Covid Backlog

Netherlands Delay Treatment for Cancer and Heart Patients to Free up Space for Covid Patients

Preparing for another Covid wave, the Netherlands has begun to delay treatment and vital operations for cancer and heart patients to ensure that there is more space in intensive care units for incoming Covid patients. Reuters has the story.

Dutch healthcare officials said on Friday they have begun delaying operations for some cancer and heart patients to free up space in intensive care units during a record wave of Covid infections.

“These are cancer patients that should actually be operated on within six weeks of diagnosis, and that won’t be met in all cases. It’s also heart patients,” said a spokesperson for LCPS, the national organisation that allocates hospital resources.

“It’s horrible, of course, for the patients.”

The National Institute for Health (RIVM) reported a record of more than 23,000 new cases in the previous 24 hours on Thursday, compared with the previous daily high of around 13,000 reached in December 2020.

With 85% of the adult population vaccinated, both hospital and intensive care unit (ICU) admission rates have so far remained lower than they were at the height of the initial wave in April 2020, although there is a delay between the date of infection and the date of admission to hospital.

With fewer than 200 beds remaining in Dutch ICU as of Thursday, hospitals are scrambling to add more capacity.

Worth reading in full.

NHS Waiting List Tops 5.8 Million

More than 5.8 million patients were waiting to receive treatment from the NHS in September, the highest reported figure since August 2007. In addition, last month saw a record number of calls to ambulance services, with response times also experiencing a significant increase. The Independent has the story.

The average response time for category two patients who needed emergency, but not life threatening, care such as strokes, was nearly 54 minutes, which is the longest average waiting time since records began in 2017.

Response times for urgent calls, such as late stages of labour, non-severe burns and diabetes, averaged three hours, nine minutes and 58 seconds. This is up from two hours, 35 minutes and 45 seconds in September, and again is the longest average since current records began.

The Independent has previously revealed ambulance response times doubled during the pandemic, as all 10 ambulance services raised their alert levels to the highest point.

The investigation found a 26% spike in the most serious incidents reported by paramedics so far in 2021 compared to the whole 12 months of 2019, before the Covid pandemic began.

Patients waiting for more than 12 hours in A&E also reached the highest levels ever in October, with 7,059 waits recorded. This is more than five times higher than the number of 12 hour waits recorded in October 2020, which saw 1,268 patients waiting.

Meanwhile there were 121,000 patients waiting over four hours in A&E, following a decision to admit, during the same month, which is the highest number on record.

The number of patients waiting more than year for treatment has also risen for the first time in five months, from 292,138 in August to more than 300,566 in September.

A total of 12,491 people in England were also waiting more than two years to start routine hospital treatment at the end of September 2021.

This is up from 9,754 at the end of August and is more than four times the 2,722 people who were waiting longer than two years in April.

Worth reading in full.

500,000 Learner Drivers Hit by Lockdown Backlog

According to the DVSA (Driver and Vehicle Standards Agency), there are roughly 500,000 learner drivers waiting to take a test, with the average waiting time being 14 weeks but some have had to wait twice as long in the worst effected parts of the country. Driving tests only resumed in April this year, allowing the backlog to swell over the course of 12 months of repeated lockdowns, with the Transport Committee informed that the situation will not return to normal until 2023. The Mailonline has the story.

The delay means learners are having to fork out thousands of pounds for extra driving lessons as they are required to keep up their skills to ensure they are ready when their slot comes round.

Others who had taken their theory test – a requirement to sit the practical – were forced to pay for another as it had expired before they were able to take their practical exam. 

Figures from the DVSA show that the number of tests conducted in the U.K. between April and June this year was 26% lower when compared with the same period in 2019.

Critical workers, such as those in health and social care, were still able to book tests throughout the various lockdowns. 

Peter Hearn, operations director at the DVSA, told the Commons Transport Committee: “The backlog on car testing at the moment is double what we would normally expect.

We normally expect a backlog of about 250,000 tests – we’re double that at the moment. 

We have had significant periods in which we have not been able to test drivers so we are now in a period in which we are trying to recover those services.

We’re doing lots of additional things right across the organisation with additional hours, we’re bringing people in that can test.”

Hearn told the committee the agency was recruiting extra staff, including examiners and support staff, and said they had already hired 90 with plans to bring in up to 300.

Worth reading in full.

Rishi Sunak to Announce £6 Billion Spending Package to Fight Growing NHS Backlog

In an effort to turn the tide on the expanding NHS backlog, estimated to encompass a record 5.7 million people on the waiting list, with an additional 100,000 being added every month, Rishi Sunak is set to announce a £6 billion spending package to help solve the crisis. In turn, roughly £2.3 billion will be earmarked for diagnostic services in an attempt to treat patients who have yet to receive access to NHS services. The Guardian has the story.

In an effort to get a grip on the crisis, the Chancellor will unveil plans for investment in NHS capital funding this week to help deliver about 30% more elective activity by 2024-25 compared to pre-pandemic levels. This is equivalent to millions more checks, scans and procedures for non-emergency patients.

“We are committed to getting health services back on track and ensuring no one is left waiting for vital tests or treatment,” said Sunak. “This is a game changing investment in the NHS to make sure we have the right buildings, equipment and systems to get patients the help they need and make sure the NHS is fit for the future.”

Dr. Layla McCay, Director of Policy at the NHS Confederation, said health leaders would welcome the funding, but added that it still “falls short” of what is needed “to get services completely back on track”.

McCay also warned that the funding would only deliver results if there were “the right number and mix of workers”. She said: “Recruitment is ongoing but with 80,000 vacancies across the NHS and fully qualified GPs per patient having dropped by 10% over the past five years, this is a long-term issue that cannot be fixed quickly.”

The waiting list is now rising by about 100,000 a month as more people who did not seek or could not access NHS treatment over the past 18 months visit a GP and are referred to hospital. The number of patients waiting more than two years has risen to nearly 10,000.

Worth reading in full.

More Than a Million People Waiting at Least Six Months for Vital NHS Services in England Alone

Close to 1.2 million people in England alone are being forced to wait for at least six months to access vital NHS services. So much for “Protect the NHS”! And “the waiting list figures are going one way only – up”, warns the Chief Executive of the Patients Association. The Guardian has the story.

The May 2021 figure is almost five times that recorded in the same period in 2019 , before the pandemic hit, and also includes patients requiring gynaecological services.

Senior doctors said such long delays were causing patients to be left in pain, while experts said the full impact of the pandemic may not yet be known. …

Rachel Power, the Chief Executive of the Patients Association, warned: “The waiting list figures are going one way only – up. And they won’t come down until the NHS can deliver activity faster than patients are presenting with new need.” …

Though the vast majority of patients are supposed to be seen within 18 weeks, six-month waiting lists have doubled for ear, nose and throat services and gastroenterology services when compared to the same period in 2020.

The number of patients waiting for gynaecological services stood at 15,647 in May 2019, rising to 48,168 in May 2020 before reaching 87,628 in the same period this year.

Dr Edward Morris, the President of the Royal College of Obstetricians and Gynaecologists, said the college was very concerned that women were having to wait far too long to be diagnosed.

“The current backlog we are facing in gynaecology is made up of people needing clinically urgent treatment, so many women are being left in pain with these benign conditions.” …

In May, more than 336,000 patients were waiting for treatments for at least a year, with almost 21,000 in Birmingham university hospital alone.

The hospital also recorded the longest median wait time, with patients waiting an average of 18 weeks, while some patients were waiting even longer for certain treatments. …

The figures come just before NHS England releases its latest monthly statistics on waiting times for treatments including A&E care, surgery and cancer care, which officials believe will be grim reading.

An NHS spokesperson said: “Despite the significant disruption caused by the pandemic, with staff treating 410,000 seriously ill Covid patients and launching the biggest and fastest vaccination programme in our history, NHS services continued to be available for patients who needed them, and are now making good use of the £1 billion in additional funding for elective recovery.

“The number of routine treatments and operations performed by NHS staff is increasing, with cancer and mental health services back at pre-pandemic levels, and so we continue to urge anyone who needs the NHS to come forward so we can help you.”

Worth reading in full.

Backlog in Scottish Court Cases Due to Lockdown to Last Until 2025

Lockdowns have caused a “significant backlog of criminal cases” in Scotland, according to the country’s Courts and Tribunals Service. The Telegraph has the story.

The backlog in Scotland’s court cases due to Covid will not be cleared until 2025, justice system chiefs announced on Friday.

There is now a “significant backlog of criminal cases”, according to the Scottish Courts and Tribunals Service (SCTS), and cases are taking longer to come to trial while the number of people held on remand has increased.

This creates “downstream impacts” on community justice services and prisons, they warned.

The SCTS has announced plans to expand remote jury centres and create additional courts from this September as part of a court recovery programme to deal with the backlog.

New jury trials were put on hold for several months last year due to the virus outbreak.

There will also be four additional High Courts, two additional Sheriff Courts for solemn cases and up to 10 more Sheriff Courts for summary cases.

With these extra resources, the SCTS said it predicts the backlog of High Court and Sheriff solemn cases will be cleared by 2025, and summary trial backlogs will be dealt with by 2024.

The picture isn’t much more positive in England and Wales. In January, four criminal justice watchdogs said that they had “grave concerns” about the impact of court backlogs caused by lockdowns. They highlighted that some crimes committed in 2020 will not go before a jury until 2022. The number of outstanding cases for Crown Courts increased by almost 10,000 between March and December 2020.

The report on the Scottish court backlog is well worth reading in full.