– in the Scottish Parliament on 19th April 2023.
3. To ask the Scottish Government what its position is on reported potential reductions to bed numbers and the closure of a ward at University hospital Ayr. (S6O-02110)
NHS Ayrshire and Arran has been clear that the planned closure of beds relates to additional pandemic capacity across the system and that there are no plans to close core beds at either Ayr or Crosshouse hospital.
Five months ago, I wrote to Humza Yousaf to demand that services at Ayr hospital not be reduced. He replied that there were “absolutely no plans” to close surgical, intensive care unit or accident and emergency services. Now, however, it is reported that ward 10 in Ayr hospital may close, 75 beds could be cut and ICU beds are being moved to Crosshouse hospital. One senior national health service staff member described that move to me as “shocking”. It lets down NHS staff and puts patient safety at risk.
Can the cabinet secretary tell us why the First Minister has broken his promise to the people of Ayrshire?
First, we need to be careful not to conflate two different issues. The first issue is the surge capacity that was created during the pandemic. Ward 10 in Ayr hospital, which the member made reference to, was exactly that—surge capacity to deal with challenges during the pandemic. As boards across the country are going through that process, they no longer require that capacity and are, therefore, removing those particular facilities. That is exactly what is happening there. As has also been made very clear by the health board, core capacity remains the same.
The second issue that Sharon Dowey mentioned was in relation to the ICU beds. Members will be aware—as, I am sure, Ms Dowey is—that Ayrshire and Arran health board has put in place an interim arrangement to deal with the specific staffing issue of not being able to recruit a consultant to cover the ICU beds at Ayr hospital. I am sure that Ms Dowey will recognise that it is absolutely critical that beds of that nature have the right skilled medical cover to meet their needs. Those staffing challenges are exactly why the board has put in place that interim arrangement, which allows it to maintain its level of ICU beds across the health board area in a way that delivers the necessary quality of care and patient safety. It is important to recognise the staffing challenge for that board, which is exactly why it has had to put that interim arrangement in place, in order to facilitate safe patient care.
As the cabinet secretary has alluded, NHS Ayrshire and Arran announced that intensive care beds at Ayr hospital would transfer to Crosshouse hospital on an interim basis, but I have subsequently been contacted by staff who tell me that the transfer is to be made permanent and that, consequently, vascular and orthopaedic surgery have already moved, with more categories likely to follow. That is a significant service change, so can the cabinet secretary advise whether that is the case and why that has not been subject to public consultation? Can he also advise whether the process for consulting on major service change is being amended? If so, why has that not been made public—
The answer to Ms Baillie’s latter point is that there has been no change to that particular process. If the board was taking forward permanent changes, it would be required to undertake a full consultation exercise in order to do so. That is why the board has confirmed that the arrangements that it is putting in place are on an interim basis, because of its staffing challenges and desire to make sure that it continues the full complement of ICU beds on a basis of 24 hours a day, 365 days a year, across the board area. For the reasons that I have just mentioned, the board has had to put those interim arrangements in place.
The A and E target at Ayr hospital has not been met for two years; delayed discharge in South Ayrshire has almost doubled in the past year; and NHS Ayrshire and Arran has reported capacity levels of 100 per cent at Ayr hospital. Will the cabinet secretary accept that those cuts in bed numbers are nothing to do with a lack of demand or need, but are due to a lack of funding? NHS Ayrshire and Arran’s deficit is set to double to an eye-watering £56 million this year.
As I have already mentioned—and I am sure that Colin Smyth heard me—the core bed capacity in NHS Ayrshire and Arran remains the same. Those surge capacity beds were put in place for the purpose of the pandemic. The health board has also made it very clear that the closure of those particular beds will be carried out in a safe, sequential manner over a period, as it manages its delayed discharges in order to see their reduction in the acute sector and moves towards more care support in the community. NHS Ayrshire and Arran has given an assurance that it will take that forward in an appropriate way, to make sure that quality of care is maintained going forward.