1. The first thing you have to do to make the patch is figure out how to predictably replicate the problem. Some people claim the framerate problems are caused by large savegame files, but that's not 100% guaranteed as there are also plenty of other people with equally large save files who haven't experienced any lag. Same with the claims that it's caused by how much time you've logged in the game. Sometimes just replicating a bug predictably enough to figure out what's really causing it is a major pain in and of itself.
2. Once you actually nail down the cause of the bug, you have to come up with ideas on how to fix it. Sometimes it's a quick fix, sometimes there's a pretty solid amount of additional programming to do.
3. After implementing what you think will fix a game bug, then you have to test the crap out of it to see if you A. actually fixed the bug and B. didn't accidentally break something else in the process. Scenario B there actually happens fairly often and then you're off to either undo what you tried or do more work to address the new stuff you broke with your original fix.
4. Even once you have a good fix and have confirmed that you've resolved the problem and gotten it internally certified, you're still faced with the problem of distributing said patch. With platform-based games, you have to first submit the patch to Microsoft/Sony for them to also test and certify it before it can be downloaded by end users.
Every one of those steps take time. The best thing for anybody to do at this point is to understand that and be patient while Bethesda works on the problem. Yeah it really really svcks that the problem exists in the first place, but running around on forums and screaming about it all over the place at this point isn't going to get the patch released any faster or affect anything else except to cause general frustration and annoyance.
