BOA Response to NHS England Figures on people waiting over 18 weeks for T&O surgery

NHS England figures show number of people waiting over 18 weeks for trauma and orthopaedic surgery highest since records began.

Today NHS England has released new data on waiting times for elective orthopaedic surgery during February 2018. This data follows on from the increased waiting times and cancellations put in place during the recent winter months, which have seen widespread disruption to orthopaedic surgery services in many parts of the country.

This new data revealed a situation unprecedented in recent years:

• The proportion of patients on the waiting list for less than 18 weeks fell to 83.4% - the lowest level this decade, and far short of the national NHS target of 92%.
• Over 76,000 people had been waiting over 18 weeks for trauma and orthopaedic surgery - the largest number since published records began in November 2010.
• The average (median) waiting times for trauma and orthopaedic surgery fell slightly in February to 7.6 weeks. However, in January the average was 8.5 weeks – the highest level since monthly publication of this information began in May 2010.
•  In addition to the issues with lengthening waiting times from referral to treatment that are covered by this data, we have concerns about recent restrictions placed upon referral for many orthopaedic conditions.

As such, these figures for lengthening waiting times represent a significant under-reporting of the true adverse impact on orthopaedic patients.

The British Orthopaedic Association (BOA) considers this unacceptable and is calling on the NHS to put the necessary resources in place to ensure those needing orthopaedic surgery such as hip and knee replacements are not continuing to suffer needlessly.

The BOA is alarmed and dismayed to see the gradual backwards transition to the long waiting lists of the past for what the NHS are wrongly interpreting as ‘optional’ surgical procedures. People with crippling arthritis should not be put at the back of the queue as resources dry up.

Ananda Nanu, President of the BOA, said,

“Elective surgery is not optional surgery. Many patients suffering with arthritis are in significant pain, which severely affects their quality of life and their ability to perform the simple activities of daily living. Leaving patients waiting in pain for treatment longer than is clinically necessary is not acceptable. Arthritis is common and often dismissed, but it is life changing, threatening patients’ independence, their ability to earn a living and care for their loved ones.

“Delays to surgery can have multiple and significant consequences for the patient - they may not have such a good outcome from the surgery, as well as the extended wait resulting in deterioration in their physical and mental health as a result of immobility and chronic pain. In some cases, the delay may result in permanent impaired mobility and for others, especially those with rapidly progressive hip osteoarthritis, a delay in surgery can result in the need for more complex surgery at increased cost with greater risks of complications, as well as poorer outcomes.

“Cancelling elective surgery through the winter months must stop. We can’t expect elective surgery to cease in the winter and then cope with double demand in the summer without doubling capacity. Additional resources are needed to increase capacity throughout the year to reduce waiting times. 

“NHS England should also realise there are consequences for the training of future surgeons. When large numbers of operations are cancelled, this reduces training opportunities for weeks or sometimes months at a time. If NHS patients are redirected into the private sector to recover the backlog, this further reduces training opportunities within the NHS where trainees are placed, as well as meaning that funding will then follow patients into the private sector and leave the NHS, where it is badly needed. The Government needs to act now to stop this spiralling chain of events before next winter.”

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