A health board will only be able to do half of the planned operations it was able to carry out before the pandemic as it tries to catch up with a backlog caused by covid.

In a snapshot of the ‘catch-up’ challenge faced across the country, NHS Borders told healthandcare.scot it will not be able to return to pre-virus levels of activity ‘for some time’ due to the need to maintain social distancing and stick to infection control procedures.

A re-mobilisation plan submitted to the Scottish Government on how services will restart warned Borders General Hospital can only operate at 55% of usual theatre capacity.

Face-to-face outpatient activity and GP appointments have fallen by similar margins.

In the Borders alone, more than 20,000 outpatient appointments that would have normally happened were lost to the pandemic by May, according to a separate update considered by the region’s health board last week.

Health bosses hope to return to half the usual level of routine outpatient face-to-face appointments in August.

In GP practices steps to reduce numbers in waiting rooms and infection control measures have almost doubled the time for each consultation.

It comes as a doctors’ leader says the country needs as “honest and adult” conversation about what the NHS can provide in future, and how much that will cost.

Glasgow’s empty NHS Louisa Jordan hospital, which was set up to take covid-19 patients but not used, is being trialled as a centre for orthopaedic appointments.

NHS bosses have been asked to restart cancer surgery where possible, instead of using private hospitals, with the option of sending the most urgent patients elsewhere in Scotland as soon as slots become available.

Ideally, surgery should take place in ‘green’ sites that do not have potential covid patients to minimise the risk of infection.

Borders General Hospital is classed as an ‘amber’ hospital, meaning there are set-apart areas on the same site for surgery patients and confirmed or suspected virus cases.

However the board report says: “It would be helpful to have clear and consistent Scottish guidance for the appropriate pre-testing / isolation regimes for all elective patients in Scotland.”

It adds: ‘Without an increase in resource (both capital and revenue), it is estimated that only 55% of previous levels of elective theatre capacity can be delivered.’

The number of patients who face unnecessary waits in hospitals, known as delayed discharges, is also starting to rise after a sustained reduction in the early days of the pandemic.

One board member said it was “really frustrating” that more patients were not able to be sent home, despite the efforts of staff.

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