To accompany the below communication we have links and resources available on our guidance page which can be found under 'patient information'
Summary
Duplicated from 'Stakeholder briefing note – 11th April 2022 NHS Waiting list backlog'
Reducing the waiting list backlog continues to be a focus for the health and care system in Greater Manchester (GM).
At the beginning of January 2022, the difficult decision was made to pause non-urgent surgery due to the impact of the Omicron variant which saw increased hospitalisations and staff absences. The number of people on the total waiting list to start treatment has increased as a result.
Non-urgent surgery started to resume from 24th January and hospitals continue to work hard to reschedule procedures and get more people seen and treated. We are pleased that we were able to continue outpatient appointments during the recent wave.
On 8th February 2022, the Government published the national ‘Delivery plan for tackling the COVID-19 backlog of elective care’. This sets out a clear vision for how the NHS will recover and expand elective services over the next three years.
We have a number of initiatives in place that are helping to support people while they are waiting such as our GM website While You Wait. On 24th February 2022, NHS England also launched My Planned Care which is an additional national platform that allows patients to look up the average waiting time at their hospital and advice to help manage their physical and mental wellbeing.
The rest of this update provides more information about the current situation. It also provides some additional detail on each of the initiatives.
Introduction
This briefing is to update stakeholders in GM on the NHS waiting list backlog and the work that is being done to tackle it. There have been three previous stakeholder briefings on this topic, the last one in October 2021.
Current position
GM continues to be one of the areas hardest hit by COVID-19 in the country and this has impacted the speed of our recovery, with elective care resuming later than in other places. Our waiting list challenges in GM have been further compounded by the pause in elective care in January 2022 due to the impact of the Omicron wave.
Long waiting lists for hospital treatment are here to stay for a while but the NHS and its partners in GM are doing their best to tackle them. Reducing the number of patients who have to wait for operations or surgery continues to be a primary focus.
To date, our hospitals and local healthcare systems have responded well to the challenge of recovering services, working together to provide mutual aid to ensure that services can be maintained. We continue to try to ensure that those patients who have waited the longest and with the greatest clinical need are prioritised.
Local data shows that the number of people on the total waiting list to start treatment continues to increase (around 455,000). The three specialties with the biggest number of people waiting over 52-weeks are ENT, Gynaecology and General Surgery.
The total amount of elective work that can be delivered is limited by the need to also provide both urgent care and COVID-19 requirements including Infection Prevention and Control restrictions. To note, the waiting list includes those waiting for a procedure/surgery and people waiting for an outpatient appointment (the majority).
The number of people being seen in Outpatient departments continues to be above pre COVID-19 levels and the number of day case and other elective procedures also continues to improve.
As we continue the work of restoring services impacted by the pandemic, it is vital that we ensure this is balanced with the recovery and resilience of our staff. Supporting hospital, primary care and community staff to recover, who have been going above and beyond the call of duty for 2 years now is crucial.
Key areas of work and improvement:
There are a number of initiatives taking place across GM to bring down the waiting list backlog and support patients that have featured in our previous briefings. Here are some of our most recent initiatives:
Addressing the longest waits
Treating patients who have waited the longest is a key priority for us in GM. A number of patients have waited over two years for treatment, many of whom have particularly complex medical conditions or require additional support to have treatment. Our initial focus is to ensure we treat these patients wherever possible before the end of June.
Our hospitals are working together to identify ways that they can increase the number treatments for patients who have been waiting the longest whilst balancing the needs of those who are clinically urgent. To support this, we are looking to utilise our surgical hubs and independent sector hospitals as much as possible.
Key to getting people seen and treated, is the mutual aid across our local hospitals. This means that patients may be offered appointments at hospital sites other than their local hospital. Patients will be supported to take up these opportunities, including support with transport.
Where particular treatments require specialist procedures or where they can only be undertaken at specific specialist sites, we are in discussion with hospitals outside GM to identify opportunities to ensure people receive the care they need in a timely way.
We will be looking at how we can expand these approaches to help reduce the number of patients who have been waiting for more than 78 and 52 weeks. Patients who have been waiting for over two years will be contacted by the hospital soon to discuss the options to get them treated.
Surgical Hubs
Hospitals across GM will continue to work together to increase the number of operations that can be done. We’ve previously shared that surgical hubs have been set up for Orthopaedics and Children’s surgery to help to reduce the waiting list backlog by delivering additional surgical lists at the weekends. Across GM we are looking at whether this approach can be used in other specialties. We are also exploring ways we can support patients to attend the surgical hubs.
Virtual Wards
Virtual wards are being used across GM to enable patients to get the care they need at home safely, rather than being in hospital. The use of digital technology means patients can receive 24-hour monitoring and management support at home using apps, technology platforms, wearables and medical devices, such as pulse oximeters. The added benefit of this is keeping hospital beds available for us to admit patients for their planned procedure.
Outpatient appointments
Many clinicians across GM will be offering patients the option to get in touch when they think they need a follow up appointment rather than one being automatically generated. This is called Patient Initiated Follow Up (PIFU). We are working to introduce this in most specialties across GM. We are also looking to increase the availability of ‘Advice and Guidance’ services that enable primary care clinicians (including GPs) to get advice from hospital specialists as to the best next step for a patient. This is helping primary care to support more patients without the need for a hospital referral which will help us use our hospital resources most efficiently.
Supporting people while they wait
The While You Wait website is a digital resource designed to support patients waiting for hospital treatment across GM.
The website aims to provide further information and advice, along with handy resources, to help patients manage their physical and mental wellbeing while waiting for hospital care. The website includes where patients can find extra support online and provides information about approximate waiting times at different hospitals (using national data).
It has also been developed to support colleagues in primary and secondary care as well as our Voluntary, Community and Social Enterprise (VCSE) partners so they can all signpost this resource to patients.
We are currently developing new content for the website and will be adding three new specialty sections for Orthopaedics, Gastroenterology and Children’s surgery. Please contact: gm.hsccomms@nhs.net if you have any feedback or questions about the website.
On 24th February 2022, NHS England launched My Planned Care which gives patients direct access to the latest average wait time information for each Trust which is updated weekly.
In GM we are coordinating efforts to make sure that My Planned Care links to our local While You Wait offer.
My Recovery App
The My Recovery App is a digital companion designed to support patients waiting, preparing for and recovering from surgery. The app provides a range of information and advice from clinical teams about what patients can do in the lead up to surgery and in the recovery period, to help them get the best possible outcome from their treatment. The app also enables patients to complete important surveys which enables the clinical team to track and monitor patient status before and after surgery.
The app is being implemented across hospitals in GM and is currently available to people who are waiting for hip or knee replacement surgery at Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, The Northern Care Alliance NHS Foundation Trust (NCA) and Stockport NHS Foundation Trust.
The My Recovery App will be rolled out to more Orthopaedic specialties and areas across GM to support people while they wait.
Challenges
We will continue to provide updates as the work progresses.
Thank you to everyone for their continued patience.
For further informationFor any further information, please contact:
Laura Marsh, Programme Director GM Elective Care Recovery & Reform Programme
