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Navigating the NHS: How patients are affected by delays | NHS

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Navigating the NHS: How patients are affected by delays | NHS

Patients face further delays at almost every stage of their National Health Service treatment, while the health system struggles to find the resources to cope with the demand.

The most recent data shows waiting lists throughout England they have broken all-time highs every month for two years in a row, one of many significant challenges currently facing the NHS.

“There is not one area of ​​NHS provision that is not really struggling,” Alastair McLellan, editor of Health Service Journal, told the guardian in August. “There’s literally nowhere where it’s not bad, and in some cases really bad.”

But what impact does this have on ordinary people trying to access the NHS in 2022?

Through a combination of interviews with healthcare professionals and analysis of official data, The Guardian has charted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment. and recovery.

We analyze how the crisis affects the daily lives of four patients: a person with breast cancer, one who requires cataract surgery, a patient with heart problems and one with a hip fracture. These case studies have been created in consultation with health experts and represent realistic patient pathways that a person with one of these conditions might expect.

Macmillan’s Head of Policy Cancer The supporter, Minesh Patel, said delays existed before the pandemic, but Covid “has made them much worse and caused delays.”

“Hard-working cancer professionals are doing the best they can to treat people, but huge gaps in the workforce have been growing for years, leaving NHS staff exhausted and burned out, and too many people in limbo waiting. be cared for”.

Patel warned that “these excruciating waits can significantly affect people’s physical and mental health.”

Daniel Hardiman-McCartney MBE, Clinical Advisor to the College of Optometrists, said the “rapid increase in the number of [independent NHS-funded] clinics has disrupted the traditional provision of eye care in some areas and has exacerbated problems related to shortages of ophthalmologists.

The lack of ophthalmologists in NHS trusts has “resulted in longer delays in some areas for people with chronic eye conditions” such as glaucoma or people with co-morbid or complex problems, which may increase the number of people affected by vision loss preventable.

For Mr. Hardiman-McCartney, eye care could be improved by better supporting local eye departments with optometrists. While there are some areas in England with successful examples, this “frustratingly remains a postcode lottery, with the main barrier being the reluctance of local systems to fully utilize the optometric workforce.”

Professor Antony Johansen, a consultant orthogeriatrician in Cardiff and clinical lead in the national hip fracture database, told The Guardian: “Hip fracture care is losing the momentum that was so successfully maintained during the pandemic. , and the chance of a patient having surgery the next day has decreased. lower than we have seen for a decade.

“This may reflect worse population health, as well as pressure on ambulance services, emergency departments, hospital beds and operating rooms. Delayed surgery will worsen these pressures by increasing patients’ risk of complications and prolonging their time in hospital.”

Professor Ioakim Spyridopoulos, an honorary consultant interventional cardiologist at Newcastle’s Freeman Hospital, told The Guardian that while the NHS response to acute life-threatening conditions is “still excellent”, urgent or elective care such as valve replacement, “lags behind other leading European nations.” ”

For patients who require urgent treatment for a heart condition, “the cause of delays for urgent patients is mainly due to problems with hospital staff and bed capacity.

“Due [of longer waiting times]these patients are at higher risk of dying while waiting for treatment, and even the overall outcome is much worse when treated too late.”

In a statement issued to coincide with the release of several of the metrics covered here, NHS England said the service was dealing with the busiest October in its history, including the most serious ambulance calls.

NHS chief medical officer Professor Sir Stephen Powis said “there is no doubt that October has been a challenging month for staff now facing a triple epidemic of covid, flu and record pressure on emergency services.”

“The pressure on emergency services remains high as a result of more than 13,000 beds being filled each day by people who no longer need to be in hospital. But staff have kept their foot on the gas to reduce the backlog of 18-month servers by three-fifths from last year.”

The service said a recent NHS analysis found the service was diagnosing more cancer patients at an earlier stage than ever before.


While patient routes vary by geography, patient, and case severity, each scenario has been verified by a healthcare professional as a reasonable route of care that someone might expect. Most of the data used in this article comes from NHS England and NHS Digital, however some data was also sourced from Royal College of Physiciansthe Royal College of Ophthalmologists and the British Heart Foundation. macmillanthe Health Foundationthe Royal College of Nursingthe College of Optometrists Y heart research uk were consulted in developing accurate patient tours. Our cataract operation scenario refers to Leicester City CCG as equivalent national figures were not available.

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