Derbyshire hospitals facing big challenge to stabilse waiting lists

Health chiefs in the county are not expecting the thousands of patients waiting more than a year to have hospital treatments or operations to fall within the next six months.

Instead their aim is to now ‘slow the growth’ and ‘aim to at least stabilise the position over the next six months’.

But officials said that, unlike during the second wave, ‘routine’ surgery is continuing to take place.

They said they were keeping in contact with patients who needed non-urgent procedures but urged anyone whose condition has deteriorated significantly since their initial contact to their GP.

They added that patients with the most urgent clinical needs, such as cancer, had to be prioritised.

Over the course of the pandemic, the number of Derbyshire patients waiting a year or more for treatment or surgery has soared from 45 to more than 3,500, as of the most recent data to November 6.

The number of patients waiting 52 weeks for treatment before lockdown was typically in the single digits or non-existent.

Papers to be discussed by the Derby and Derbyshire Clinical Commissioning Group (CCG) this week show 3,140 patients waiting 52 weeks for treatment across the county, including 426 at the Chesterfield Royal Hospital.

This is a 20 per cent increase from figures published just a month ago when there were 2,807 patients on the list, with 2,509, including 298 at Chesterfield.

Bu contrast, on March 20, just before lockdown, but as the Covid impact was surging, Chesterfield did not have any.

These are elective appointments and the most common type is for trauma and orthopaedics (40 per cent), which includes hip and knee surgeries.

While these may be minor and less urgent, patients are having to cope with pain and discomfort and a range of other complications for much longer than they would normally be expected to.

This is due to the focus on Covid-19 patients in the first wave of the pandemic and the suspension of all elective surgeries.

Over that time, thousands of patients have seen their surgeries and treatment postponed and new patients have been added to that list.

In response to the updated figures, the CCG said in a statement: “The arrival of coronavirus has made 2020 one of the most challenging years for the NHS and staff, at every level, have gone above and beyond to respond to Covid-19 in remarkable ways, showing extraordinary dedication, skill and compassion.

“The way the NHS had to change to respond to the pandemic, and speed at which it had to move to do it, was phenomenal.

"In the space of six weeks the NHS went from caring for zero Covid-19 patients to 19,000 Covid-19 inpatients per day across the UK.

“Clinically-essential service provision has been maintained throughout the pandemic in Derbyshire, thanks to the determination and adaptability of many services and colleagues.

"In order to do this, services had to review provision, temporarily stopping some services and making adjustments to others – in line with the rest of the NHS. Doing this enabled the NHS in Derbyshire to release extra capacity and add resilience where it was needed the most.

“In May the NHS entered the second phase of its response to Covid-19.

"This marked the beginning of ‘restoration and recovery’ and saw the NHS begin to release capacity to resume non-Covid services where it was safe to do so while continuing work to tackle coronavirus.”

Angie Smithson, chief executive of Chesterfield Royal Hospital and executive lead for the planned care steering group, said: “Since then we have been working closely as a system to assess all patients currently on a waiting list for cancer, elective and outpatient services.

"Patients are being reviewed by the appropriate clinical teams and kept informed of the current situation.

"This work is being overseen by our capacity planning and system quality and performance groups and our overwhelming priority continues to be providing safe care for both patients and staff.”

Dr Steve Lloyd, GP, medical director of NHS Derby and Derbyshire CCG, said: “There are now more patients with Covid-19 in our hospitals than at any point during the first wave of the virus.

"This, combined with winter pressures, is now beginning to have an impact on our plans for service restoration as it has for other NHS trusts nationwide and healthcare systems in Europe.

“As the number of patients with Covid rises, the ability of the NHS to respond to patients with non-Covid issues reduces.

"Inevitably this means our capacity for elective surgery is less than it would ordinarily be, but routine surgery continues to take place during the second wave which is very different to the position during the first wave.

“The best way to ensure the NHS can do what it needs to do is to reduce infection rates.

"This is what ‘protect the NHS’ really means and will enable us to ‘help us help you’.”

Ms Smithson added: “Our clinical and operational teams are working hard to treat as many people as possible.

"We are endeavouring to prioritise those with the highest clinical need – such as patients with cancer – with a view to seeing and treating them as soon as possible.

"We recognise there will now be many patients listed for more ‘routine’ procedures who have now waited extraordinary lengths of time for their treatment, but our priority at this time has to be to care for those with the most urgent clinical needs.

"This means allocating extra beds in our hospitals to look after patients who are acutely unwell.

“Patients waiting for more ‘routine’ procedures will be contacted in due course to discuss their individual plans, however, if there is anyone who is awaiting contact, or whose condition has deteriorated significantly since their initial contact, then they should contact their hospital clinician or GP.”