Health

NHS patients could be moved around the country under plan to reduce waiting lists

Follow-up appointments are to be scrapped and patients moved around the country under radical plans to tackle the enormous NHS waiting list backlog, it was reported last night.

The Health Secretary Sajid Javid is understood to have ordered NHS health chiefs to come up with proposals to ease the backlog.

A review will recommend patients who’ve received treatment should have follow-up appointments slashed, and instead only contact doctors if they experience issues.

The Government is also said to be considering plans to speed up non-urgent hospital care through ‘hubs’ for routine surgery separating it from emergency care.

For those who face long waiting times, the option could also be given to travel further in order to get treated more quickly.

Clearing houses are also being considered for patients who have waited too long for treatment including routine surgery such as knee replacements. 

Chris Hopson, the chief executive of NHS Providers, said it was more likely patients would be offered appointments in neighbouring hospitals rather than being told to travel the 230 miles ‘from Durham to Dunstable’.

He added many currently come in for check-ups every three months for up to a year after surgery, but that in most cases this is ‘not needed’. 

The NHS waiting list for routine hospital treatment in England has reached 5.83million, official data revealed today marking the eleventh month in a row that the figure has hit a record high. Some 1.6million more Britons were waiting for elective surgery — such as hip and keen operations — at the end of September compared to the start of the pandemic

The proportion of cancer patients starting treatment within a month has fallen to the lowest level since records began in 2009. The health service's own standards set out that 96 per cent of people should begin treatment, such as chemotherapy and immunotherapy, within 30 days of the patient and doctor deciding to proceed with it. But in September, just 92.6 per cent of patients (25,329 out of 27,342) had their first treatment within the time frame, meaning 2,013 people were forced to wait for longer to receive life-saving care

The proportion of cancer patients starting treatment within a month has fallen to the lowest level since records began in 2009. The health service’s own standards set out that 96 per cent of people should begin treatment, such as chemotherapy and immunotherapy, within 30 days of the patient and doctor deciding to proceed with it. But in September, just 92.6 per cent of patients (25,329 out of 27,342) had their first treatment within the time frame, meaning 2,013 people were forced to wait for longer to receive life-saving care

The proportion of patients beginning cancer treatment within two months of an urgent GP referral — which NHS guidelines should be 85 per cent — fell to its lowest-ever level since records began more than a decade ago. Just 68 per cent of cancer sufferers start treatment within the window, meaning more than three in 10 were forced to wait for longer

The proportion of patients beginning cancer treatment within two months of an urgent GP referral — which NHS guidelines should be 85 per cent — fell to its lowest-ever level since records began more than a decade ago. Just 68 per cent of cancer sufferers start treatment within the window, meaning more than three in 10 were forced to wait for longer

Ambulance response times for the most urgent incidents, called Category 1, which includes cardiac arrests, took an average of nine minutes and 20 seconds, well above the target of seven minutes from a 999 call

Ambulance response times for the most urgent incidents, called Category 1, which includes cardiac arrests, took an average of nine minutes and 20 seconds, well above the target of seven minutes from a 999 call

Figures show the average ambulance response time to Category 2 calls, which includes strokes and other emergencies, was 53 minutes and 54 seconds in October, compared with the target time of 18 minutes. The figure is more than double the average time for the year since 2018

Figures show the average ambulance response time to Category 2 calls, which includes strokes and other emergencies, was 53 minutes and 54 seconds in October, compared with the target time of 18 minutes. The figure is more than double the average time for the year since 2018

Mr Hopson said hospital chiefs had a ‘moral obligation’ to clear the back log to ensure patients received proper care and did not spend months on waiting lists.  

Waiting lists for routine NHS care in England have snowballed since the start of the pandemic to 5.8million.

Some 300,000 patients that have waited more than a year for care, up from just 1,305 before the pandemic began.  And 10,000 that have waited two years.

Patients will not need to travel from ‘Durham to Dunstable’ for care, says health chief 

Patients will not be asked to travel long distances for care under plans to clear the backlog, a health chief said today.

NHS bosses are currently considering offering patients appointments in different hospitals.

They say this will help them get care faster, and reduce the spiralling waiting list.

But Chris Hopson, chief executive of NHS Providers which represents hospital trusts, said it was likely they would only be sent to nearby hospitals.

And that patients would not be asked to travel from ‘Durham to Dunstable’, a 230-mile one-way trip.

He told Times radio: ‘What I think will happen is that, by getting trusts to work together more efectively — as they’ve been doing for the last 18 months — you can see people being asked to be moved, you know, relatively short distances.’ 

The waiting list has now spiralled to another record-high of 5.8million.

This includes some 300,000 patients who have been waiting more than a year for care, and 10,000 that have waited two years.

Health chiefs have branded the list ‘unsustainable’, while Labour has slammed the ‘dangerously lengthy’ waiting times for care.

Ambulance waiting times are also spiralling as Accident and Emergency beds are filled, leaving many waiting hours to off-load seriously ill patients. 

Health chiefs have branded the ever-growing list ‘unsustainable’, while Labour has slammed the ‘dangerously lengthy’ waiting times for care. 

Mr Hopson — who heads up a union representing hospital trusts — said NHS staff recognised that the waiting list was not ‘an acceptable situation’.

He told Times Radio: ‘What we’re working on at the moment is a really comprehensive plan to get through those backlogs as fast as possible.

‘And some of it will be all the traditional things that we do, which is: we will expand temporary capacity; we will ensure that we use overtime as much as possible; we will ensure that we use the capacity that sits in the independent sector.

‘But I think we recognise we need to go further and that’s why, some of those radical ideas, we are considering and looking at them.’

He added that patients are not likely to be asked to travel hundreds of miles to get care or from ‘Durham to Dunstable’.

He said: ‘So, what I think will happen is that, by getting trusts to work together more effectively — as they’ve been doing over the last 18 months — you can see people being asked to be moved, you know, relatively short distances.’

Asked about reducing follow-up appointments, he said: ‘Our clinicians manage clinical risk and nobody is going basically suggest to a patient who might have a risk “Oh, no, we don’t need to see you, off you go” and “Actually, we’ll only see you if it turns into an emergency”.

‘That is absolutely not what’s going to happen.

‘The way the outpatient system tends to work in lots of specialties is that we do say to people “Come back in three (months), come back in six, come back in nine, come back in 12”.

‘Actually, you won’t need all of those four appointments in many cases.

‘And moving towards a system where you can give patients the opportunity to say “Actually, I’ll only do the six, but if I’ve got a problem at the three in the nine-month period, I know I can get hold of you”.

‘Then that will free up a lot more capacity for those consultants to actually do elective surgery and backlog recovery.

‘The implication that we’re suddenly just going to say to everybody “We don’t want to see you anymore” — absolutely not.

‘It will be risk-based, as it always is, and that’s what our clinicians are brilliant and they’re really good at identifying when they need to ask people to come back.’

A government source told The Times: ‘The elective recovery plan is still in development, no decisions have been made and there is plenty of road still to go before anything is signed off.’ 

It is understood that Mr Javid has been consulted on the changes but is yet to formally agree to anything.

The review is being led by Sir Jim Mackey, the head of Northumbria Healthcare NHS Foundation Trust. 

Another way to help clear millions of people from waiting lists could be technology to enable patients to communicate with clinical staff without in-person appointments.

The NHS app, currently used for Covid vaccine certificates, could be expanded to become the first point of contact when managing care in hospitals.

An NHS leadership review will also consider if pay rises should be offered to NHS chiefs who drive down waiting times. 

It comes as  research showed thousands of heart patients could die unnecessarily because they are having to wait up to two years for life-saving scans. 

The enormous Covid backlog means 64,962 patients in England have been waiting longer than the six-week NHS target for heart ultrasounds, known as echocardiograms.

A review led by Sir Jim Mackey, the head of Northumbria Healthcare NHS Foundation Trust, will recommend that follow-up appointments after certain treatments be cut (file photo)

A review led by Sir Jim Mackey, the head of Northumbria Healthcare NHS Foundation Trust, will recommend that follow-up appointments after certain treatments be cut (file photo)

Despite the total A&E admissions in England being just two per cent more than one month earlier and equal to the number of people who came forward during the same month in 2019, 7,059 patients were forced to wait more than 12 hours to be seen at A&E. The record-high figure is 40 per cent more than the 5,024 forced to wait that long one month earlier. It is also five times bigger than in September 2020 and ten times more than the same month in 2019

Despite the total A&E admissions in England being just two per cent more than one month earlier and equal to the number of people who came forward during the same month in 2019, 7,059 patients were forced to wait more than 12 hours to be seen at A&E. The record-high figure is 40 per cent more than the 5,024 forced to wait that long one month earlier. It is also five times bigger than in September 2020 and ten times more than the same month in 2019

NHS England data show ambulance staff had their busiest-ever October, with staff answering a record 1million calls. Staff responded to more than 82,000 life-threatening calls, 20,000 more than than in October 2019. But those who called had to wait an average of 56 seconds for an answer — seven times longer than in October last year when it took operators seven second to answer the calls. Richard Webber, of the College of Paramedics and a working paramedic, said his colleagues 'have never before experienced anything like this at this time of the year'

NHS England data show ambulance staff had their busiest-ever October, with staff answering a record 1million calls. Staff responded to more than 82,000 life-threatening calls, 20,000 more than than in October 2019. But those who called had to wait an average of 56 seconds for an answer — seven times longer than in October last year when it took operators seven second to answer the calls. Richard Webber, of the College of Paramedics and a working paramedic, said his colleagues ‘have never before experienced anything like this at this time of the year’

This ‘distressing’ waiting list is 20 times longer than the pre-pandemic list of 3,238 patients, analysis by the British Heart Foundation (BHF) shows.

They look at the structure of the heart and nearby blood vessels, and are needed to decide the best course of treatment.

But spiralling waiting lists for non-Covid care mean patients face waiting months or even years for the crucial checks — triggering delays to treatment and potentially leading to death or disability. About 10,000 fewer echocardiograms are being carried out each month than before the pandemic, the BHF found.

Meanwhile, a record 275,569 patients were waiting for heart treatment or surgery at the end of September as the backlog continues to grow, latest NHS England figures show.

A cross-party group of 52 MPs and peers wrote to the Health Secretary last week, warning that delays to heart care during the pandemic have already led to 5,800 excess deaths.

The letter added: ‘Treatments like heart surgery aren’t a luxury. Long waits for diagnosis and treatment of conditions like coronary heart disease, abnormal heart rhythms and heart failure are emotionally distressing and can increase the risk of someone becoming more unwell or even dying while they wait for care.’

Heart and circulatory diseases cause one in four deaths in the UK — 160,000 each year, and about 7.6million Britons live with these diseases. 

Dr Sonya Babu-Narayan, associate medical director at the BHF, said: ‘We need to see a specific plan for cardiovascular care recovery focused on tackling cardiology vacancies, training more heart specialists, and using new diagnostic hubs to deliver delayed heart diagnosis and care.’ Waiting lists have snowballed since the start of the pandemic to 5.8million last week.

And health chiefs say the backlog will only grow this winter because A&E departments are ‘overwhelmed’ – some hospitals have already cancelled elective care.

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