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Orthopaedic patients get faster treatment
Apr 6, 2005 - 6:26:00 PM
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The British Orthopaedic Association believes patients who need orthopaedic or trauma care should be seen quickly, evaluated promptly and treated expeditiously. The National Orthopaedic Project has recognised there has been an imbalance between supply and demand which the Association has highlighted over many years.
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By DN, UK,
[RxPG] The number of patients waiting over six months for orthopaedic surgery has fallen by more than 50 per cent in just over a year, Health Minister John Hutton announced today.
Orthopaedics - common surgery like hip and knee operations - is considered the biggest challenge to delivering the December 2005 target that no-one will wait more than six months for an operation.
Demand for orthopaedic treatment has grown over the last 20 years, both in terms of numbers of patients seen per year and the number of treatments. In March 1998 the number of patients waiting longer than six months for orthopaedic surgery stood at 95,000.
Mr Hutton today published a progress report about the work of the National Orthopaedic Project (NOP) - a programme set up in January 2004 to help speed up access to surgery.
The report shows that:
* the number of patients waiting longer than six months for orthopaedic surgery has fallen by 55 per cent from 57,000 in January 2004 to 25,700 in February 2005;
* average waiting time for orthopaedic patients has also fallen - from over 19 weeks in 1998 to the current average of just over 12 weeks, a reduction of over 40 per cent; and
* a troubleshooting team working with the 40 most challenged health economies helped to implement especially fast progress - the improvement rate of these sites is 15 per cent quicker than in all other sites.
Mr Hutton said that early indications of NHS performance data for March 2005 made him confident that the NHS would meet the December 2005 target. He said that the progress of the NOP represented an important step towards the 18 week referral-to-treatment target.
John Hutton said:
"The Government has made faster access to treatment a key priority.
"Patients can now expect faster treatment than ever before. Those on the waiting list have fallen by almost 300,000 from more than a million in March 1997.
"The National Orthopaedic Project was set up to reduce long waits in a challenging area. It has delivered real benefits with the number of people waiting over six months for surgery dramatically reduced.
"In 1998, 95,000 patients were waiting six months and over for surgery. Latest data shows the number stands at 25,694 - a reduction of 73 per cent. Within the last year, progress has been especially fast with a 55 per cent reduction in those waiting from 57,128 to 25,694.
"That's unprecedented progress but I know we need to build on this achievement so that no-one is waiting longer than six months by the end of the year. I'm confident we can meet the target.
"This project is a real example of increased investment and NHS reform delivering benefits for the patients. By working in new ways the NHS is providing patients with faster access than ever before.
"The project will also help drive progress towards the 18 week referral-to-treatment target. The NOP will work with other teams to speed up access, such as cancer treatment."
The NOP strategy contained four workstreams:
* increasing the focus on orthopaedics - to ensure awareness and ownership by all those involved in delivering orthopaedic care;
* maximising the benefit of existing initiatives on orthopaedics - co-ordinating programmes across the Department to maximise impact, such as driving choice at six months and using treatment centres;
* risk-based performance management - two-way performance management such as providing action plans for at risk SHAs; and
* the tailored support programme - a support team, comprising a chief executive, orthopaedic surgeon, project managers and analysts - identified challenges and assisted progress in 40 local health economies. Using the average number of patients waiting for 6 months per Trust as a measure, the improvement rate of these sites is 15% quicker than all other sites.
The success of this project is in no small part due to a collaborative working approach between the NHS, the NOP team and key stakeholders.
Michael Benson, President of the British Orthopaedic Association (BOA) said:
"The British Orthopaedic Association believes patients who need orthopaedic or trauma care should be seen quickly, evaluated promptly and treated expeditiously. The National Orthopaedic Project has recognised there has been an imbalance between supply and demand which the Association has highlighted over many years.
"There are other issues of how services are organised and run that also needed to be addressed. A series of initiatives has been undertaken to accelerate treatment. The Tailored Support Programme has proved very helpful in supporting those health economies with major challenges and intrinsic working difficulties.
"Recognition that team working and efficiency are key elements is laudable. It is good to know the Department of Health can work with specialist associations to improve access and it is hoped that continued collaboration will ensure that the quality agenda is also delivered."
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Additional information about the news article
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1. In December 2003 a Priority Review was established between the Department of Health and the Prime Ministers Delivery Unit to consider the challenges surrounding the target that no patient will wait longer than six months for surgery by the end of 2005. The review confirmed that the NHS could meet this target in all specialties but that orthopaedics would require more support to achieve this target.
2. The National Orthopaedic Project (NOP) was therefore established in January 2004 to achieve the December 2005 target that no patient will wait longer than six months for surgery.
3. The NOP has already been recognised as an outstanding example of programme and project management to drive the delivery of key NHS commitments. The project team received one of three annual Team Delivery Awards from the Treasurys Office of Government Commerce in November last year.
4. Case studies:
Cornwall Local Health Economy
Cornwall recognised that there was a need to increase the focus on orthopaedics across the whole health economy. The Tailored Support team provided assistance in establishing a weekly health economy forum, allowing clinical, managerial, and operational representatives from across the trust, Primary Care Trusts, and the Strategic Health Authority to focus on orthopaedics. This ensures strong working relationships within the health economy, and ensures that planning and decision making have a strong clinical input. The health economy are also piloting a scheme to reduce the length of stay, which will be beneficial to patients who could make a faster recovery in their own homes, as well as enabling the trust to treat more patients.
Performance Management at Norfolk and Norwich University Hospital (NNUH)
The Local Health Economy recognised that extra capacity was needed at Norfolk and Norwich. The Tailored Support team assisted the health economy to identify all available capacity in Norfolk across both the NHS and the independent sector, and developed a plan for a staged increase in capacity at NNUH. Commissioners agreed to outsource treatment to the independent sector until the staged increase in NNUH capacity becomes operational.
Robert Jones and Agnes Hunt Trust, Oswestry, Shropshire
The Trust had recognised the need for more capacity and put together a business case for a new operating theatre. The Tailored Support team confirmed that there was a significant gap between the number of patients currently being treated at RJAH, and the number they would need to treat in order to have no patients waiting longer than six months for treatment by December 2005. The team also recognised that the Trust was already running efficiently and managing its existing capacity effectively, therefore it would not be possible to treat more patients using existing resources. This lent weight to the business case, and enabled the Trust to secure funding for the new theatre. The theatre was fully operational by November 2004.
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