Staffing and scanner problems behind trust’s soaring waiting times

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Brighton and Sussex University Hospitals Trust’s performance has dropped sharply in last few months
In May 2018, just 6.4 per cent of patients breached six-week target at trust
Trust says issue with scanner now resolved and is outsourcing work to get “back on track”

Power and workforce problems led to nearly a third of patients referred for diagnostic tests waiting longer than the six-week target at one acute trust.

The trust said a lack of staff and power supply issues for a CT scanner saw 29.6 per cent of patients wait more than six weeks at Brighton and Sussex University Hospitals Trust in May. The national target is for no more than one per cent of patients to wait this long.

The trust’s performance has declined dramatically in the latest figures. In March, only 19.7 per cent of patients waited longer than six weeks, while only 6.4 per cent of patients breached the target in May 2018.

BSUH said the power supply issue with one of its CT scanners had now been resolved, and it was outsourcing some non-obstetric ultrasounds in a bid to get “back on track” by September this year, although it was unable to tell HSJ how many tests would be outsourced.

Jayne Black, chief operating officer, said: “The main challenge we have faced in meeting our diagnostics targets – particularly in imaging and endoscopy – has been a combination of rising demand and difficulties in creating additional capacity to accommodate this. In the short term, we’ve responded by developing a recovery plan which aims to put us back on the right track by September. And for the longer run, the trust board has just approved a £4.6m investment in endoscopy services at both the Royal Sussex County and Princess Royal Hospitals.

“This is one of the biggest investments we have made in recent years and will allow us to replace all endoscopy scopes and sterilisation and decontamination equipment across the two sites.”

BSUH is now the poorest performing non-specialist acute trust in England for diagnostic tests with 3,160 patients waiting more than six weeks in May, of whom 871 had waited more than 13 weeks. It is performing particularly badly on colonoscopy, flexible sigmoidoscopy and gastroscopy – all of which had around two-thirds of patients waiting more than six weeks and large numbers waiting more than 13 weeks. However, non-obstetric ultrasound, which represents around 40 per cent of all tests, had 35.4 per cent of patients waiting more than six weeks.

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On average, 4.1 per cent of patients waited more than six weeks for diagnostic tests in May, according to data released last month, compared with 2.7 per cent in May 2018. While BSUH was the acute trust with the highest proportion of patients waiting more than six weeks, a handful of specialist providers had even higher figures. At Echogenicity, a community-based provider in Cornwall, 64.9 per cent of patients – 670 patients – waited more than six weeks. It did not respond to HSJ’s request for a comment.

The non-specialist acute trusts with the highest proportion of patients waiting more than six weeks for diagnostic tests in May were:

Brighton and Sussex University Hospitals Trust - 29.6 per cent (3,160 patients)
Royal Devon and Exeter Hospitals FT - 19.9 per cent (1,350 patients)
Northern Devon Healthcare Trust - 19.3 per cent (559 patients)
Calderdale and Huddersfield FT - 15.2 per cent (1,521 patients)
Taunton and Somerset FT - 14.1 per cent (790 patients)

Deputy chief executive at NHS Providers Saffron Cordery said: “An increase in demand for diagnostic tests, combined with workforce shortages and an inability to invest in new scanners and machines, means trusts are struggling to keep up with diagnostic standards. In particular, trusts are seeing an increase in patients referred under the two-week wait standard, which is adding to the pressure.

“Workforce shortages mean that trusts are struggling to ensure they have the range of specialists needed to carry out tests and report the outcomes within the expected timeframe. We know that the shortages of endoscopists and radiologists are particularly severe. This is compounded by the current pension taxation rules which are resulting in some professionals reducing the number of hours or overtime that they are working and more patients will likely be waiting longer than the six-week diagnostic standard over the coming months.”

When approached by HSJ about its performance, Royal Devon and Exeter FT said it had a programme of work underway to address staffing pressures and create additional capacity. Northern Devon Healthcare Trust said it had improved diagnostic waiting times over the last 12 months and had invested in MRI and CT scanners. Taunton and Somerset FT said it had purchased a third MRI scanner which will be installed next month, while a high number of patients with suspected cancer had been referred in April, which led to capacity issues. Calderdale and Huddersfield FT had particular issues with echocardiograms and neurophysiology tests, which had impacted on its performance.