Key NHS operations ‘being rationed’ – Hospitals: A system under pressure

Nick Triggle reports for BBC 6th December 2013: Key NHS operations ‘being rationed’

“The NHS in England appears to be rationing access to vital non-emergency hospital care, a review suggests.

The analysis by the Dr Foster research group looked at three key procedures – knee, hip and cataract operations.

For much of the past decade, patient numbers have been rising as would be expected with an ageing population.

But since 2010, the numbers have levelled off – with just one in eight areas now doing more hips and knees and one in five seeing rises in cataracts.

It comes amid mounting pressures on the health service.

The challenges facing A&E units have been well documented, but reports have also been emerging that non-emergency care is being squeezed too.

‘Highly effective’

These findings – to be published on Monday in Dr Foster’s annual hospital guide – provide perhaps the most comprehensive picture yet of what is happening

The health care analysts looked at the number of operations being carried out for the three types of procedures – among the most life-enhancing done by the NHS – for the past decade.


It found virtually no change in the overall numbers over the past two years with the total numbers hovering around the 475,000 mark each year.

Hip replacements were the only treatment out of the three that were still going up – although the rate of increase has slowed.

Meanwhile, the number of cataract operations is at its lowest level for five years and 2012-13 saw the first fall in knee replacements for a decade……”

Look at the “perverse” behaviour report on a friend in a posting in October and updated to date. This patient had not yet had a complete diagnosis and definitive operation. In a private or an insurance based system this would be despicable. Since it’s in Wales its not surprising.. This patient is in Wales and has found their way to a tertiary centre…

Nick Triggle also comments: Hospitals: A system under pressure

“….The annual hospital guide produced by the Dr Foster research group, which is published on Monday, will point to evidence which suggests the NHS is starting to ration access to the most life-enhancing non-emergency operations, such as knee and hip replacements.

But this is just the tip of the iceberg. Wherever you look, there are signs of trouble….”

Implosion – BBC News reports in Wales 14th November..

NHS Wales waiting times more than double in six months

Wales on Line 4th September reports the worst wait: “According to latest figures for June 2013, the number of people waiting more than 36 weeks for their first appointment for opthalmology treatment has risen from 97 a year ago to 1,437 – a rise of 1,380%.

I looked up the “rights in the NHS” England with regard to waiting times, for Welsh people to think about since they don’t apply to them. “

Guide to NHS waiting times

Part of the NHS pledge to put patients at the centre of everything they do involves making sure that you are diagnosed and start treatment as soon as possible, at a time that is convenient for you. The NHS Constitution says you have the right to access certain services commissioned by NHS bodies within maximum waiting times. Where this is not possible and you ask for this, the NHS will take all reasonable steps to offer you a range of suitable alternative providers.

This promise is made a legal right by NHS England and Clinical Commissioning Groups (CCGs) in the responsibilities and standing rules regulations 2012 (PDF, 259kb).   (Not for Wales!!!)

This entry was posted in Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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