NHS Tayside is quietly scaling back surgery work to avoid direct action from the government over a £39 million black hole in its finances.
We can reveal the health board is on track to be the second worst performing in Scotland and be plunged into special measures from April.
It means an external team would be appointed to help run services.
But in an explosive internal email leaked to The Courier, bosses set out how they hope a “rapid change of course” will “protect our autonomy moving forward”.
The plan will see surgery pared back until the next financial year in April to hide the extent of the board’s money woes for at least another 12 months.
The move has been described as a “betrayal” of hardworking staff.
What does the email say?
Dr Julie Christie, associate medical director in the surgical care division at NHS Tayside, wrote to all surgical consultants on Friday afternoon.
Her email reveals health chiefs plan to “retract back” to the number of surgical beds already funded for Tayside “as soon as possible” in a bid to curb spending.
Dr Christie confirmed beds for elective surgery at Ninewells Hospital in Dundee will be reduced to 14 in Ward 26, with six trolleys to replace unfunded beds for day patients in Ward 27.
Under the plans, Ward 7 will eventually be used for surgical beds but the number will reduce from 24 to 16.
A number of other changes will be made to bed provision across a number of wards as part of a switch in focus from medical to surgical.
Doctors will “prioritise the cancers and life, limb, organ preserving work”.
But so called “amber” cases – the second highest priority level – will only be seen “where possible” and only if they allow staff to continue to admit higher priority cases.
Meanwhile, changes will be made to how day patients are cared for at Stracathro and Perth Royal Infirmary.
It is understood the plans began to take effect from Monday.
‘I know many will disagree’
Dr Christie’s email states: “I know many will disagree with the acute response but we have to look towards the longer term gains.
“You are all well aware of the current financial position of NHS Tayside.
“We are currently on a trajectory to be overspent by £39 million by the end of the current financial year.
“This will make us the second worst performing board and will result in us being put back into special measures from April, where what we do is controlled by an external team.
“We need to reduce spend over the next 10 weeks to prevent this happening.”
Health chiefs identified staffing costs as the highest spend so will limit the number of bank and agency workers “where possible”.
Trainee doctors will be asked not to work through their breaks in order to save a further £2 million a year.
Staff will also be asked to reduce how long patients stay in hospital for planned and unscheduled procedures as the “best way” to reduce the number of beds needed.
Dr Christie says the measures will be in place for a “short period” until the start of the next financial year.
Staff ‘betrayed by mismanagement’
NHS Tayside was placed in special measures in 2018 following a number of financial scandals, mental health failings and concerns about long-term leadership.
It was de-escalated after more than two years in June 2021.
North East MSP Michael Marra said the crisis at the health board has been “years in the making” and insisted SNP ministers have “utterly failed” to fix the root causes.
“Operating theatres are lying empty across Tayside while people lie at home in pain,” he said – a claim disputed by NHS Tayside.
“This is the worst NHS crisis since it’s foundation and all resources must be mobilised to deal with this crisis of care.
“Hardworking staff are outraged that when they are stretching every sinew they are being betrayed by mismanagement.
“That, at this moment of all moments, managers are choosing to stand down care instead of stepping up provision beggars belief.”
Mr Marra called on Health Secretary Humza Yousaf to act immediately or “get out of the way”.
NHS Tayside denies surgeries lie empty
NHS Tayside denied that surgery theatres are lying empty, said their teams “work tirelessly”, and highlighted their “best performing” four-hour A&E waiting target.
A spokesperson said: “Our teams have not had to pause all electives or declare a blanket cancellation on procedures and operations which is the case in other areas.
“Elective operations are continuing across all three of our acute sites at Ninewells, PRI and Stracathro. Theatres are not lying empty as has been suggested.
“We are responding dynamically and at pace to the changing pressures on health and social care.”
More beds were opened in the past month to cope with flu and Covid patients, as well as trauma.
“These beds are now being safely retracted as flu and Covid levels stabilise and the trauma patients are discharged, meaning we can reduce the number of additional, unfunded beds and, with them, reduce our reliance on higher cost agency staffing,” the spokesperson said.
“We have reduced waiting times for our longest waits and have continued to run outpatient clinics, as well as performing as one of the best NHS Boards for cancer waiting times targets.
“All of our teams take our fiscal responsibility very seriously and we will continue to do everything we can to deliver the safest care to our patients in the most efficient and effective way.”
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