24-hour surgery to combat NHS waiting times PATIENTS across the Lothians will be called in for routine hospital appointments at weekends and evenings as part of a radical overhaul of the way the NHS operates in the region. High-level talks have taken place over an extensive redesign of elective services in Lothian hospitals, with health bosses keen to reduce the £12 million bill it was left with in 2012-13 after paying for thousands of patients to be sent into the ­private sector. The schedule could eventually apply to a wide range of pre-planned appointments and operations, with one source saying it would mean a dramatic culture shift in the NHS. But under the new plans, more people would be treated directly by the NHS at evenings and weekends, reducing the overheads charged by the private sector and meaning NHS Lothian is better-equipped to deal with rising patient numbers. Patients" groups and unions welcomed the proposals, which are in their early stages but could begin as soon as next year, although health bosses were warned that workers" rights must be protected. Unison organiser David Forbes said: "There will have to be discussions with unions about what this will mean and an agreement before any major changes take place. We are supportive of what the board is trying to do in bringing its capacity up to deal with demand. Given the obscenity of paying millions to the private sector, we would rather see better use made of the resources we have. The Scotland Patients Association backed the likely shift towards longer opening in NHS services, and said many patients who had full-time jobs would prefer the new regime. Dr Jean Turner, director of the charity, said: "We will need to have more staff to ensure we have safe rotas, it's important to ensure everyone gets the work-life balance. But I think this would be a more cost-effective use of theatre time and diagnostic equipment. There may be one-stop test and treat clinics, as the health board's focus shifts from boosting emergency capacity to pre-planned procedures. Despite private sector spend, at the end of April there were still more than 2000 outpatients waiting more than the 12-week appointment target, compared to 4400 last year. Melanie Hornett, NHS Lothian's nurse director, said the NHS had to adapt to cope with more over-75s, patients with multiple illnesses and health inequalities. She added: "In the face of these challenges, we need to do some things differently. Our focus at the moment is on improving the provision of unplanned care to increase capacity, improve the speed with which people can access care they need and to reduce time patients spend in hospital. We also intend to look at options for increasing capacity within planned or elective care. This may include looking at the possibilities for the provision of some non-emergency surgery and tests seven days a week.