Toll of Covid on acute hospital services revealed
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The toll of Covid-19 on acute hospital services has been revealed against a backdrop of hundreds of deaths.
The pandemic has challenged all parts of the health and social care system, and in hospitals, waiting times for treatment have rocketed.
The impact of Covid-19 has left waiting times for treatment in mid and south Essex as among the worst in the country, according to new data.
Just 42.1 percent of patients – equivalent to 38,250 people – were seen within 18 weeks in June, leaving the Mid and South Essex NHS Trust in the bottom seven per cent of trusts.
It means that around 52,000 have been waiting for 18 weeks or more for treatment.
It comes after months of focus on tackling the disease and as of September 2, the Mid Essex South NHS Trust had treated around 2,000 patients with Covid-19.
More than 1,200 patients were successfully discharged from hospital, although many report ongoing health issues. A total of 864 patients have died in hospital as a result of Covid-19.
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Elective care is the area most significantly impacted as a result of Covid-19, and comes as a result of the cessation of non-urgent services.
At the end of August the total waiting list across mid and south Essex stood at 90,000, with over 3,000 patients waiting over a year to complete their treatment as the trust implemented reset and recovery plans and modelled how quickly it could reduce the number of very long waits for treatment.
While it is a significant increase in the pre-Covid reported waiting list size, the pre-Covid figures did not include data from Mid-Essex Hospital Services NHS Trust at Broomfield Hospital.
It had been given permission to pause its national reporting of elective care waiting times as it worked to resolve significant data quality issues linked to the migration of its patient administration system.
These issues have now been resolved and the Broomfield waiting list is now included in the overall figure.
The cessation of non-urgent services have also heavily impacted on diagnostic services, such as radiology.
The percentage of people waiting less than six weeks for a radiology scan reduced from being consistently above 95 per cent to around 40 per cent at the end of June 2020.
The trust has significantly increased activity and is working through this backlog in a clinical priority order. As of the end of August this position had improved to 50 percent, with the principle long waits being for ultrasound and CT scans.
The trusts continued to achieve the two week wait standard from GP referral to initial assessment during the pandemic with around 93 per cent of all referrals being seen within this time period. The number of patients awaiting more than 62 days from their original GP referral through to the start of their treatment increased from around 180 pre-Covid to a peak of around 650.
This is being progressively reduced as activity has been restored and at the end of August was around 350.
A statement to the health and wellbeing board at Essex County Council (ECC) said: “As a partnership, we are working together to address these significant challenges with the absolute aim of treating patients with urgent conditions (eg cancer) and those who have waited longest for planned care, as soon as practicably possible. We have established a number of operational re-set programmes to oversee the safe resumption of services, and have dedicated resources to support recovery of the cancer and elective care waiting times standard.
“This includes using independent sector capacity where safe and possible, and asking our clinicians to work extended days and weekends to clear waiting lists. In addition, our clinicians are working together across primary and secondary care to review waiting lists and support those patients waiting for treatment at the hospital with alternative treatment options and non-hospital based support.
“We are working to define our system recovery plan, while also planning for winter and a potential second wave of Covid-19 cases however it is clear that it will be some time until services are recovered to the waiting times seen previous to Covid.”
Services at Princess Alexandra Hospital (PAH) in Harlow have also been severely impacted. 71.2 per cent of patients – or 9,926 people – were seen in 18 weeks, meaning that 3,840 people waited for more than 18 weeks.
At its peak in April, PAH’s ventilated capacity for known Covid-19 patients was at almost 650 percent of its normal capacity, and at one point, had in excess of 150 positive Covid-19 patients.
To date it has treated more than 500 patients with a positive Covid-19 test.
A total of 211 patients have died in its hospital as a result of Covid-19.
Referrals to PAHT for suspected cancer fell significantly during the height of the pandemic and the rate of referral for suspected cancers has largely returned to pre-Covid-19 levels over the last six weeks, PAH said.
Similarly, the demand for urgent Emergency Department care fell sharply throughout March and April, and started to pick up in May. It is now up to more than 90 per cent of pre-Covid-19 levels.
A statement from CEO Lance McCarthy said: “All system colleagues are working well together to plan for winter and a potential second Covid-19 peak. Other winter preparation includes the important ability to provide all our colleagues with access to the ‘flu vaccination.
“Our vaccination programme will start shortly and learning from last year’s campaign as well as recent Covid-19 testing has been taken to ensure that we are able to quickly and effectively mobilise colleagues to provide the vaccination to all our people.
“Despite a huge amount of hard work from many across the system, the impact of Covid-19 has been significant on our services and it will be some time before we have managed to recover our services fully and meet the access targets and waiting times that we achieved pre-Covid-19.”