RCS calls for urgent action to improve access to surgery across Wales

Ahead of the Assembly elections in 2016 The Royal College of Surgeons (RCS) has today published a seminal report, The State of Surgery in Wales, which warns that unacceptably high waiting times in Wales need to be urgently tackled. Almost 450,000 people are now waiting for treatment in Wales - 10% higher than three years ago.[1] This is the equivalent of one in seven people, or the entire urban population of Cardiff. The number of patients waiting over 26 weeks for surgery has increased by over 70% since September 2011.

The report shows that Wales is leading the way with some ground-breaking advances in surgery and championing surgical excellence.  However, it also highlights the pressure the NHS in Wales is under.

Mr Tim Havard, RCS Director of Professional Affairs for Wales and consultant general surgeon said:

“The Welsh health service is now treating more patients than ever before and this must be celebrated. More people are living longer as a result of the care they receive, and the recently published National Survey for Wales shows people have a high level of satisfaction with the NHS. There are also many surgical innovations happening in Wales that we should rightly be proud of.

“However, much more needs to be done to tackle deteriorating waiting times in Wales. The equivalent of one in seven Welsh people are awaiting treatment and there is no sign of this improving. The 26 and 36 week planned surgery targets are not being met. Instances of patients waiting over a year for knee surgery should not be tolerated.

“While there have been a number of important initiatives from the Welsh Government such as ‘prudent healthcare,’ addressing the need to avoid unnecessary treatment, demand continues to grow. Many of the causes of high waiting times are complex and will not be solved overnight, but the focus given to tackling high waiting times in heart surgery demonstrates the NHS can improve access when this is made a priority.

“Policies aimed at tackling waiting lists should be a priority for all political party manifestos ahead of the 2016 Welsh Assembly elections.”

In July 2013 the RCS raised concerns following the publication of figures which showed a large number of patients were dying while waiting for elective cardiac surgery under Cardiff and Vale Health Board. At the time, 279 patients were waiting longer than the Government target of 26 weeks. Following this, the Welsh NHS has successfully reduced waiting times for heart surgery, and as of September this year, 42 patients are now waiting over the target.

Mr Tim Havard added: “As part of the solution to tackling waiting times, the health service must also change and improve the way it provides services. The Welsh Government has rightly prioritised the reconfiguration of services but in many places service change is still far too slow. For example, we know there is wide variation in mortality from emergency surgery but improvements to emergency care have been deprioritised in recent years in the face of more immediate challenges including financial problems.”

The report’s other recommendations include:
•Critical care bed capacity needs to increase. A recent report for Welsh Government shows that Wales has the lowest number of critical care beds in Europe.
•The collection and publication of data needs to dramatically improve, including the publication of surgical unit outcomes data. This would help the Welsh NHS to better understand the quality of the care it is providing and where improvements can be made.
•There needs to be a much clearer system of inspection and external challenge of the NHS in Wales.
•The Welsh Government should look to commission a review to look at what more the NHS can do to support the uptake of innovation and new techniques.

Table: No. of patients waiting over 26 weeks for treatment by surgical specialty

The total number of patients waiting for surgery over 26 weeks has increased by over 70% since September 2011. Vascular surgery, and oral and maxillo facial surgery are not recorded separately.

https://statswales.wales.gov.uk/Catalogue/Health-and-Social-Care/NHS-Hospital-Waiting-Times/Referral-to-Treatment/PatientsWaitingToStartTreatment-by-Month-GroupedWeeks Accessed 23 November 2015