Northwest Arkansas Democrat-Gazette
Wait list for elective care growing long in England
LONDON — There are nearly 4 million people in England on the National Health Service waiting list for routine hospital treatments, which have been disrupted in recent months as hospitals have been forced to suspend services in favor of coronavirus cases.
Many patients are experiencing a significant deterioration in their health because of the delay and are growing anxious and frustrated because of the lack of guidance as to where they are placed on the list or how long they will have to wait before they can receive treatment.
Many fear they could be pushed down the list if hospitals resume services on a triage basis.
As she waited nine months for surgery, Ruth Fawcett’s knee muscles wasted away, causing her joint to come loose in its socket and leaving her unable to walk without assistance.
“They won’t tell me where I am on the list or how urgent they consider my case to be,” Fawcett said. “I can hardly walk. My knee just wobbles about, and if I don’t use my two walking sticks, I will fall. It’s very scary.”
Even before the pandemic, the government-run health care service was struggling to meet waiting-time standards, with 1 in 6 patients waiting more than the target of 18 weeks for routine treatment in January.
The number of people on the waiting list for elective care fell from 3.94 million in April to 3.84 million in May, according to NHS figures published Thursday. However, the drop has been attributed to fewer people being referred for testing and treatment during the pandemic; numbers are expected to start climbing again when services resume.
With hospitals operating at reduced capacity to accommodate patients suffering from covid-19, the waiting list could soar to 10 million people by the end of the year, according to the NHS Confederation, which represents hospitals and other health care providers.
“There is a real determination to rise to this challenge, but it will need extra funding and capacity, not least in rehabilitation and recovery services in the community, where so much of the coming demand will be felt,” said Niall Dickson, chief executive of the confederation.
The NHS rejects the confederation’s estimate, saying that waiting lists for both diagnostic tests and elective care have fallen since February.
“The overall waiting list has fallen by more than half a million since the onset of covid, but as more patients come forward, local health services continue work to expand services safely,” an NHS spokesperson said.
“Despite responding rapidly to the coronavirus pandemic and the need to ensure over 100,000 patients could receive hospital care, NHS staff also provided more than 5 million urgent tests, checks and treatment in a safe way during the peak of the virus.”
Experts say there is a growing crisis in the provision of diagnostic tests, including MRI and CT scans.
“The total number of patients waiting six weeks or more from referral for one of the 15 key tests is at almost 571,500 — 58.5% of the total number of patients waiting — which is shocking, given the target is 1%,” said Dr. Nick Scriven, former president of the Society for Acute Medicine.
Cancer patients have been hit particularly hard.
About 2.4 million people were waiting for cancer treatment or tests in June, according to the charity Cancer Research UK, and thousands of people have missed out on hospital referrals for the diagnostic tests that are critical in the early detection and successful treatment of cancer.
Even after patients were referred to a specialist, the median length of time they waited for treatment in April was 12.2 weeks, the longest time in more than a decade. More than 1 million patients waited more than 18 weeks, NHS England figures show.
Sylvia Traynor has cervical cancer and was undergoing a six-month regimen of chemo and radiation therapy when her doctor called in late April to tell her that her treatment had been paused for seven weeks because of the risks posed by the coronavirus.
“Just like that, they said, ‘Don’t come in,’” she recalled. “I couldn’t believe that they could just pull the plug like that. I know they have higher-priority cases to deal with, but my treatment was actually working, and all I could think was, ‘What if this goes on for the rest of the year and I regress? What if all this treatment was for nothing?’”
The uncertainty and anxiety caused by the backlog has been taking a toll on mental health.
Many patients waiting for surgery complain about having to deal with excruciating pain on a daily basis, and many of them are reluctant to take strong opioid painkillers prescribed by doctors because of the side effects and addictive properties.
“I may not be young, but my brain is very active, and sometimes I just get so down because I’m in so much pain and I can’t do anything,” Fawcett said. “I feel trapped.”
Fawcett signed the consent for her surgery in October and has still not been given an appointment for the preliminary medical examination to determine whether she is fit for the operation.
“So many older people on the waiting list have seen their health decline during this time and are finding that they are losing their mobility further because they have not been able to move much during lockdown,” said Jane Mindar, deputy chief executive officer for the charity Age UK in West Cumbria.
“They may not be in good enough health by the time they receive an appointment for their operation, and that, combined with loneliness, anxiety and depression, is quite a big thing for one person to tackle,” she said.
Many younger people and families are also being affected by the delays. Melis Kip, 31, a client manager at a retail consultancy firm in London, has been waiting more than six months to see a dermatologist for her 1-year-old son, who has an acute form of eczema.
“Our doctor says this is not serious, it is OK to wait, and we will treat him in the meantime, but the treatment is not working,” Kip said. “He gets these terrible flare-ups where his skin becomes all itchy and red, and he is very uncomfortable. It’s worrying.”
Kip has also been struggling with her own health issues. She has been unable to get a referral to her local women’s clinic for a contraceptive fitting because it is not considered urgent.
“Women’s health is a big issue, but most matters are dismissed because they are not seen as life-threatening,” Kip said. “But when the whole health system is on hold for nonurgent treatment, that can lead to other problems. For example, women can suffer from mental health issues because of hormonal imbalances.”
Now that borders have reopened, Kip, who is Turkish, plans to travel to Turkey with her son for treatment.
“We can’t afford to wait any longer and are in the fortunate position to be able to travel and receive good care at an affordable price,” she said.
In England, some people have resorted to private clinics for diagnostic care, but many of them say they are unable to afford surgery or treatment once they have gotten a diagnosis.