NHS: Funding Crisis Leads to New Minimum Waiting Periods

The NHS funding crisis has reached the point that some hospitals have begun cancelling non-emergency operations to save money and introducing a minimum waiting period of at least three months before patients can be treated.

The minimum waits have been adopted by a number of NHS clinical commissioning groups (CCGs) as a result of the nationwide cash squeeze and also because at least one of the commissioning groups insists that some patients’ conditions clear up while they wait.

The group making that extraordinary claim is the Lincolnshire West CCG, which has provoked sustained criticism after deciding to introduce minimum waiting times for such non-urgent surgery as cataract operations and hip replacements. According to the Health Service Journal (HSJ), which reported the plans, Lincolnshire West CCG said it had a “responsibility to ensure public money is spent effectively and efficiently.”

It added that “there is evidence that some conditions do get better over time and that, in some cases, surgery may be unnecessary” although it did not specify which conditions it had in mind.

“Shameful”

Liberal Democrat MP, Norman Lamb (left), a former health minister, said the move was “a shameful indictment of the under-funding of the NHS” that would prove unfair and divisive. “It undermines the core principles of the NHS: that everyone should get compassionate treatment, as early as possible, when they need it,” he said. “Those who can afford it will go private to skip the wait, while others will be left waiting in pain and discomfort. This is simply impossible to justify.”

Trafford CCG in Greater Manchester has confirmed that it is also bringing in a similar policy, according to the HSJ. NHS England oversees all 209 CCGs, which between them spend more than £60bn of the NHS’s £125bn annual budget. It appeared to back minimum waits, despite the controversy they have aroused.

A spokesman for NHS England said health budgets were so squeezed that NHS bodies face “difficult choices” about what they spend their money on. However, there are doubts about whether it is legal for any CCG to bring in minimum waits for care, given that the NHS constitution is supposed to guarantee patients that they will be treated as soon as possible.

The commonest non-urgent operations include removing cataracts, replacing worn-out hips and knees and repairing hernias.

Deliberate Delays

Sue Hill, the vice-president of the Royal College of Surgeons, urged the CCGs to reconsider the new policy. “Patients in Trafford currently wait an average of 7.2 weeks for any type of treatment,” she said. “If this policy were to go ahead average waiting times in Trafford would double.”

While the RCS appreciated the severe financial pressures facing CCGs, “introducing an arbitrary minimum waiting time for surgery is unlikely to save money in the long-term and is ethically wrong,” she said. “Delaying surgery can mean a patient’s condition worsens, and can make surgery more difficult and less successful.”

Cambridgeshire and Peterborough CCG was the first to bring in minimum waits for non-urgent surgery, also for 12 weeks, but it recently abandoned the policy two months after it was brought in.

Jon Ashworth, the Shadow Health Secretary, urged the Government to forbid NHS bodies from using the tactic. “I’m demanding Jeremy Hunt intervenes, enforces the NHS constitution and bans these minimum waiting times. Secondly, in the Budget Theresa May must provide the NHS with the money it needs to end this postcode lottery of care that has developed under the Tories.”

An NHS England spokesperson said that CCGs “face difficult choices about what can be afforded within the funds Parliament has made available, recognising the priority being accorded to emergency care, mental health, cancer and GP services. Last month 1.3m patients started consultant-led elective treatment and the vast majority of patients wait less than 18 weeks.”

 

by Bob Graham

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