Derbyshire hospitals are facing waiting list challenges

Health chiefs in the county are not expecting the number of patients waiting more than a year to have hospital treatments or operations to fall within the next six months.

Instead their aim is to now “slow the growth” and “aim to at least stabilise the position over the next six months”.

But officials said that, unlike during the second wave, “routine” surgery is continuing to take place. They said they were keeping in contact with patients who needed non-urgent procedures but urged anyone whose condition has deteriorated significantly since their initial contact to their GP.

They said patients with the most urgent clinical needs, such as cancer, had to be prioritised.

Over the course of the pandemic, the number of Derbyshire patients waiting a year or more for treatment or surgery has soared from 45 to more than 3,500, as of the most recent data to November 6.

The number of patients waiting 52 weeks for treatment before lockdown was typically in the single digits or non-existent.

Papers to be discussed by the Derby and Derbyshire Clinical Commissioning Group (CCG) next week show 3,140 patients waiting 52 weeks for treatment at the University Hospitals of Derby and Burton NHS Foundation Trust and 426 at the Chesterfield Royal Hospital NHS Foundation Trust.

This is a 20 per cent increase from figures published just a month ago when there were 2,807 patients on Derbyshire’s 52-week waiting list, with 2,509 at Derby and Burton and 298 at Chesterfield.

On March 20, just before lockdown but as the Covid impact was surging, the Derby and Burton trust had 45 patients on its 52-week waiting list, while Chesterfield did not have any.

These are elective appointments and the most common type is for trauma and orthopaedics (40 per cent), which includes hip and knee surgeries.

While these may be minor and less urgent, patients are having to cope with pain and discomfort and a range of other complications for much longer than they would normally be expected to.

This is due to the focus on Covid-19 patients in the first wave of the pandemic and the suspension of all elective surgeries.

Over that time, thousands of patients have seen their surgeries and treatment postponed and new patients have been added to that list.

In response to the updated figures, the CCG issued a statement which said: “The arrival of coronavirus has made 2020 one of the most challenging years for the NHS and staff, at every level, have gone above and beyond to respond to COVID-19 in remarkable ways, showing extraordinary dedication, skill and compassion.

“The way the NHS had to change to respond to the pandemic, and speed at which it had to move to do it, was phenomenal. In the space of six weeks the NHS went from caring for zero COVID-19 patients to 19,000 COVID-19 inpatients per day across the UK.

“Clinically-essential service provision has been maintained throughout the pandemic in Derbyshire, thanks to the determination and adaptability of many services and colleagues. In order to do this, services had to review provision, temporarily stopping some services and making adjustments to others – in line with the rest of the NHS.

"Doing this enabled the NHS in Derbyshire to release extra capacity and add resilience where it was needed the most.

“In May the NHS entered the second phase of its response to COVID-19. This marked the beginning of ‘restoration and recovery’ and saw the NHS begin to release capacity to resume non-COVID-19 services where it was safe to do so while continuing work to tackle coronavirus.”

Angie Smithson, Chief Executive of Chesterfield Royal Hospital and Executive Lead for the Planned Care Steering Group, explains: “Since then we have been working closely as a system to assess all patients currently on a waiting list for cancer, elective and outpatient services. Patients are being reviewed by the appropriate clinical teams and kept informed of the current situation.

"This work is being overseen by our capacity planning and system quality and performance groups and our overwhelming priority continues to be providing safe care for both patients and staff.”

Dr Steve Lloyd, GP, Medical Director of NHS Derby and Derbyshire Clinical Commissioning Group, said: “There are now more patients with COVID-19 in our hospitals than at any point during the first wave of the virus.

"This, combined with winter pressures, is now beginning to have an impact on our plans for service restoration as it has for other NHS Trusts nationwide and healthcare systems in Europe.

“As NHS Chief Executive, Simon Stevens, said in a press conference earlier this month, as the number of patients with COVID rises, the ability of the NHS to respond to patients with non-COVID issues reduces. Inevitably this means our capacity for elective surgery is less than it would ordinarily be, but routine surgery continues to take place during the second wave which is very different to the position during the first wave.

“The best way to ensure the NHS can do what it needs to do is to reduce infection rates. This is what ‘protect the NHS’ really means and will enable us to ‘help us help you’.”

Ms Smithson added: “Our clinical and operational teams are working hard to treat as many people as possible. We are endeavouring to prioritise those with the highest clinical need – such as patients with cancer – with a view to seeing and treating them as soon as possible.

"We recognise there will now be many patients listed for more ‘routine’ procedures who have now waited extraordinary lengths of time for their treatment, but our priority at this time has to be to care for those with the most urgent clinical needs. This means allocating extra beds in our hospitals to look after patients who are acutely unwell.

“Patients waiting for more ‘routine’ procedures will be contacted in due course to discuss their individual plans, however, if there is anyone who is awaiting contact, or whose condition has deteriorated significantly since their initial contact, then they should contact their hospital clinician or GP.”

The CCG statement continued: “In the last few weeks Emergency Departments have also seen a rise in patient numbers. With social distancing in place in waiting areas, the number of patients that can safely be seen in the department is lower than in previous years.”

Gavin Boyle, Chief Executive at University Hospitals of Derby and Burton, said: “We are absolutely committed to doing the right thing by our patients and are working closely with our NHS system partners across the region to ensure that all of our patients receive the treatment that they need as quickly as possible.

“Going to the right place for treatment has never been more important. Where patients have serious or life threatening injuries or illness then they are urged to continue to call 999 or visit the emergency department, but patients who have less serious conditions are being asked to visit NHS 111 online or call NHS 111 for advice on the best place to go for care.

“This will mean emergency departments are able to treat the sickest patients more quickly and safely, as well as meaning that less serious patients will get faster treatment in other services.

"NHS 111 can book appointment slots for patients at urgent treatment centres (formerly known in Derbyshire as minor injury units or urgent care centres) and emergency departments.

"Visiting NHS 111 online or calling NHS 111 in advance of seeking treatment for urgent or emergency care, unless it is for a life threatening condition, is really important.“There remains a clear message for patients to continue to use the NHS where they have concerns about their health. Pharmacists can provide a wide range of healthcare advice and treatments and GPs are open for business with telephone, video and face to face appointments all available.

"Anyone concerned about potential cancer symptoms should not hesitate to speak with their GP at the earliest opportunity.”​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

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