Here we update on the latest planned care recovery news as we continue the challenging task of bringing down waiting times for the people we serve.
Despite increasing COVID-19 rates, related hospital admissions and urgent and emergency care pressures, Gloucestershire remains the best performing system in the South West when it comes to overall waiting times for planned treatment.
Earlier this year, we received further national guidance on planned care, including targets to eliminate the longest waits for treatment (more than 104 weeks and over 78 weeks), ensuring 95% of patients waiting for diagnostic tests receive them within six weeks and prioritising 28- and 62-day cancer targets.
We’ve received significant investment to help us deliver our ambitious plans to meet these priorities, with £19 million of revenue and £17 million for equipment and facilities, including £10 million investment in additional orthopaedic theatre capacity and infrastructure improvements at Cheltenham General Hospital.
Gloucestershire Hospitals NHS Foundation Trust (GHFT) and system partners continue to work tirelessly to provide as much planned care and treatment capacity as possible whilst also being mindful of the health and wellbeing of staff.
Extra outpatient clinics and theatre lists regularly run into the evening and at the weekend, and additional facilities in the independent sector are also used for the treatment of NHS patients, some of whom have been waiting the longest.
A new hernia service has recently been commissioned within the independent sector, enabling GHFT to concentrate more on their gastrointestinal (GI) cancer work, while also ensuring speedy treatment for people with hernias.
GP Practices continue to support recovery by accessing more specialist advice and guidance from consultants before referring patients to hospital. They are also able to send more patients directly for diagnostic tests, ensuring that patients see the right specialist service first time, avoiding unnecessary appointments and delays.
At GHFT over 125% of diagnostic tests, such as endoscopies, CT scans and MRIs, are being delivered compared to pre-pandemic levels.
Expansion of diagnostic services is continuing, including through the development of community based diagnostic services.
Additional tests currently include CT, MRI, Xray and ultrasound, and are being delivered by local hospital and independent sector partners. Approximately 11,000 additional tests have been provided since April. There are also tests being provided in primary care, including blood tests and tests for respiratory conditions such as asthma.
In June 93.2% of patients with suspected cancer were seen within two weeks of their referral compared to a national average of just 80.6%.
GHFT is also one of a small number of Trusts consistently meeting the recently introduced Faster Diagnosis Standard (FDS) that ensures patients with suspected cancer have their diagnosis confirmed or ruled out within 28 days of being referred urgently by their GP. In June this was achieved for 87.5% of patients, well above the target set of 75% by March 2024.
Outpatient recovery has been excellent with GHFT now doing an average of 12,700 outpatient appointments a month (102% of pre-pandemic levels). Telephone and video appointments continue to be offered as alternatives to face to face appointments where appropriate.
Operations at GHFT are now back up to 81% of the level that they were pre-pandemic. This figure is expected to improve even further in the coming months with planned additional day case capacity.
As of 17 July, there were no patients in Gloucestershire waiting 104 weeks for treatment compared with 892 across the South West. There were 62 patients waiting more than 78 weeks for treatment in Gloucestershire, compared with a total of 5,172 in the region. Plans are in place to treat all these patients shortly.
One Gloucestershire partners acknowledge the size of the challenge and that many patients are still waiting longer than they would like due to the backlog which built up during the first phases of the response to the pandemic. However, we are well on track to deliver the national priorities for reductions in planned care waiting times.
Longer term investment has been secured for the recently established Elective Care Hub – Patient Access Support Team. This team play a vital role in the way we communicate with, and support, patients while they wait for treatment.
Through questionnaires and one-to-one conversations, the team can determine the needs of the patient, provide reassurance, signposting to self-care advice and link them to appropriate services such as social prescribing and the community health and wellbeing service. They can also escalate their case to an appropriate clinician if their condition has deteriorated.
The team have also been able to remove a significant number of people from the waiting list (9% of those contacted) who no longer wish to proceed with their treatment, thereby reducing the waiting time for those who wish to remain on the list.
Whilst recovery is an immense challenge, the Gloucestershire plan and the additional investment associated with it gives us the best possible opportunity to succeed and make further progress in reducing waiting times for patients.