‘Public health catastrophe’ looms
Half a million people on waiting list for NHS treatment across region
THE number of people waiting for operations in the West Midlands has reached ‘‘impossible’’ levels, with no hope of lists shrinking without urgent action and investment, according to new Birmingham research.
The region risks ‘‘sleepwalking’’ into a public health catastrophe if the situation is not addressed quickly, researchers have warned.
The work, the most in-depth analysis yet of the challenge facing hospital waiting lists in England, has revealed 4.3 million people need invasive surgery or procedures such as an endoscopy, the largest number since 2007.
A staggering 515,106 people in the West Midlands region are waiting for surgery or need invasive procedures used to check for cancer and other critical conditions.
More than 200,000 of them are in Birmingham and the Black Country – the equivalent of 8.64 people in every 100.
In neighbouring Worcestershire the impact is even worse, with more than one in ten (10.55 per 100) affected.
The figures lay bare the huge challenge facing hospitals battling to reduce waits, just as a new wave of Covid threatens to derail some services again. The researchers used procedure-level data to produce estimates of the need for elective procedures including interventional cardiology (such as coronary stenting), interventional radiology, endoscopy (such as colonoscopy needed to diagnose conditions like cancer), and planned operations (such as hip replacements and hernia repairs).
Many of those cases are hidden, yet to find their way on to official lists, but the research team say they can show with confidence the reality.
The research also reveals that where you live will be a major factor in how quickly you will get your op.
The report from the University of Birmingham, called ‘Forecasting the NHS waiting list in England, 20222030’, also warns that the lists will triple in just eight years, by 2030, unless there is a huge increase in NHS capacity.
They say efforts to reduce the backlogs are inadequate and it is ‘‘impossible’ for the existing frontline workforce to tackle need.
Report co-author Dr Dmitri Nepogodiev,
a public health registrar and coauthor, said: “Unless we take this situation seriously, we risk sleepwalking into a public health catastrophe.
“The 3.3 million patients on the ‘hidden’ waiting list nationally will have delayed diagnosis and treatment. “Some patients will experience worsening of their symptoms, resulting in deterioration of their quality of life, with a knock-on effect on education, work, and social activities.”
He says he fears, too, that initiatives to tackle this need to be equitable and reduce health inequality.
“The ‘postcode lottery’ of where you live determining how quickly you might receive treatment risks amplifying health inequalities.”
Most of those waiting required 20 common procedures, many of which can be performed as day case procedures.
If those were prioritised – including colonoscopy, cataract surgery and hernia repair – the current backlog would be reduced significantly.
Aneel Bhangu, 40, senior lecturer in surgery at Birmingham University and consultant colorectal surgeon at University Hospitals Birmingham NHS Foundation Trust, the lead author of the study, added: “The real crisis is this hidden waiting list. I know there are people out there now with diseases and conditions that need treatment but they cannot navigate through the system.
“Taking the most optimistic scenarios, a [significant] waiting list is inevitable by 2030.
“The percentage increase in activity required per year to combat that, bearing in mind the needs of the population, is impossible from a frontline point of view.
“Just addressing today’s need requires an extra £9 billion of funding based on current NHS costs.
However, tackling the rapidly increasing need requires substantial capital investment in additional facilities, staff and training on top.”
Unless we take this situation seriously, we risk sleepwalking into a public health catastrophe. Dr Dmitri Nepogodiev