• Syed Ahmar Shah, Rachel H Mulholland, Samantha Wilkinson, KatikireddiSrinivasa VittalSVMRC/CSO Social & Public Health Sciences Unit, University of Glasgow G3 7HR, Glasgow, UK., Jiafeng Pan, Ting Shi, Steven Kerr, Uktarsh Agrawal, Igor Rudan, Colin R Simpson, Sarah J Stock, John Macleod, Josephine-Lk Murray, Colin McCowan, Lewis Ritchie, Mark Woolhouse, and Aziz Sheikh.
• Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, EH16 4UX UK.
• J R Soc Med. 2022 Nov 1; 115 (11): 429438429-438.

ObjectivesCOVID-19 has resulted in the greatest disruption to National Health Service (NHS) care in its over 70-year history. Building on our previous work, we assessed the ongoing impact of pandemic-related disruption on provision of emergency and elective hospital-based care across Scotland over the first year of the pandemic.DesignWe undertook interrupted time-series analyses to evaluate the impact of ongoing pandemic-related disruption on hospital NHS care provision at national level and across demographics and clinical specialties spanning the period 29 March 2020-28 March 2021.SettingScotland, UK.ParticipantsPatients receiving hospital care from NHS Scotland.Main Outcome MeasuresWe used the percentage change of accident and emergency attendances, and emergency and planned hospital admissions during the pandemic compared to the average admission rate for equivalent weeks in 2018-2019.ResultsAs restrictions were gradually lifted in Scotland after the first lockdown, hospital-based admissions increased approaching pre-pandemic levels. Subsequent tightening of restrictions in September 2020 were associated with a change in slope of relative weekly admissions rate: -1.98% (-2.38, -1.58) in accident and emergency attendance, -1.36% (-1.68, -1.04) in emergency admissions and -2.31% (-2.95, -1.66) in planned admissions. A similar pattern was seen across sex, socioeconomic status and most age groups, except children (0-14 years) where accident and emergency attendance, and emergency admissions were persistently low over the study period.ConclusionsWe found substantial disruption to urgent and planned inpatient healthcare provision in hospitals across NHS Scotland. There is the need for urgent policy responses to address continuing unmet health needs and to ensure resilience in the context of future pandemics.

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