One of England’s most high profile foundation trusts has admitted it unknowingly left hundreds of patients waiting more than 18 weeks for orthopaedic surgery, including at least 10 who had waited more than a year.
Salford Royal Foundation Trusts’ latest board papers reveal it has made changes to the senior leadership of its surgery division following a “fundamental breakdown” of its systems for managing the trauma and orthopaedics waiting list.
The surgery division launched a review of its trauma and orthopaedics waiting list management in March, after a GP complained about one patient’s excessive wait. This found that more than 300 patients had been waiting past the national target of 18 weeks from referral, and nine had been waiting more than a year.
However, a board paper published yesterday states that shortly after the probe was completed “a further 52 week breach was brought to our attention from a GP”, casting “significant doubt over the accuracy of the previous review”.
The trust has begun a second probe, reviewing all of the more than 1,500 patients currently on its trauma and orthopaedics waiting list.
The board paper warns it is possible this review will uncover more patients who have been waiting more than a year. A trust spokeswoman today said the review would be finished by the end of July, and “the trust will not have a clear picture until this is completed”.
She added that as a result of action taken to clear the backlog of orthopaedic patients the trust would fail the national 18 week waiting target in the second quarter of this year.
The board paper says that 348 orthopaedics patients have already breached the 18 week target. The trust intends that all the patients who have already waited more than 18 weeks will be treated by the end of December, with roughly a third of the surgery required performed by private provider Spire. Until the backlog is cleared Salford Royal will not be accepting orthopaedics referrals from outside Salford.
National targets are for 90 per cent of patients on an elective pathway to wait no more than 18 weeks from referral to treatment, with year-plus waits the subject of a “zero tolerance” approach and £5,000 fines.
The paper adds that in light of the “significant failings within the division of surgery” the trust has “made changes to our senior leadership arrangements”.
Responsibility for trauma and orthopaedics has been handed to Janelle Holmes, managing director of the trust’s Salford Health Care division. The managing director of the trust’s neurosciences and renal division, Sue Toal, has taken responsibility for all other activity within the surgery division.
The trust declined to comment on what had happened to Jacqui O’Reilly, who had formerly held these responsibilities as managing director of the surgery division. The trust spokeswoman said: “It is not trust policy to comment on the employment matters relating to individual staff members.”
Salford Royal executive director for organisational development and corporate affairs Paul Renshaw said: “Our priority has been to ensure that the patients affected by unacceptable waiting times for our orthopaedic service receive the treatment they need as soon as possible. We have apologised to these patients for the delay in their treatment.”
He added: “Our review into this matter has identified that the issue is not organisation-wide but is isolated to the orthopaedic department. The vast majority of our patients have been treated within the correct timescales, therefore we are pleased to report that the trust has continued to achieve its overall referral to treatment performance targets in the past quarter.”
Over the past year Salford Royal has become one of the highest profile trusts in England, highlighted by politicians for its pioneering work on patient safety. Its chief executive, Sir David Dalton, is currently leading the Sign up to Safety campaign championed by health secretary Jeremy Hunt, and a major review for the Department of Health of new organisational forms in the provider sector.
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