Clinical Negligence & Catastrophic Injury Solicitors
NHS Covid legacy - long waits and lives at risk.
More than a year battling the Covid-19 pandemic has left the NHS facing a huge backlog of patients needing help, putting lives at risk, patient groups and staff are warning.
Analysis shows that almost a third of hospitals have seen far longer waiting times with more than 10% of patients enduring a year without treatment; major cancer services disruption, with some hospitals struggling to treat half of their patients within the two-month target time; concern for 45,000 "missing cancer patients", after falls in GP referrals and screening services across the UK.
As the success of the UK vaccine programme helps bring the pandemic under control, NHS England has launched a £160m initiative to tackle the growing waiting lists.
A network of "accelerator" areas is being established to pilot new initiatives, including extra weekend clinics, virtual home assessments and new clinics to complete high numbers of cataract operations
NHS England chief operating officer, Amanda Pritchard, says: "With Covid cases in hospitals now significantly reducing, our focus is on rapidly recovering routine services."
But some health trusts are struggling to start treatment for even half of patients in the recommended timeframe of two months after an urgent GP referral.
University Hospitals Birmingham struggled to start treatment for even half of those on its waiting list as it saw performance deteriorate despite sending patients to be treated in local private hospitals.
The trust treated more Covid patients than any other in the country with more than 14,000 admitted during the pandemic, leading to the redeployment of 1,500 staff locally.
The trust says the disruption has been unavoidable and that it is now "working hard" to have patients diagnosed and treated.
But it has found not all the delays are caused by the disruption to services. About one in every four patients waiting the longest has postponed treatment themselves and nurses at the trust have been phoning and pleading with them to have treatment.
This reluctance to come forward, coupled with problems accessing GP and screening services at points in the pandemic, is the reason why the number of patients coming forward for checks and being diagnosed has dropped, although there are now signs the numbers are rising.
Even so, Macmillan Cancer Support analysis suggests across the UK there are 45,000 "missing" cancer patients, which the charity fears will lead to more later-stage diagnoses, which reduce the chances of survival.
Executive director of advocacy & communications at Macmillan Cancer Support, Steven McIntosh, said "The knock-on impact of the pandemic on cancer care cannot be overstated. We're likely to be dealing with Covid's long shadow for many years to come."
Attempts are being made to get people to come forward. An NHS advertising campaign, Help Us, Help You, is urging people with cancer symptoms to come forward.
But cancer doctor and Catch Up With Cancer Campaign founder, Prof Pat Price, says a "monumental political effort" is needed, with significant investment in equipment and the workforce to "super-boost" services as the NHS was already at a disadvantage after years of underinvestment.
Cancer was prioritized by the NHS from the start of the pandemic to try to keep disruption to a minimum
An analysis by the Institute for Fiscal Studies and Imperial College London breaks the impact of the pandemic down by emergency admissions, planned care and outpatient work.
Cancer falls in all three categories and has seen one of the smallest drops in activity with services such as knee and hip replacements affected much more.
Overall planned care fell by a third in 2020, with the north of England and Midlands hardest hit. Outpatient appointments fell by a fifth, with physiotherapy almost halving, as did non-Covid emergency admissions
The report says this will have a considerable impact on the quality of life and health of many people. As a result there are longer waiting times for many non-emergency treatments.
In England, nearly five million people are now on a hospital waiting list, nine per cent of the population, the highest number since records began, in 2007.
Most worrying, the numbers waiting for more than a year have rocketed, in England, from 1,600 before the pandemic to 436,000 at the end of March 2021.
Nearly a third of hospitals now has more than a tenth of their patients in this position. A handful of hospitals have a fifth of their patients waiting more than a year.
One is Hull University Teaching Hospitals. Chief operating officer Ellen Ryabov says it is now running extra weekend clinics, as well as using the private sector. She adds: "Our aim is to get down to 14.5% of patients waiting more than 52 weeks by the end of September and then look to clear that entirely."
Meanwhile, Tracey Loftis, of the charity Versus Arthritis says the wait for "life-transforming" surgery can be devastating.
Brenda Pugh, 61, has been waiting for a double hip replacement since June 2021, after developing severe osteoarthritis at the end of 2019.
She says: "The hip pain is unbearable. I can just about walk from the sofa to the bathroom. Otherwise, I can't move. It's like standing on jagged glass. I get so depressed about the pain I'm living with."
But the NHS was routinely missing its targets before March 2020. A council member of the Royal College of Surgeons of England, Tim Mitchell, said: "The problems predate the pandemic. We already had too few beds and not enough staff."
The Health Foundation analysis has also found that six million fewer patients were referred on to hospital treatment in 2020 than in 2019, a drop of nearly a third.
As with cancer, people seem to have been deterred from seeking help, either because they were worried about catching Covid, or did not want to burden the NHS.
And, if only a fraction of this return, it could create serious problems for the recovery of services.
Surveys by both the Royal College of Nursing and British Medical Association in recent weeks have suggested high levels of staff exhaustion, fatigue and low morale, with many reporting they feel under pressure to work extra hours without pay, which, trade unions warn, is unsustainable.
Chief executive, of the Health Foundation, a think tank that monitors NHS performance, Dr Jennifer Dixon, has sympathy for staff.
She says: "The impact of the pandemic on the NHS has been immense," adding that workforce shortages are now critical and, if this is not solved, the backlog will not be addressed soon.