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Focus on inequalities as key part of tackling backlog

Monday, 14 June, 2021
Focus on inequalities as key part of tackling backlog

A North East NHS trust which has taken a range of practical steps to reduce its waiting lists has turned its attention to tackling the wider inequalities in accessing healthcare.

The impact of the Covid-19 pandemic has resulted in a rise in the number of patients waiting for treatment – with a record 5.1 million people on waiting lists at the end of April this year.

But analysis also shows that this increase is spread unequally across different parts of the country, exactly as was the case for the direct impacts of Covid-19 as well.

The research was carried out by LCP’s (Lane Clark & Peacock) Health Analytics team, which is headed up by Jonathan Pearson-Stuttard, who is also chair of Northumbria Healthcare NHS Foundation Trust’s new health inequalities programme board.

Sir James Mackey, the Trust’s chief executive, said: “As Covid-19 hospitalisations have thankfully reduced, we have ensured that we are now focused on enabling patients to access the treatment they need as quickly as possible, but we are aware that we also need to prioritise those that need it most.

“Dr Pearson-Stuttard is a leading and well-respected expert on population health and inequalities, and his expertise will be invaluable in helping us to manage this process, ensuring that we direct our resources in the right places.”

New data out last week (Thursday, June 10) shows both Northumberland and North Tyneside Clinical Commissioning Groups (CCGs) are among the 10 with fewest patients waiting for orthopaedics more than 52 weeks. Northumberland’s 143 patients and North Tyneside’s 155 compare favourably with 4,000 in Norfolk and 3,700 in Devon, for example.

Just 5.1% of the patients on orthopaedics waiting lists in the Northumberland CCG area are waiting 52 weeks or more, the eighth lowest proportion in England.

Dr Pearson-Stuttard said: “It is encouraging that both Northumberland and North Tyneside CCGs are in the top 10 for having fewest patients waiting a year or more for these procedures, but we must redouble our efforts to ensure the indirect impacts of the Covid-19 pandemic do not worsen existing health inequalities across the patient population.”

The NHS England figures include for the first time the number of patients waiting more than 18 months and more than two years for treatment – previously there was just one category for all waits over 52 weeks.

Up to the end of April this year, Northumbria Healthcare, which runs the hospitals in Northumberland and North Tyneside, had just 131 patients waiting more than 52 weeks, representing just 0.56% of the total national waiting list.

The Trust had just one patient who waited more than 18 months and none waiting more than two years. All of these figures are among the best in England.

Sir James said: “This can in part be attributed to our innovative model that we launched in 2015 by opening the first emergency care hospital in the country, the Northumbria (NSECH) in Cramlington.

“While it has resulted in the Trust being among just a handful nationally to continually meet the four-hour standard for patients being seen at A&E, it also meant that during the pandemic, NSECH could be designated as the overall Covid hub and geared up to take extra patients. This in turn meant that our other hospital sites could keep elective and non-urgent operations going for as long as possible.

“The other element is of course the hard work and dedication of our staff in ensuring that they continued to provide as much high-quality care as possible during the pandemic, as well as now making every effort to catch up where treatment was disrupted.”

One of the ways of tackling the backlog has been a focus on day case surgery – short, low length-of-stay operations, which has been an innovation of the orthopaedic team developed over several years. The Trust is currently carrying out around three times as many of these procedures as other areas.

Northumbria Healthcare also has some of the best Patient Reported Outcome Measures (PROMS) – based on patients’ own opinions of their care – in the country and is rated first in the Getting It Right First Time (GIRFT) rankings for day case surgery.

Eliot Sykes, the Trust’s surgical business unit director, said: “I am proud that more than 14,500 procedures and operations have taken place during the pandemic, a phenomenal number which underlines that it was very much business as usual in our hospitals as much as it could be, despite the additional pressures and need for enhanced infection control measures.

“However, given the scale of the impact of Covid-19, there were still non-emergency procedures which had to be postponed and we have been working hard ever since to catch up on this, something which is highlighted by the latest figures.

“We are also working together on a regional basis and have offered our support to trusts across the North East and North Cumbria to help tackle backlogs as well.”

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