UK and Ireland’s surgical Royal Colleges sharing their concern at Northern Ireland’s alarming waiting lists
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See below a letter from the four presidents of the UK and Ireland’s surgical Royal Colleges sharing their concern at Northern Ireland’s alarming waiting lists and to request an urgent meeting.
Dear First Minister, Deputy First Minister, Health Minister and Finance Minister, The four presidents of the UK and Ireland’s surgical Royal Colleges are writing to you to show their concern at Northern Ireland’s alarming waiting lists and to request an urgent meeting.
Northern Ireland has the worst waiting times in the UK, and the pandemic has regrettably made the situation much worse. There are people waiting up to five years for routine orthopaedic treatment, four years for ear, nose and throat procedures and up to seven years for a urology appointment(i). Even the most urgent of cases, red flag cancer patients, are having their operations cancelled(ii). Recent hospital statistics for Northern Ireland show approximately one in four people (in a population of 1.9 million) are waiting either to see a consultant for the first time or to receive treatment(ii). 348,867 people are waiting to see a consultant for the first time with over half (53%) waiting more than 52 weeks. In addition, 112,915 patients are waiting for inpatient hospital procedures and 3,949 waiting for admission to a Day Case Procedure Centre.
Inevitably, such long waits lead to increased distress, worsening of the disease and the potential increase in preventable deaths. Procedures that were listed as routine are now urgent as a consequence of the significant delays. The feedback from our members is that patients in Northern Ireland are now presenting with conditions at an advanced stage, including perforated colonic cancers, severe bowel obstructions and ruptured hearts.
A further burden of such waiting lists is the moral distress and ethical considerations affecting our colleagues when decisions are made to cancel, postpone or delay surgery.
Since the beginning of the pandemic, planned surgical activity in Northern Ireland has seen a start-stop approach. Even when rates of the virus were lower, surgical activity was patchy and never fully recovered.
Last year there was a 46% drop in theatre activity and 50% decrease in outpatient activity(iv). Importantly the average number of hospital beds has dropped over the last decade from 6,725 in 2010/11 to 5,672 in 2020/21(v).
The Northern Ireland health service has been described as in crisis and it will remain seriously challenged over the winter months. The situation is of such concern, that we feel compelled to come together as the four Surgical Colleges in the UK and Ireland to meet with NI Executive Ministers in a bid to identify and fast track solutions for this extremely difficult situation. We are already aware of current cancellations(vi) and that more surgery is likely to be cancelled in the coming months(vii).
We would welcome the opportunity to meet with you as political leaders and Departmental Officials.
We urgently need innovative quick solutions to address workforce pressures, including an enhancement of the perioperative and critical care workforce. We also need plans that can be introduced rapidly, including surgical hubs on COVID-light sites. Implementing these green pathways will enable us to keep planned surgery going over the coming months in the face of further possible surges in the Covid-19 virus(viii), Emergency Department pressures or the expected winter flu season.
Seeing the harm that is being done, patients and clinicians are ready for change and are prepared to travel greater distances than previously. Patients deserve the right to timely access to surgery. Surgeons stand ready to play their part. On behalf of the four Colleges, we stand ready to assist in any way we can.
Yours sincerely,
Professor Neil Mortensen - President Royal College of Surgeons of England
Professor Jackie Taylor - President Royal College of Physicians and Surgeons of Glasgow
Professor Michael Griffin - President Royal College of Surgeons of Edinburgh Professor
Ronan O’Connell - President Royal College of Surgeons of Ireland
For the full letter, please click here.
