'I waited two years for a new knee - I was lucky'

As a dog owner, Heather Shepherd has always had plenty of walking to do - but for the last two years she has been waiting for a knee replacement.

She lived with increasing pain and had to rely on family for help with daily tasks before she was offered surgery at a centre set up to tackle lengthy waiting times.

“I did have quite an active life, walking the dogs and that but it gradually got less and less,” Ms Shepherd said.

“It really does impact you. I mean, you go shopping and even standing in a queue is really hard. You can’t walk very far so you rely on other people a lot.”

But Heather now considers herself “lucky” to have had her left knee replaced after two years of pain.

Figures due to be published later are expected to show more than 500,000 people are waiting for an outpatient appointment or for a planned operation on the NHS in Scotland.

Meanwhile a recent report from the Nuffield Trust showed the number of patients abandoning NHS waits in Scotland to pay for private procedures had almost doubled.

Ms Shepherd, 62, was offered knee replacement surgery at the National Treatment Centre (NTC) Highland in Inverness at the beginning of May.

It meant a 100 mile trip from her home near Peterhead.

“I was told I could possibly be another two years in Aberdeen if I had to wait,” Heather said.

“Within getting the phone call to come (to Inverness) I was about a month. It’s been a mad rush.”

NTC Highland was to be part of a network of 10 sites across Scotland set up to tackle long waiting times for non-urgent care by delivering at least 40,000 additional elective surgeries, diagnostics and other procedures per year by 2026.

But a pause on capital spending means that only three centres are up and running so far, with two more scheduled to open this year. There is no timeline in place for the others.

The Scottish government said building projects have been paused due to a reduction in the block grant from the UK government.

A spokeswoman said: “Our emphasis for the immediate future will be on addressing backlog maintenance and essential equipment replacement.”

For surgeons working at the Highland site, the NTC is how elective surgery should work. With no emergency department, planned operations are not interrupted by the need for urgent care.

About 1,400 hip and knee replacements have been carried out at the centre since it opened in April last year.

Orthopaedic surgeon Gerry Cousins led the team replacing Ms Shepherd’s knee, the first of four scheduled procedures carried out that day.

“I come into work and I don’t have to worry about the patient having a bed after the operation, I don’t have to worry about any emergency patients,” he said.

“The environment allows me to see a patient next door and then they are in theatre.

“This feels like how it should be – lovely environment, enough staff, enough beds.”

The centre in Inverness opened in April 2023 and is focused on “high volume, low complexity” operations, mainly hip and knee replacements, and ophthalmology such as cataract surgery and eye procedures.

It primarily treats patients from the Highland health board area as well as people from Grampian and Tayside who are able to travel.

Clinical director Colin McNair said it was “without a doubt” making a difference to national waiting times.

“We would take patients from anywhere in Scotland if they are willing to come here," he added.

“Unfortunately with the pause in capital spending the other NTCs are shelved at the moment.

“I hope that’s something that will change because these facilities are what is going to make a difference in the future, getting away from providing schedule care in acute sites.”

The Scottish government set ambitious targets to eradicate all long waits for NHS treatment but so far none have been met.

That is in contrast to NHS England where almost no-one waits more than two years for treatment.

The latest headline waiting time statistics - for the quarter to December 2023 - were:

• About 8,000 patients have been waiting more than two years for treatment or to see a specialist.

• Nearly 40,000 people have been waiting more than 12 months.

The Scottish government said it was committed to eradicating long waits to "ensure people receive the treatment they need as soon as possible".

A spokesperson added: “The Scottish government has also opened two National Treatment Centres to increase capacity with a further two centres opening this year.

These centres will provide capacity for more than 20,000 additional procedures annually once fully operational.”

The NTC Highland may be chipping away at long waiting lists but the absence of intensive care on site means the kind of patients that can be treated is limited.

Mr McNair said: “If you have significant medical co-morbidities you can still be a candidate for a hip or knee replacement but we would maybe have to do your procedure in a facility with an intensive care unit and unfortunately they are in acute hospitals.

“We are aware nationally with the Scottish government that we have to address the fact that we could be creating a two-tier system with patients fit for the NTCs having shorter waiting times whereas those that require surgery in acute centres could inherently have to wait longer.”

For Ms Shepherd, back home after her operation, she is focusing on her recovery so that she can soon get out back out with her German Shepherds, Murphy and Rolo.

“I’m feeling good and keeping up the exercises,” she said.

“It won’t be long until I’m chasing the dogs again.”