic backlogs, including orthopaedics treatments, diagnostics for cancer referrals and patients waiting the longest time.”

The government said ministers are ‘committed to reforming health and care services’, with the Deputy First Minster promising national engagement on the future of the NHS.

It added that the Cabinet Secretary ‘will set out these plans in the coming weeks’, and the NHS will always remain in the hands of the public and be free at the point of need under this government.

Read more: COVID dentist recovery insight underway; Auditor General: Difficult choices for Scotland's NHS; Urgent workforce reforms needed for Scotland's NHS; Psychiatrists in ‘disbelief' over cut funding

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