We take a look at the current state of knee replacement waiting lists in the private sector and in Mid Yorkshire Hospitals Trust.
If you’re on a waiting list for a knee replacement, you don’t need me to tell you there hasn’t been much good news recently. So here’s a note of cautious optimism from Mid Yorkshire Hospitals Trust (Mid Yorks), where things are starting to improve.
As you will no doubt have read, staff absence within the NHS has been a real problem in recent months. Confounded by Covid, the challenge for every hospital has simply been ensuring there are sufficient staff to run operating theatres. That’s not just surgeons – it’s the entire team, without whom operations can’t happen.
As this piece in The Guardian notes, overall NHS absence has been reducing, although data does show that, as Omicron has spread north, an improving picture in London isn’t yet matched in Yorkshire where absence remains high.
At Mid Yorks, we’re operating seven days a week. Pre-Omicron, this extra capacity was really just enabling us to tread water. We weren’t reducing waiting lists by any significant degree because the Covid requirements of theatre meant every procedure took longer.
That is, thankfully, no longer the case. PPE restrictions have eased which has made operating less arduous and less time consuming. Surgical times per procedure are now pretty much back to normal.
To address staff shortages and enable us to run seven-day operating, we’re using agency staff drawn from other NHS trusts. To protect patient safety, we always operate with a blend of local and agency staff to ensure no theatre is operated by an entire team unfamiliar with local systems.
As a result of all the above, the extra capacity really is making a difference and waiting lists are starting to drop.
The Mid Yorks advantage
So that’s the good news. You may think it paints a picture that sounds somewhat different to the position elsewhere, and that’s true.
Mid Yorks is in the rare but fortunate position of being spread across three hospitals: Pinderfields, Pontefract and Dewsbury. That enables us to ringfence one site (Pontefract) as a ‘golden hospital’ that is entirely Covid and trauma-free. Few NHS trusts are so fortunate, and it’s much harder to return to normal levels of elective procedures, such as knee replacements, when the geography of your trust means you simply can’t ringfence them as we can.
So our picture is not a common one. My NHS colleagues elsewhere in the UK, and even elsewhere in Yorkshire, aren’t in the same position as we are because they can’t be. It will take others far longer to start making inroads into their waiting lists, which is why the current waiting list figures will take years to resolve.
Private sector waiting lists
Throughout the pandemic, one extremely valuable pressure valve has been the role the private sector has played in treating NHS patients. Private hospitals are continuing to treat NHS patients, but here too, waiting times are rising.
They’re rising because many more people are looking at the current state of the NHS waiting lists and choosing to explore the private surgery route for their knee replacement and other procedures.
A traditional 4-6 week wait has become an 8-12 week wait (in some circumstances), even for those growing numbers of patients deciding to self pay for their treatment.
It remains the case that, even at 12 weeks, the wait for private knee surgery is miniscule compared to the wait in the NHS. Private is still the fastest route to knee surgery.
Where does that leave us? Well, from my personal experience at least, it’s the slightly curious position of seeing private wait times increase (from a very low level) and NHS times decrease (from an extraordinarily high level). Overall, that has to qualify as positive news.
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