ONS data released today on diagnostic waiting times show that the total waiting list for endoscopy procedures reached a record 180,000 in May, representing an increase of 44% on May 2019.
Although total activity has increased compared to last month and was up by 65% on April, the total number of endoscopic procedures, including Colonoscopy, Flexi Sigmoidoscopy, Cystoscopy and Gastroscopy, was significantly below the normal level. In May 2020, activity was 81% down compared to the same month last year.
This lower activity level has had a substantial impact on endoscopy waiting lists. The total number of patients now waiting for an endoscopy is 180,000, compared with the 120-130,000 level we’ve seen over the last 12 months.
While waiting lists have risen, the most significant impact has been on the time patients are waiting for procedures, with the number waiting more than 6 weeks for a procedure rising from around 11,000 in May last year to around 120,000. As a percentage share of all patients on the waiting list, 6 week + waits accounted for 9% of all those waiting in May 2019, and this has now risen to 66%!
It’s inevitable that the list will continue to grow. While activity in June is likely to have increased further, some have not been able to restart routine procedures yet, and those that have are operating well below previous capacity due to the stricter infection control measures they’ve been required to implement.
Increasing downtime between procedures to allow for additional air changes, cleaning and for staff to change into and out of enhanced PPE, have had an impact, as has the requirement for social distancing and the need to maintain a separation between Covid and non-Covid zones within hospitals.
Something we can’t see in the ONS data is the amount of missing referrals for endoscopic procedures. Access to primary care has been reduced during the past few months, and there is no doubt that many patients will have put off their visit to their GP during the Covid-19 pandemic. This will have an impact on waiting lists in the coming months, as the level of referrals start to increase back to normal levels.
Does the NHS have sufficient endoscopy capacity to cope with the backlog and bring the 6 week wait list down to more acceptable levels in the near future, given the lower productivity levels? Possibly not.
One solution could be to bring in temporary flexible infrastructure solutions, such as mobile or modular endoscopy suites, for a limited time. These have the added benefit of being able to provide a stand-alone ‘cold site’, with built in recovery ward and decontamination facilities, adjacent to the main hospital building, minimising any Covid-19 risk to patients and reassuring them it’s safe to attend procedures.
Get in touch to find out more about our mobile endoscopy suites.