NI waiting lists lead to doctors telling patients to ‘go private’

And they have warned the impact of Covid-19 on healthcare provision in Northern Ireland is likely to be felt for many years to come.

Analysis of the latest official figures has highlighted the deterioration in services since the arrival of the virus in Northern Ireland at the start of last year, as it can be revealed the number of people waiting longer than one year for a hospital appointment has jumped by 79% during 12 months of the pandemic.

According to figures from the Health and Social Care Board (HSCB), 188,453 people were waiting longer than 12-months for a first outpatient appointment at the end of February – up from 112,607 at the same time last year.

Meanwhile, the number of people waiting longer than 52 weeks for inpatient or day case treatment more than doubled between the end of February last year and this year, going from 29,010 to 65,630.

Dr Tom Black, chair of the British Medical Association’s Northern Ireland Council, said: “The system has never been in a worse position than it is now.

“There isn’t a day goes by now where GPs aren’t worried their patients are coming to harm or even dying because of the waiting lists, it’s a constant worry.

“Managing patients on waiting lists is a daily occurrence for GPs, we’re trying all the time not to send them to A&E because people don’t want to go to hospital, but sometimes there’s no alternative and they end up waiting 24 hours on a trolley waiting to be admitted to a ward.

“The emergency departments are being overwhelmed at the moment too.”

Figures relating to breast cancer treatment also highlight the way some trusts are struggling to deliver an adequate service in the specialty.

With the exception of December 2019, the Belfast Trust saw 100% of urgent breast cancer referrals every month between April 2019 and February this year. It still managed to see 98% of urgent referrals in December 2019.

However, the performance in other trusts has raised alarm, with as few as 15% of urgent breast cancer referrals seen within the 14-day target some months.

According to the HSCB, the statistics have reinforced the importance of changing the way breast cancer services are delivered in Northern Ireland – a proposal which was met with strong opposition by campaigners.

An HSCB performance report said: “The need to reform breast assessment services regionally is clear – a shortage of specialist staff and a growing demand for breast assessment services has resulted in uneven performance across the five trusts.

“Action is needed to address the vulnerability of the current system to make the service more resilient to both current and future demand.

“The public consultation on ‘Reshaping Breast Assessment Services’ closed on August 30, 2019, however, further progress and decisions on the way forward have been paused by the need to redeploy health service resources to manage the pandemic response.”

In February this year across Northern Ireland, only 41% of patients urgently referred with a suspected cancer began their first definitive treatment within 62 days, down from 49% the previous February.

The performance report continued: “Cancer waiting times were unacceptable before the Covid-19 pandemic.

“Cancer referrals, screening, diagnostic and treatment services have all been significantly impacted by the pandemic resulting in immeasurable distress for patients.

“The service needs to act now not just to build services back but to build them back better.”

The performance of mental health services has also deteriorated during the pandemic.

Regionally at the end of February, 444 children had been waiting longer than nine weeks for mental health services – an increase of 72 in just one month.

West Belfast GP Dr Michael McKenna said: “There has been a definite increase in the number of children experiencing anxiety disorders, referrals have gone through the roof and I would say there isn’t a week where I’m not making a referral for a child to mental health services.

“We are seeing a lot more children with eating disorders, there has been so much out of the control of young people during the pandemic and this is their way of taking back some control.

“When you have patients on a waiting list for a couple of years there will definitely be people on that list who have cancer that hasn’t been picked up.

“I am optimistic that we can address waiting lists and there is already some good work going on but I think mental health services are going to take quite a considerable amount of time to sort out.

“The most important thing is that we change the status quo, the system is broken and it simply can’t continue on as it is.”