Thank you Mr President,
Our ‘Island Plan’ has an objective to “address how waiting times and access to health and social care services can be improved as a priority” – and this motion for consideration here today directly supports that goal.
Manx Care inherited a significant waiting list backlog across all inpatient, day-case and outpatient specialties.
These waiting lists were prolonged by the impact of Covid-19 with most specialties reporting more than a 52 week wait for both inpatient surgeries and outpatient appointments.
I’m sure that many of us in this honourable Court have been contacted by concerned constituents who have had to wait far too long for appointments, which are seriously affecting their quality of life.
If Tynwald agrees here today to vote through the funding, around 3,800 surgical procedures will be completed over the course of the next few months.
As the new Health and Social Care Minister
I fully acknowledge the excellent work already undertaken…. and the success we have already seen in some specialities.
Funding of £1.8m was previously agreed by Treasury for the Restoration and Recovery Phase 1, which addressed some of the Covid-19 backlog, along with providing virtual hospital outpatient appointments across certain specialities.
Mr President
I confirm that 458 endoscopy procedures were completed in phase 1, which eliminated that waiting list.
We also completed 356 cataract operations with patients returning home on the same day.
Further funding of £908,400 was also agreed to fund hip and knee surgery, and this work started on Island in April and delivered 115 operations.
To date we have invested £2.7m to undertake 929 individual procedures, which will help improve the quality of life for many members from within our community.
In support of the “Island Plan” objective, and as part of their Mandate, Manx Care are required to address waiting times to levels comparable with other health and care systems…
….and to improve waiting times across services, with the ultimate target of an 18 week “Referral to Treatment time” (known as RTT).
Therefore this next phase of the programme, Restoration and Recovery Phase 2 plans to address the backlog in the three areas that have the largest numbers of patients waiting for an inpatient or day case procedure.
These are orthopaedics, general surgery and ophthalmology.
The aforementioned specialties are also those that have been targeted in the UK by NHS England.
With this plan, waiting list numbers as at the end of 2022/23 would be reduced by 2,200 cases across the three specialities.
This should bring the waiting list sizes to a level that should enable patients on the Orthopaedic, Ophthalmology and General Surgery inpatient waiting list to have average RTT waiting times of around 52 weeks… which includes the outpatient element of the pathway.
At present, the average waiting times for day cases across the 3 specialities is about 85 weeks.
Treasury and Council of Ministers has approved interim funding of £5m, which has allowed the work to begin in October.
If we are unable to secure the necessary funding here today, the department will need to give immediate notice to end the work in 8 weeks’ time, meaning that no further Restoration and Recovery activity work can take place after December.
If Tynwald approves the funding then we anticipate completion of the work in quarter 1 of the new financial year subject to winter pressures, human capacity and supply chain pressures etc.
Mr President
As for the cost – I fully understand that £18.3 million is a lot of money.
However, the plan addresses a legacy of issue, which means that waiting lists have unfortunately grown to beyond what can be considered safe.
The financial governance for this project is robust given the blend of independent provider and internal resources providing services … and a contingency of £2m is inclusive of the £18.3m to address any rise in costs associated with consumables and equipment.
Following delivery of these procedures, we expect the waiting lists in 3 defined areas to be reduced significantly….
…and the quality of life for many within our community will be enhanced.
In Orthopaedics the current average waiting time for in-patient and day case is 46 weeks and that is expected to reduce to just 4 weeks, with the numbers waiting being reduced from 669 to 100.
In General Surgery the current average waiting time for in-patient and day case is 43 weeks and that is expected to reduce to just 3 weeks, with 554 people being removed from the waiting list, leaving just 60 patients awaiting for treatment at the end of the programme.
In Ophthalmology the current average waiting time for in-patient and day case is 58 weeks and that is expected to be reduced to 18 weeks at the end of the programme.
The number of people waiting is forecast to reduce from 1,359 to 300.
Summary
To summarise Mr President,
The Island Plan has made a clear commitment to reduce our historic waiting list backlog and this funding is critical, in order to help deliver against that commitment.
Failure to address these backlogs will undoubtedly have a detrimental effect on a patients’ condition in the longer term.
It could also create even greater cost pressures in the future due to the increased complexity and risks around conditions that have worsened whilst on the waiting list.
Addressing the waiting list position quickly also has an economic benefit to the wider community, and the economy.
The proposed model of using external resources to support Manx Care’s teams to deliver additional activity over and above business as usual on-Island is already proving successful as I have already outlined.
Mr President
I beg to move the Motion.