Leader: "Running the ERI like this is not sustainable" THE fact that the Royal Infirmary is overcrowded will be of no surprise to anyone, but few will realise just how severe the problem has become. Today's revelation that on an unremarkable day in January there were more patients at Little France than beds will set fresh alarm bells ringing. The staff at the ERI do a wonderful job in constantly juggling resources to cope but it is clearly not sustainable to run a hospital at 101 per cent capacity without something giving way. The ideal is to maintain a hospital at 85 per cent to ensure there is the ability to deal with emergencies or an unexpected surge in patient numbers. Clearly, we are a long way from being able to achieve those kind of numbers at the ERI, and the fear is this is a problem which will simply continue to get worse with a growing and ageing population in the Lothians. So what can be done? Perhaps the most stark revelation from today's report is the fact that one in five patients do not need to be in the hospital at all as they wait for transfers to care homes or recovery beds in other units - an acute issue during winter. Responsibility, then, does not lie completely with NHS Lothian but must involve other agencies working closely with the health board to improve and speed up the system. For its part, the health board is introducing a series of initiatives aimed at relieving the pressure, including deploying more doctors to the frontline of the hospital to ensure patients are sent to the correct place from the beginning. GPs will also be encouraged to discuss cases with consultants before sending patients into hospital. The problems with capacity at the ERI and the mistakes made when the PFI hospital was being designed are well known, and no-one is pretending there is an easy fix. Fix it, though, we must. Make positive waves inmates at Saughton prison have a captive audience for their internal radio station Clink FM. The schedule of programmes, including music, poetry and messages from relatives keeps the listeners entertained and helps those working on the project gain technical skills and confidence. Former Hearts midfielder Gary Mackay, who was interviewed for the station, says he believes it could help cut reoffending. But there will be doubters who say it's another example of a cushy life for prisoners. It is essential jail bosses demonstrate positive outcomes from the project and show it's not a case of life being easier inside than outside.