Patients in Wales face cross-border specialist ops wait
Hospitals in England providing specialist look after Welsh patients was told to delay some operations.
BBC Wales can reveal that health managers have threatened to not pay English trusts in the event that they treat patients too quickly.
As component to a drive to save cash, hospitals had been told to delay some operations, including heart surgery, until the top of March.
The Welsh government said all patients must be treated within set times.
The demand is available in a letter to the bosses of health trusts in England from the Welsh Health Specialised Services Committee (WHSSC), the body liable for planning and commissioning specialised health services on behalf of Welsh health boards.
BBC Wales has obtained a duplicate of the letter which instructs English hospitals to not treat Welsh patients as quickly as they currently do until the top of the financial year.
They also are told to just undertake scheduled procedures if there’s a risk that patients should wait longer than 26 weeks.
Under Welsh government targets, only 5% of patients should spend greater than 26 weeks on a waiting list.
But waiting time performance for Welsh patients being treated in England is usually sooner than the 26-week target. The NHS in England has a waiting time target of 18 weeks.
In the letter, WHSSC says it’s implementing new controls to be able to stay within “available resources”.
“That allows you to ensure equity for Welsh patients we require that each one providers to deliver activity both according to the Welsh waiting times and inside the available resources,” it said.
“Routine elective (scheduled) activity between 17th of January 2013 and 31st of March 2013 should only be undertaken whether it is required to prevent breaching the 26-week target.”
The letter says that if cases are considered “clinically urgent” then English hospitals would have to obtain “prior approval” from WHSSC before proceeding with treatment.
It adds: “This can be a significant initiative for NHS Wales and therefore failure to conform with the above will end in non-payment.”
BBC Wales understands that the verdict will affect quite a lot of operations for Welsh patients undertaken by English hospitals. These could include heart surgery, neurosurgery and cosmetic surgery.
A senior doctor from the north west of britain, who didn’t want to be named, said the verdict could put patients at increased risk.
“i will be prevented from operating on patients that i’d otherwise have operated on,” he said.
“Some patients get further problems and infrequently die while on waiting lists… so there’s always a risk if they’re waiting longer for an operation.”
Conservative health spokesman Darren Millar called on Health Minister Lesley Griffiths to behave.
“This recommendation is absolutely unacceptable and grossly unfair,” said Mr Millar. “Any instruction which puts the health of Welsh patients at the backburner is unjust and will be stopped immediately.
“There isn’t a the reason is, Welsh patients spoke of a hospital over the border could be forced to stay in pain and discomfort at the whim of this committee and that i urge the minister to take decisive action to overrule this recommendation.”
The Welsh government says its position is that every one patients must be treated within set waiting times.
A Welsh government spokesperson said: “The Welsh government expectations are unchanged – that each one patients are to be seen within our waiting time target and so as of clinical importance.
“The minister requires all health boards and WHSSC to work in this basis.”
Marcus Longley, director of the Welsh Institute for Health and Social Care on the University of Glamorgan, said: “People find it offensive with the health system seems to be putting money in front of clinical considerations.
“This is a high profile issue and emotive however it is fair to indicate that the numbers involved are very small,” he told BBC Radio Wales.
A WHSSC spokesperson said: “To confirm equity for all Welsh patients, action was taken to align all elective take care of specialised services that is delivered in England with Welsh waiting times standards.
“Providers of this care have also been informed that if there’s any uncertainty in regards to the urgency of treatment to contact the Welsh Health Specialised Services Committee to acquire prior approval.
“This affects all inpatient and outpatient appointments for specialized services which can be provided by English organisations.”
The instruction from WHSSC follows moves by Powys Health Board last year to delay treatment for its patients at hospitals around the border.
At the top of November, BBC Wales revealed that Powys Health Board had told English health trusts it might only pay for operations for the county’s patients once they had waited between 32 and 36 weeks.
The health board insisted nobody could be at greater risk due to the decision.
Plaid Cymru health spokeswoman Elin Jones said it was a “worrying revelation”.
“It shows how the Welsh government’s failure to become familiar with NHS finances is affecting patients,” she said.
“Most worryingly, it reveals that cancelling scheduled treatment is seen as a simple option for cutting costs by the Welsh government. We desperately desire a new method to the NHS in Wales.”
Welsh Liberal Democrat leader Kirsty Williams said: “The Welsh Labour government only sees statistics and waiting times, they do not see the folks suffering behind those statistics.
“i’m really concerned that cash saving ‘initiatives’ like this are happening all around the Welsh NHS to the detriment of Welsh patients.”
All seven health boards in Wales are facing big financial pressures. In November the Wales Audit Office predicted health boards were more likely to be £70m in deficit by the tip of the financial year in March.
Later, Ms Griffiths announced £82m will be provided from the Welsh government to ease the pressure facing the NHS around the country.
The minister fiercely denied suggestions that the cash amounted to a bail out.