00:00in Edinburgh. Last week, NHS Lothian announced that, from late October, the eye pavilion
00:06will be vacated for a period of around six months. That is to allow critical maintenance
00:11to be carried out and subsequent recommissioning of the site. It is clear that that will cause
00:16disruption to patients and staff. I understand that both groups are concerned about the impact
00:21that that will have on arrangements for providing care and on waiting times. I am sorry for
00:27the worry that I know that that will cause for many. Let me start by being clear that
00:31my priority and that of NHS Lothian is ensuring safety and, to the fullest extent possible,
00:37minimising disruption.
00:38In my statement today, I will provide further information on the critical maintenance that
00:42will be carried out at the eye pavilion and on the planning for those patients' appointments
00:46that need to be rearranged as a consequence. I hope that that will provide assurance to
00:50all concerned that the matter is being addressed with due care and speed. I will also speak
00:55to the need for service and financial sustainability and reform in the future. We know that change
01:01is needed and we must do things differently.
01:05Let me briefly explain the issue that has led to the temporary closure of the eye pavilion.
01:10Two copper waste pipe stacks require to be replaced. It is critical that that is done
01:14quickly to prevent damage that would require more significant remedial works and cause
01:19greater disruption. That is why vacating the hospital is being done at pace. With NHS Lothian
01:25planning to hand the building over to contractors on 25 October.
01:29With regard to the expected duration of the closure, the current estimate from NHS Lothian
01:34is six months. That is an estimate and the timeframe and programme of works is being
01:39developed. It will be kept under review ahead of and during the works and recommissioning.
01:46In terms of what will happen during the period of closure and why that takes time, the site
01:51requires to be decanted before remedial works can be undertaken and recommissioning is required
01:56before reopening. Decanting the site is a complex process and includes the removing
02:01of equipment as well as the relocation of clinics. Unfortunately, during surveys to
02:06assess the work required, it has been identified that one of the waste pipes is located within
02:10a cavity that contains asbestos. That adds to the complexity and timeline of the remedial
02:16works.
02:17Brief removal of the asbestos material is essential ahead of the pipework replacement
02:21for the safety of those carrying out the work and for those who use the site. Once the remedial
02:27works are complete, the process of recommissioning is required to provide assurance that the
02:31site is fully operational and to ensure safety ahead of reopening.
02:36During the coming weeks and months, my officials and I will stay in close contact with NHS
02:40Lothian to seek the necessary assurances around progress. As I have said, patient safety is
02:47paramount. Following my visit to the eye pavilion this morning, along with Miles Briggs,
02:51Sarah Boyack and Daniel Johnson, I am assured that the board is doing everything possible
02:56to minimise disruption and any potential harm to patients. NHS Lothian is looking at all
03:03possible options across its estate to maximise capacity for ophthalmology patients. After
03:09hearing directly from patients at a previous meeting on the issue, I have also sought assurance
03:15that there will be minimal travel for those patients with the most profound needs, which is a
03:20critical issue that patients have raised with me. The vast majority of patients who are scheduled
03:25before Friday 25 October will be unaffected, and the small number of patients who are affected
03:31will be contacted by NHS Lothian at least two weeks prior to their appointment. Patients who
03:36are booked for appointments from Monday 28 October will be contacted with changes to
03:41their appointments, and new patients will be given an alternative location in their booking letter.
03:46Although NHS Lothian is still finalising all the details of its plans, I have heard
03:51from it that communication with patients, MSPs, local partners and Government is and will be
03:58on-going. I know that it will also have a planned meeting on 4 October with all
04:04Lothian MSPs, where it will share more detail following the conclusion of its final plan.
04:09The board is also working closely with staff and unions for staff who will be
04:13displaced to manage their concerns.
04:16I turn to the future of eye care services. It is important to recognise that the replacement of the
04:21eye pavilion was included as part of the national treatment centre programme, which is intended to
04:25provide capacity for all of Scotland. As we look ahead, we must continue to plan on the basis of
04:30need and available resources across the whole of Scotland. The landscape has changed significantly
04:35since the national treatment centre programme started, not least as a result of Covid,
04:41Brexit and soaring construction costs. As we have made clear repeatedly,
04:47the financial climate is extremely challenging across the revenue and capital budgets.
04:52We have also made clear that health service reform is essential for operational and
04:57financial sustainability. Our actions must enable NHS Scotland to maximise capacity,
05:02build greater resilience and deliver reductions in the number of patients who have waited too long
05:07for treatment. In that context, all spending, even that previously committed, must be carefully
05:12considered so that it is directed where it will have the greatest impact.
05:16We know that the NHS estate is ageing and that it is not affordable to replace everything as
05:20quickly as we might like—a position that is not unique to Scotland. We must make better use of
05:25our existing resources to support reform and improvement, and we must consider where strategic
05:30investment across our existing estate will provide better value than replacement.
05:35We must also consider how we can improve through service redesign to ensure that we have a
05:39resilient service for the future. We are working with all health boards, including NHS Lothian,
05:45to develop a whole-system infrastructure plan. That will consider health infrastructure needs
05:50for the whole of Scotland to support continued safe operation of existing facilities and inform
05:55longer-term investment priorities. As I have made clear, a key part of our consideration
06:01must be how existing resources can be better utilised to provide the required capacity.
06:08We must also retain focus on preventing the need for hospital treatment in the first place.
06:13That means investing in our existing estate and reducing pressure on that estate by delivering
06:18services in a different way. For eye care services, that includes consideration of how
06:23we better utilise capacity at existing treatment centres. A key part of that is ensuring that more
06:29people are treated in a community setting where that is clinically appropriate. We know that
06:34treatment closer to home is of benefit to patients, with the potential to improve patient experience
06:39and overall health outcomes. Making better use of community services frees up acute capacity
06:44for more complex cases. The community optometry sector already provides a first port of call
06:50service to patients with eye problems. That is enabled by Scotland being the only nation
06:55in the UK to provide free universal NHS eye examinations, a policy that the Government
06:59is committed to maintaining. That has been successful in supporting many patients to
07:03be managed in the community, closer to home, instead of needing to be referred to hospital
07:08or to be seen by a GP. However, the community optometry sector has the capacity and capability
07:13to do much more. An example of that is the new community glaucoma service,
07:19which moves lower-risk patients who are traditionally seen in a hospital setting
07:22to available capacity in the community optometry sector, freeing up hospital capacity for patients
07:28with the most sight-threatening conditions. That service has been rolled out nationally and will
07:33deliver the capacity and technology for an estimated 20,000 patients to receive their
07:37care closer to home. We are also investing in our future optometry workforce through Scotland's new
07:43UK-leading master's optometry undergraduate degree. That, among other things, will enable
07:49students to graduate as independent prescribing optometrists, and it will help to build additional
07:54capacity to support more patients being managed in the community instead of being referred to
07:58hospital. The course has just been launched at Glasgow Caledonian University, and the
08:02public health and higher education minister visited the university on Tuesday to meet the
08:07new students and teaching staff. The Government looks forward to the University of the Highlands
08:11and Islands launching a similar course next year.
08:16I understand that members and their constituents are extremely concerned about the announcement
08:21that the eye pavilion will close for a period of time. I share that concern. Let me reaffirm
08:27that my priority, along with that of NHS Lothian, is to limit disruption and avoid harm, as well as
08:34ensuring that eye care appointments that would have taken place at the eye pavilion go ahead,
08:38despite the temporary closure. I also know that many are concerned about the future of
08:42the eye pavilion and will be disappointed that I have not been able to confirm today
08:46its replacement in my statement. I give my commitment that we will continue to look ahead
08:51to how eye care services can be delivered most effectively, with a clear focus on improved
08:56services and reduced waiting times. We must be open to all possibilities on how that can be
09:01achieved, including how we make better use of existing services.
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