Feeling the Wait: Annual Report on Elective Surgery Waiting Times The Patients Association

The Patients Association | Published online: August 2016

This is our sixth annual report on hospital waiting times for elective surgical procedures in England. The Patients Association believes that all patients should be accessing their legal right to surgery within the 18 week (126 days) waiting time limit as set out in the NHS Constitution. Sadly, over the last five years for too many patients this has not been their experience. This year’s report based on 2015 data shows that on the whole, waiting times are getting worse, not better. This report also highlights regional variations in waiting times across England.


The key findings from the report are:

  • The total number of patients waiting over 18 weeks for the calendar year of 2015 was 92,739, compared to 51,388 patients waiting over 18 weeks in 2014. Excluding the figures for bariatric and gender operations which we did not collect last year, this represents an increase of 79.5% in the number of patients waiting for over 18 weeks.
  • Average waiting times for five procedures (hip replacement, knee replacement, hernia, adenoid and tonsillectomies) are above 100 days, which represents the highest average waiting time in the six years data has been collected by the Patients Association.
  • Adenoid operations had the longest average waiting time at 110 days, with a rise of around 15 days from 2014 to 2015.
  • Around 10% of Trusts do not have a process to recognise patients’ changing needs while on the waiting list. This represents a significant risk to patient safety and patient well-being.
  • 77% of Trusts are failing to notify patients of their rights under the NHS Constitution when the 18 week limit has been missed.
  • Trusts cancelled an average of 753 patient surgeries ‘on the day’ in 2015.
  • Equipment shortages and/or lack of beds were the most common reasons for surgery cancelled on the day.
  • Theatre improvements were the most commonly reported programme being used by Trusts to improve compliance to the 18 week waiting time.
  • Two Trusts reported that they have implemented bans for out-of-area procedures. This is incompatible with patient choice rights from the NHS Constitution.

Read the full report here

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Physical Activity Associated With Fewer Cancers

Jenks, S. (2016) JNCI: Jnl of National Cancer Institute. Volume 108, Issue 8

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Even moderate leisure-time physical activity may protect against 13 cancers, according to a massive observational study that appeared May 16 in JAMA Internal Medicine (doi:10.1001/jamainternmed.2016.1548).

But which type of exercise brings the most benefit is not yet clear, researchers say, nor is exercise alone likely to account for its association with a lower cancer risk in colon, breast, and endometrial cancers, among others.

“Physical activity is not a stand-alone, magic bullet,” said William McCarthy, Ph.D., adjunct professor in the department of health services in the Fielding School of Public Health at the University of California, Los Angeles. “The biggest bang [in risk reduction] comes when exercise is coupled with a Mediterranean-style diet and not smoking.”

Still, McCarthy said, the recent joint study by researchers at the National Cancer Institute and the American Cancer Society highlights exercise’s importance to cancer risk and overall health, despite what he described as years of skepticism in the scientific community. “It’s a shot in the arm for those of us doing exercise studies for years,” he said.

Researchers at both organizations analyzed pooled data for the self-reported leisure-time physical activities of 1.44 million people in 12 U.S. and European studies conducted between 1982 and 2004. Analyzing data from those combined studies gave investigators greater statistical power than a single study.

Read the original article abstract here

Read the commentary here

Is there a future for smaller hospitals in the NHS?

Centralising hospitals is a controversial topic, with many arguing that it does not lead to savings or improve care for patients. On the other hand, smaller and rural hospital sites face many challenges in staffing and sustainability. In this podcast, Nigel Edwards and former NHS Chief Sir David Nicholson sit down to discuss the viability of the smaller hospitals.

 

New guidelines on anti-clotting drug could benefit thousands

The Guardian | Published online: 12th August

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Government advice suggests heart attack and stroke sufferers take 60mg of ticagrelor with aspirin to help prevent further cardiovascular events

New UK guidelines recommending treatment with an anti-clotting drug that prevents heart attacks and strokes looks likely to benefit thousands.

The National Institute for Health and Care Excellence (Nice) has published draft guidance suggesting people who have had a heart attack should take 60mg of the drug ticagrelor with aspirin – a £2-per-day treatment – to reduce the risk of any further cardiovascular events.

Although a higher dose of the drug (around 90mg) is already prescribed to heart attack patients for 12 months, this new guidance recommends continuing with a lower dose for a further three years.

The anti-clotting drug is used by most UK centres because blood clots are responsible for causing heart attacks and strokes – and people who have already had one are at a higher risk of having another.

Heart attacks and strokes are caused by the buildup of fatty material in artery walls to form a plaque. If the plaque ruptures it can cause a blood clot which can block blood flow to heart muscles, causing a heart attack. If the clot dislodges it can travel in the bloodstream and block blood to the brain, causing a stroke.

Read the full news story here

Levels of stress among primary care staff

Mind has released research which shows that 88% of primary care workers find their work life stressful.

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The poll of over 1,000 NHS workers in primary care including GPs, practice nurses, practice managers and their colleagues, also showed that work is currently the most stressful area of their lives, ahead of their finances, health, family life and relationships.

Volunteering in the over 40s can increase mental well-being

Tabassum, F. et al. (2016) Association of volunteering with mental well-being: a lifecourse analysis of a national population-based longitudinal study in the UK. BMJ Open. 6:e011327

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Objectives: The association of volunteering with well-being has been found in previous research, but mostly among older people. The aim of this study was to examine the association of volunteering with mental well-being among the British population across the life course.

Design: British Household Panel Survey, a population-based longitudinal study.

Setting: UK.

Participants: 66 343 observations (person-years).

Main outcome measures: Mental well-being was measured by using the General Health Questionnaire (GHQ-12 or GHQ); high values denote high mental disorder. Four groups of volunteering participation were created: frequent (once a week), infrequent (once a month/several times a year), rare (once or less a year) and never. Multilevel linear models were used to analyse variations in mental well-being over the life course by levels of volunteering.

Results: When not considering age, those who engaged in volunteering regularly appeared to experience higher levels of mental well-being than those who never volunteered. To explore the association of volunteering with the GHQ across the life course, interaction terms were fitted between age and volunteering. The interactions were significant, demonstrating that these associations vary by age. The association between volunteering and well-being did not emerge during early adulthood to mid-adulthood, instead becoming apparent above the age of 40 years and continuing up to old age. Moreover, in early adulthood, the absence of engagement in voluntary activity was not related to mental well-being, but GHQ scores for this group increased sharply with age, levelling off after the age of 40 and then increasing again above the age of 70 years. The study also indicates variation in GHQ scores (65%) within individuals across time, suggesting evidence of lifecourse effects.

Conclusions: We conclude that volunteering may be more meaningful for mental well-being at some points of time in the life course.

Read the article here

Dementia Evidence Toolkit

MODEM. Published online: August 2016

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Image source: MODEM

The Dementia Evidence Toolkit is for commissioners, care providers, people working in health and social care and people with dementia and their families.

The toolkit has two resources:

An intervention is something that aims to make a change and is tested through research. For example this might be giving a medical treatment or drug, providing a counselling or care service, improving a person’s environment or giving people information and training.

The summaries look at:

  • What the intervention is
  • Why is it important for people with dementia and family carers?
  • Does it work?
  • Is it value for money (is it cost effective)?
  • How much does it cost?

The toolkit will help those planning and shaping services and treatments for people with dementia and their carers make informed decisions about which services and treatments to provide and how much they cost.

Find the full toolkit and resources here