NOW WAIT AYEAR FOR YOUR HIP OP
Patients face long delays for routine surgery in wake of Covid
PATIENTS will have to wait up to a year for hip and knee replacements as the NHS imposes strict infection controls, doctors’ leaders warn.
Hospitals are facing a huge backlog of routine operations but are running at only about half their usual capacity due to the coronavirus crisis.
Non-emergency surgery cases were paused for three months in mid-March, and have only just resumed.
Doctors are also concerned that some patients on the waiting list are being prescribed highly addictive opioid painkillers.
NHS waiting times are expected to increase substantially over the coming months because hospitals must enforce stricter infection control measures. This means only a limited number of patients can attend clinics or stay overnight on wards and theatres must be more thoroughly cleaned between procedures, meaning fewer operations can take place.
Professor Philip Turner, the immediate past president of the British Orthopaedic Association, said hospitals were ‘re-prioritising’ patients awaiting operations, including hip and knee replacements, to identify which cases
were the most urgent. He said: ‘It may seem unfair to those who have been on the list the longest and who thought they were just about to come in.
‘I’ve been talking to some who received their admission letters – they’ve now been told “no”. But they may not be the ones who require treatment the most urgently.’
Professor Turner said that ‘sadly’, many would be waiting longer than six months, adding: ‘I think it could be up to a year.’
He predicted it could take two years before normal service was resumed. It came as:
■ Holiday bookings surged as ministers are poised to confirm which destinations will be connected to the UK through ‘air bridges’;
■ Leicester could be the first UK city to be put into a second ‘local’ lockdown after an increase in cases;
■ Government advisers warned Britain was on a ‘knife edge’, and virus cases could rise in days;
■ Global cases of Covid-19 topped 10 million with almost 500,000 deaths;
■ Boris Johnson will today pledge £1.8 billion to fix Britain’s crumbling schools and confirmed attendance will be mandatory for pupils from September;
■ More gastric band surgery could be offered on the NHS under plans to reduce the impact of a second wave of coronavirus.
The latest NHS figures show the numbers of patients waiting a year or more for operations or other procedures has increased by ten-fold compared to 2019. A total of 11,042 people had been waiting at least 52 weeks as of April, up from 1,047 in April last year.
Professor Derek Alderson, president of the Royal College of Surgeons, said the increasingly long waits were a ‘cause of great concern’, adding ‘a substantial number of patients in these categories are people waiting for orthopaedic joint replacements’.
Nigel Edwards, chief executive of the Nuffield Trust think-tank said: ‘The reality is some people may end up waiting a very long time. All the orthopaedic surgeons in an area will need to look at their waiting lists and say, look, if we can do a thousand cases and we’ve got 2,000 people, who do we do?’
Under the NHS constitution, patients shouldn’t wait longer than 18 weeks for routine procedures.
The situation is being made worse because GPs slashed their referrals during the coronavirus outbreak, meaning many patients aren’t even making it on to the waiting list.
Figures from the British Orthopaedic Association show the number of patients referred for orthopaedic procedures in April was down by 80 per cent – 33,966 referrals compared to 176,033 in April 2019. Professor
Turner said: ‘To get back to anything like the throughput we normally would, we’re probably looking at two years.’
He added that he was ‘very concerned’ that patients were being put on opioid painkillers by their GPs because they were in such agony.
‘We have concerns about the sorts of analgesia (painkilling medication) they may be receiving. The other big controversy is about the use of opiates for analgesia.
‘We’re very concerned and there’s some evidence when we do see patients that they have been given very strong analgesics by GPs because they don’t have much alternative if they’re not going to have surgery for a while. We’re concerned about how to wean patients off the opiates once they get the surgery.’
The Mail has been campaigning for greater recognition of the prescription drugs addiction crisis, including opioids.
Professor Turner added: ‘If patients have to wait longer they’ll obviously be in more pain, their joints actually get stiffer, the deformity increases (for arthritis), there’s a risk that the complexity of the surgery required – particularly in knee replacements – may increase or it may be more difficult to do.’
An NHS spokesman said: ‘Now that the NHS has managed the first wave of coronavirus, there is an important job to do to help people whose planned care, such as knee and hip surgery, was postponed to protect their own safety.
‘That’s exactly what local health services are doing, while also remaining ready for any future increase in Covid cases.’