When I was in desperate need for a hip replacement, and a working self employed GP aged 52 (2001), I was under the care of a Welsh Health Service consultant. I have a locum insurance policy meant to cover this situation. I agreed to go in on a Thursday, with about 2 weeks notice. I arranged a locum, and signed an agreement with him for 6 weeks cover. 2 days later the operation was delayed due to an emergency infected hip replacement. A quick calculation revealed that it would be better to go privately (on the Friday of the same week, with the same consultant) than to accept the delay. Such delays are unknown for infections in the private sector, and all cold orthopaedic units have much fewer infections. Now that waiting lists are getting out of control, should we have logical rationing by prioritisation of the waiting queue? Perhaps readers think this is facetious, but cancers could be ranked by age (Youngest first), and cold operations such as hip replacements could be rationed according to a mixture of age, and employment: self employed being before the employed, and both before the retired and aged?
Another incentive for Private Medical Insurance / direct payment, and two tiers.
Are you lucky enough to live in a post code where there is a cold orthopaedic option?
Almost 300,000 patients a year miss out on surgery because of delays and inefficiencies in operating theatres, an NHS watchdog report has concluded.
A third of operations start late because staff do not turn up at the same time, equipment is missing, beds cannot be found or there are other administrative problems, NHS Improvement found. Hospitals could boost the number of routine operations by 17 per cent through basic efficiencies and some surgical teams could be treating more than half as many patients again, it said.
More than four million patients are on waiting lists for non-urgent procedures such as hip replacements. The figure has been rising as hospitals struggle to keep pace with demand from an ageing population. Waiting targets have not been hit for three years and NHS leaders fear these guarantees are about to be scrapped.
The report, which looked at eight areas of surgery in 92 hospitals, said that they could carry out 291,327 more operations a year with better planning. Poor scheduling meant that 38 per cent of surgical lists finished early enough for another operation to be performed. Hospitals were urged to make staff have holiday approved six weeks in advance, and operating lists approved four weeks in advance and checked two weeks in advance, which has been shown to reduce cancellations.
Tim Briggs, national director of clinical improvement for the NHS, said: “While waiting times for surgery are lower than they have been historically, more can be done.”
Mouth and face surgery in two hospitals was found to be so inefficient that they could have boosted patient numbers by more than 80 per cent with better planning. Seven plastic surgery centres could have increased cases by more than 50 per cent, as could one urology team and two gynaecological centres.
Rachel Power, chief executive of the Patients Association, said: “Patients needing hip and knee replacements, shoulder surgery or other non-life-saving treatments should not have the uncertainty of a long wait for their pain to be alleviated. We are pleased to see new initiatives giving patients and their loved ones increased certainty over when their procedures will take place.”
Surgeons and NHS bosses protested that a serious shortage of beds was contributing to inefficiency. Ian Eardley of the Royal College of Surgeons accepted that while “every member of staff and patient can recite examples of waste”, the NHS had the second lowest number of beds per patient in the EU. “Such shortages mean time is wasted by NHS staff in freeing up beds instead of treating patients,” he said.
Amber Jabbal of the hospitals’ group NHS Providers said: “There are opportunities for efficiencies to be made. However, theatres cannot be viewed in isolation and we have to be realistic about the current resources in place. Often cancellations and down time for theatres are because of staffing levels, patient needs and the availability of beds across the system.”
Stephen Hammond, the health minister, said: “I hope to see these innovative and clinically-led proposals — many of which are based on what is already working across the country — adopted by trusts wherever possible.”
The Independent: Patients facing long delays for operations because of NHS …
The number of patients waiting longer than 18 weeks for routine operations such as hip and knee replacements is rising year on year in England.
The total waiting list of more than 4.1 million is up more than 10% over 12 months…..