Deadline dash forces stricken trust to outsource elective work

Papers presented to the board of King’s College Hospital Foundation Trust show that, in February and March this year, 294 procedures were outsourced to private providers or other NHS trusts. The trust said BMI Healthcare had done the bulk of this work, taking on 149 endoscopy patients and 67 general surgery and trauma and orthopaedics patients over the two months.

Ten bariatric patients were sent to the Princess Grace Hospital in the Harley Street area, which is owned by the Hospitals Corporation of America. Other work was sent to the NHS-run South West London Elective Orthopaedic Centre and Queen Mary’s Hospital, Sidcup.

NHS Improvement committed the NHS to halving the number of year-plus waiters by March 2019, while holding the overall waiting list to the same size.

King’s had 192 patients waiting more than a year for treatment in March this year, compared with 249 in March 2018. The longest waiter had been awaiting colorectal surgery for 138 weeks, the trust said.

In March 2019, the English NHS had 1,154 patients waiting more than a year for treatment, compared to 2,756 in March 2018.

However, the total waiting list has ballooned to record size.

King’s also revealed it is having to validate its entire waiting list to ensure patients’ wait times are correct – and that its longest wait could be as much as 238 weeks, or four-and-a-half years. 

A report to the May board said: “Following a recent review by NHS England into the trust’s elective care management position, an immediate action was for the trust to validate the entire planned waiting list In particular where patients either did not have an ‘admit by date’ recorded or they have waited beyond their admit by date.”

King’s said this process had so far showed, “subject to further validation” that one patient on the planned list was now 238 weeks “beyond their admit by date”.

Consultancy firm Ideal has been hired to help with the validation exercise.

Papers presented to the board said, of the 77,959 people on the trust’s waiting list, 6,064 had so far been validated. This saw 897 patients removed from the waiting list and 1,679 who “potentially need to revert to waiting on the waiting list as an incomplete reportable pathway”.

No more than 8 per cent of patients are supposed to be waiting more than 18 weeks at any one time, but at King’s the figure is 22 per cent. The trust said it would be focussing on treating patients who had been waiting between 43 and 51 weeks “to avoid further movement into the 52-week position”. The March data showed it had 935 patients in this category.