How long to clear operations backlog?

E. DRAGUN

Editor’s footnote: A spokesperson for the Committee for Health & Social Care responds:

Thank you for giving the Committee for Health & Social Care the opportunity to respond to this letter. We’re grateful to have the opportunity to provide further information on waiting lists as we’re conscious that it is understandably an area of interest to islanders. The numbers are always just a snapshot in time and, as your reader illustrates, it is the surrounding context which helps us understand what those numbers practically mean.

If the list was frozen at 1,500, it would equate to approximately two months’ work. However in practice, the list changes on a daily basis with individuals joining and exiting the lists as referrals and operations take place. The rate at which this change occurs depends on many factors, but in a typical month between 700 and 900 new cases join the list each month. These new cases will be triaged according to priority – with emergency and urgent cases prioritised first.

Similarly, when running at full capacity, and depending on the requirements of the procedures planned, we can deliver around 800 theatre and endoscopy procedure cases per month. But achieving this depends on a number of factors including ward beds being available, ICU beds, staffing, no patient delays because of sickness and no delays with theatre equipment and these are all factors which are being carefully considered as part of the ongoing Hospital Modernisation Programme. The programme will also increase the number of theatres available.

We currently have four operating theatres of which three are booked appropriately to maximise capacity across all specialities. The fourth theatre has to be maintained for spare capacity to accommodate emergencies e.g. emergency caesarean sections, serious incidents/accidents etc. The development of the hospital will provide increased theatre space and equipment storage which will enable more surgical sessions to be carried out. In particular, an increase in capacity will enable more orthopaedic surgery to be conducted.

Covid-19 has, of course, affected health and care services globally and while our favourable local position has enabled the services to resume far quicker than within the NHS, the backlog will, regrettably, take years – rather than months – to address. But while we can’t fix it overnight, it is a clear priority for the committee, which is why we’re pleased that it is features prominently in stage one of the Government Work Plan and we look forward to working with all partners to see how we can expand on this.

Losing theatre time during successive lockdowns has inevitably increased numbers awaiting procedures as only a small number of operations were able to take place, but individuals have continued to be added to the list. In addition, while individuals are continuing to be referred to the UK for emergency care, we’re not able to do this currently for electives and don’t know when we’ll be able to do so. This affects highly specialised procedures where larger hospitals are better placed to provide the necessary specialist care and also means that we’re not able to buy additional capacity for more routine procedures, such as orthopaedic surgery, to reduce our waiting list backlog.

As detailed above, cases are triaged according to priority but there are various factors unique to any particular case which may affect the final scheduling of the operation, including any clinical factors which many arise or patient choice. For this reason, referral dates alone don’t provide a full indication of how long individuals are waiting for operations.