Agenda item

The Committee considered a report of the Leicester, Leicestershire and Rutland (LLR) Health System which provided an update on the elective care recovery progress for the patients of LLR. A copy of the report, marked ‘Agenda Item 11’, is filed with these minutes.

 

The Committee welcomed to the meeting for this item Siobhan Favier, Deputy Chief Operating Officer, University Hospitals of Leicester NHS Trust (UHL) and Adam Andrews, Deputy Director of Planned Care, LLR.

 

Arising from discussions the following points were noted:

 

(i)           During the Covid-19 pandemic the LLR elective care waiting list had doubled which was a far larger increase than most other trusts experienced during the pandemic.

 

(ii)         Most cities had an Urgent Treatment Centre as well as an acute hospital but one of the problems in LLR was that there was no Urgent Treatment Centre in Leicester.

 

(iii)        When assessing the capacity of the elective care system the most important indicator was the rate of growth. However, as there was only one hospital trust in Leicester, Leicestershire and Rutland it dealt with a very large number of patients compared to many other hospital trusts. Therefore, when assessing the capacity of the system it was also important to look at the capacity data as a percentage of the overall population. The good news was that the capacity figures for LLR were improving both overall and in terms of percentage of the population. 

 

(iv)       UHL had made significant progress on reducing waiting times for those patients waiting the longest for definitive treatment and had virtually eliminated all patients waiting longer than two years for treatment. A member raised concerns that this reduction could have been achieved by increasing the number of patients waiting shorter periods for treatment. In response it was confirmed that this was not the case and the reduction was across the board. However, the reduction in waiting times for LLR was slowing and therefore more work needed to be carried out to tackle the issue and understand where the demand was coming from. Resources would continue to be invested in elective care waiting times.

 

(v)         Of the 117,318 patients on the waiting list 85% were waiting for a diagnostic procedure rather than a surgical procedure, and not all of them would ultimately require surgery once they had received a diagnosis. It was noted that the public perception of the waiting list was that all those on the list were waiting for surgery. It was more difficult to provide extra capacity on the surgical procedure side than it was on the outpatient diagnostic side.

 

(vi)       A member queried the lack of data in the report regarding the breakdown of the waiting lists and questioned whether this prevented cost-benefit analysis from being carried out. In response reassurance was given that detailed data was held and was available for the public to view. The Committee was further informed that as of 12 June 2023 the elective care waiting list was approximately 116,000, there were 300 patients that had been waiting 78 weeks and above, and 3,000 patients at 65 weeks and above. It was agreed that after the meeting data would be provided to the Committee on how many patients had been waiting between 18 and 24 weeks.

 

(vii)      The Committee was informed that of the outpatient waiting list 60% was made up from the following specialties:

·              Gynaecology;

·              Ear, Nose and Throat;

·              Gastroenterology;

·              Ophthalmology.

 

(viii)    In response to a question as to how many new patients were joining the waiting list each year it was agreed that this information would be provided to the Committee after the meeting. Reassurance was given that the increase in capacity was greater than the number of new patients joining the waiting list which resulted in the waiting list decreasing.

 

(ix)       It was not expected that planned strike action would impact on the reduction in the waiting list and it was still expected that the target of having no patients waiting over two years by July 2023 would be met.

 

(x)         Partnership working was taking place with other trusts and independent sector health providers with regards to increasing capacity and reducing the waiting list. Whilst at the moment LLR was receiving more assistance than it was providing, it was hoped that in the future it could be of more assistance to other providers.

 

(xi)       There was a policy in place which gave patients the option of going elsewhere in the country for elective procedures if the waiting time would be shorter. This now included independent providers who had been accredited as well as NHS providers. It was important to manage this process so that patients that were unable to travel elsewhere were not disadvantaged and health inequalities were not exacerbated.

 

(xii)      The new East Midlands Planned Care Centre at Leicester General Hospital had opened on 1 June 2023. It was expected that when ‘phase two’ of the project was completed in late 2024, around 100,000 patients per year would be seen in the East Midlands Planned Care Centre. In order for the East Midlands Planned Care Centre business case to be approved it had to be demonstrated that the scheme would provide additional capacity. In response to a question as to whether the 100,000 patients to be seen by the East Midlands Planned Care Centre were all additional capacity it was clarified that this could not be confirmed as there were many factors which made up the 100,000 total.

 

(xiii)    In response to questions about staffing of the East Midlands Planned Care Centre reassurance was given that there were plans in place to grow talent and train staff. Recruitment was taking place immediately rather than waiting for the facility to open.

 

(xiv)    The Patient Tracking List (PTL) related to patients on the Referral to Treatment Pathway and it included a clock showing how long they had been waiting.

 

(xv)     The Planned Care Partnership had been set up and two meetings of the partnership had taken place so far. One of the aims was to ensure that the elective care work did not have a negative impact on social care. It was agreed that a representative from Public Health would be invited to future Planned Care Partnership meetings.

 

RESOLVED:

 

(a)        That the update on the elective care recovery progress for the patients of LLR be noted.

 

(b)        That officers be requested to provide a further update on progress to the Committee in 6 months’ time with further detail and breakdown of the waiting list numbers.