A board meeting of the trust which runs the Royal Preston and Chorley and South Ribble hospitals heard that the principle was designed to help keep patients safe as work steps up to resume normal services – many of which were suspended at the height of the coronavirus pandemic.
Members were discussing the hospitals’ recovery plans just days before official publication of waiting time statistics which have since shown the scale of the challenge in clearing the backlog caused by Covid-19.
In common with the rest of England, Lancashire Teaching Hospitals (LTH) has seen the number of people waiting more than a year for treatment soar – from 21 in February to 763 by June. More people were waiting over 52 weeks for oral surgery and general surgery than any other type of procedure.
The meeting was told that the overall number of year-long waits in Central Lancashire was expected to “continue to rise”.
The operating capacity of the trust has been hit by the need to create Covid and non-Covid zones, with four theatres at the Royal Preston amongst the areas taken out of operation as a result. A bid for funding to redesign the space to make up for that loss has now been submitted.
Faith Button, chief operating officer at LTH, said that urgent cases – and, in particular, cancer treatment – were the “top clinical priority” for the trust.
According to NHS statistics, the proportion of cancer patients receiving their first treatment within 62 days of being urgently referred from their GP has actually improved at LTH during the pandemic – up from 67 percent in March to 70 percent by June. However, the national target for that measure is actually 85 percent – and, in June, 13 LTH patients were waiting over 104 days for that first cancer treatment.
“We had to stand down a number of [cancer] treatments in line with national guidance. That’s caused a backlog of patients and…they have become the focus of all of our recovery plans,” Ms. Button explained.
“Further breast [treatment] capacity has been secured and the cancer nurse specialists are working hard with patients to encourage them to attend where they are nervous.”
Elsewhere, the trust’s previously perfect performance on waiting times for diagnostic tests has nosedived as a result of the pandemic. Back in March, not a single patient waited longer than the national standard of six weeks for such a test, but by June, that had rocketed to over 4,300 – 2,900 of whom were actually waiting over 13 weeks.
That meant only 54 percent of patents received their test within the six-week target. The meeting heard that issues with a CT scanner had exacerbated the situation.
The overall waiting list at LTH for people who have been referred to the trust from their GP fell slightly between March and June from around 35,500 to 34,100.
However, the proportion of those waiting less than 18 weeks for treatment – the NHS standard measure – still dropped over the same period from 72 percent to 48 percent.
The trust is continuing to make use of capacity in the private sector which was booked as part of a nationwide contingency earlier in the pandemic.
However, board member Professor Paul O’ Neill said that he felt national talk of a “recovery plan” was premature in view of the situation LTH was facing.
“[That] implies improvement. What I’m hearing is…things are still deteriorating [and] more people are waiting.
“There has clearly been a huge amount of work [so that] we can resume certain activities – but I don’t get a sense of when the waiting lists in the short term will stop increasing,” he said.
Ms. Button said that the current phase was one of “restoration”.
“We’re trying to restore services which will start to aid that recovery,” she said.
She added that modelling was being carried out to determine the best way of improving the trust’s productivity while “keeping our patients safe and [focusing on] those clinical priorities”.
NHS RECOVERY PRIORITIES
NHS England has told all hospital trusts that they should aim to:
Restore full operation of all cancer services, including diagnostics and surgery in Covid-secure environments – as well as all cancer screening programmes.
Recover the maximum pre-planned activity possible between now and winter.
Prioritise clinically urgent patients, followed by those waiting longer than 52 weeks.
Consider avoiding asking people to attend face-to-face outpatient appointments where a clinically-appropriate and accessible alternative exists.
At Lancashire Teaching Hospitals…
21 – patients waiting over 52 weeks to start treatment (March 2020)
763 – patients waiting over 52 weeks to start treatment (June 2020)
0 – patients waiting over six weeks for a diagnostic test (March 2020)
4,301 – patients waiting over six weeks for a diagnostic test (June 2020)
72 percent – proportion of patients beginning treatment within 18 weeks of GP referral to hospital (March 2020)
48 percent – proportion of patients beginning treatment within 18 weeks of GP referral to hospital (June 2020)