As elective surgery resumes, what’s the likely wait time for your knee operation? Jim Newman shares a personal take.
Today, my NHS hospitals in the Mid-Yorkshire NHS Trust began the slow return to their elective surgery lists (one of the first trusts in the country to do so). Elective surgery is any surgery that is planned (as opposed to being a response to an emergency) so it includes all sorts of procedures from hip and knee replacements and ligament repairs to cataract removal. Initially, the priority will be given to those requiring cancer surgery or urgent operations.
It’s fair to say that, following the coronavirus shutdown of elective surgeries, we’re faced with a big, big backlog. Some trusts are already reporting waiting lists in the thousands for orthopaedic procedures alone. And they’re not even the biggest trusts.
To that figure you can add the people whose consultation was delayed for three months but who will need surgery. And then there’s the additional issue of theatre time and space. Orthopaedics is hardly the only field of surgery playing catch-up.
The current state of play
At present we’re progressing cautiously, taking extra care to ensure we have our safety procedures right, as I explain in this post. Naturally, that means we’re completing fewer procedures each day (perhaps just 3-4) than would normally be the case. You might reasonably expect things to speed up.
Combating that is the fact that private hospitals, many of which have given over their facilities to the NHS until the end of June, will no longer be under contract with NHS England.
So just as we begin to increase numbers as we become more at ease with the new procedures, much of our theatre space is likely to disappear.
If, therefore, we remained at a rate of 3-4 procedures per day (and I don’t think it’s possible at present for anyone to say so for sure whether it will be higher or lower than that moving forward) then we’d take over a year to clear the backlog. And that’s assuming no one else is added to the list – which of course is not the case – and that we are able to run full theatre capacity (which is still in doubt due to PPE resources remaining scarce).
Finally, what happens if there is a second surge? Elective planned operating would once again be one of the first things to stop.
As you can see, there is enormous pressure in the system and on NHS capacity. We are already seeing many more people turning to the private sector for elective surgery and it’s probably fair to say the private hospitals will have more capacity for this type of work given that they rarely treat cancer patients or carry out urgent work. You can quite understand why more and more people are turning to the private sector when faced with very long waiting lists.
As Clinical Director for Orthopaedics I am committed to actively shaping the recovery of the NHS elective surgery and rebuilding NHS capacity post-Covid-19 but we shouldn’t underestimate the magnitude of the challenge ahead.
When will NHS backlogs drop?
It’s possible that the rate of NHS procedures could be sped up. But it’s by no means certain it will. So where does that leave you as a patient considering your next move? With so many imponderables, we can only talk in likelihoods.
With the enormous caveat that all this could change the moment I click ‘publish’ on this piece, here’s my take:
- If you’re waiting on an NHS list for a knee operation, the likelihood is you’ll be waiting considerably longer than you expected pre-pandemic but you will be treated
- As has always been the case (but now more than ever) it is more likely you will be treated faster privately than if you were to remain on the NHS list. You will also have more choice and flexibility regarding when you have your surgery
If that information has left you feeling the need to talk over your options, we’d be only too happy to do so. By calling us you are not committing to private treatment, nor will you be removed from your NHS waiting list.
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