Healthwatch recommends improved communication and support for patients waiting for surgery in Somerset

Earlier in the year, Somerset’s NHS leaders asked us to help them understand how people are being affected by waiting for surgery to inform their ongoing work to improve support for patients.

We ran an online public survey from July to September 2021 and carried out phone interviews with patients from Musgrove Park and Yeovil District Hospitals who responded to an invitation to take part.  Seventy-two people provided feedback about their experience of waiting for treatment.

At the end of March 2021, a total of 6,382 people in Somerset were waiting for planned surgery, which is a 62.1% increase compared to March 2020, just before the start of the Covid-19 pandemic.  Despite the backlogs and other challenges faced by the NHS, there were 2,568 completed surgeries in Somerset during March 2021.  Nationally there are 5.7 million people waiting for hospital care.

Key survey findings

• 48 of the 72 patients who responded (65%) said they had been waiting over 40 weeks for surgery and many did not know how much longer they would have to wait.  (The NHS performance standard is a maximum 18 weeks waiting time from referral to treatment.)
• A common theme among those who completed the survey was a lack or absence of communication by specialists with patients who were waiting.
• Many survey respondents reported that while waiting they felt they had experienced a deterioration in their condition, reduced mobility, and mood changes, which impacted on their daily lives.
• 35 of the 46 people who commented said they had to rely on family and/or friends to help them manage their daily tasks.

We shared detailed findings with Somerset NHS Clinical Commissioning Group, Somerset NHS Foundation Trust and Yeovil District Hospital, and made several recommendations on how to improve support for patients while they wait for treatment.

Healthwatch Somerset recommendations for change and improvement

Improve communication:

• Specialists and their teams should communicate frequently with all patients waiting for treatment and provide them with information about plans for their care.
• Patients should be given an up to date ‘package’ of information, including FAQs, advice and contact details for a wide range of useful health and community care services and support groups.

Provide more support to meet individual patients’ needs:

• Patients should be treated as individuals with specific needs.
• Specialist treatment teams should work with GPs to check on patients’ health and wellbeing regularly and systematically, to quickly identify potential issues and provide timely intervention, treatment, and support.
• Patients who are unpaid carers should be identified and additional supported should be provided to help them manage their own health and wellbeing, which also affects those they care for.

In our new report, The impact of waiting for NHS surgery in Somerset, we suggest practical solutions to help services achieve these improvements and presents patients’ experiences and feedback.  The report also includes a response to our recommendations from Somerset Clinical Commissioning Group and a joint response from Somerset NHS Foundation Trust and Yeovil District Hospital.

Gillian Keniston-Goble, Healthwatch Somerset Manager said: “Measures are being put in place by the NHS to tackle the backlog, but long waiting lists look set to continue for some time due to increased unprecedented demand on services.  There is particular concern for people who experience long waits as this increases the potential for patients to develop additional issues with their physical health and emotional wellbeing.  Although long waits are not the norm, we heard from many people waiting longer than the NHS maximum wait of 18 weeks from referral to treatment.  While waiting lists are inevitable, it is clear from our research in Somerset, and from national Healthwatch England research, that what matters is how waiting lists are managed – patients need more information and better support while they wait, to prevent deterioration in their health and wellbeing.”

NHS Somerset Clinical Commissioning Group (CCG) thanked Healthwatch Somerset for providing “valuable insight into the impact that long waiting times can have on our patients within the system.”  They continued: “The CCG and health and care partners recognise that waiting for planned care can be an anxious time for patients.  Alongside our recovery plan programme, we have been working together to develop our preventative programmes to help support people as they wait for treatment… the survey has already had a significant impact on the improvement work that is being carried out by our Acute Trusts and the CCG will continue to work with all providers in supporting further improvements for the benefit of our patients.”

Somerset NHS Foundation Trust and Yeovil District Hospital Foundation Trust, welcomed the Healthwatch Somerset research, commenting: “While the increases in the length of time patients are waiting for their planned surgery have been unavoidable, it is important that we remember the very real impact these waits have on each patient individually and we welcome the Healthwatch report in providing this snapshot of people’s experiences and the recommendations on how to improve our communications with these patients.

“Reducing these waits is a key priority and we would like to thank all our staff who are working exceptionally hard to implement practical steps to make a difference in these extraordinary times.  We acknowledge the importance of communicating well with our patients and, since the report was concluded, we have taken a number of steps for those waiting the longest, with plans to develop this further, while balancing the demands on our services.  We are committed to working in partnership with patients and their families.”

Sybil, age 86, from West Somerset: 17-month wait for hip surgery

Sybil, a former nurse, is 86 and lives alone in West Somerset.  She has always been active and drives to see her friends and to the shops.  Driving allows her to maintain independence and to provide help to others – in fact, she is the go-to person for her friends who ask for lifts for things like shopping and appointments.

She had a lower leg amputated in 2008 and was waiting for a hip replacement surgery on her ‘good’ leg.  After her first X-ray, Sybil was referred in October 2019, to Musgrove Park Hospital in Taunton.  She saw the surgeon in February 2020 but then, the COVID-19 pandemic began and so did the delays in treatment.

Sybil wasn’t told when the surgery would take place or provided with support.  She phoned the hospital admissions line and the surgeons office every two weeks to check on progress and to remind them she was in pain.  She eventually had surgery in March 2021, 17 months after being referred for treatment.

Sybil said: “The waiting time was dreadful.  I was in constant pain and at times thought I couldn’t go on any longer.  I felt suicidal in December 2020.  Due to my amputated leg, I use mobility aids to get around, but I developed a shoulder injury that was so painful I couldn’t move.  I had lost a lot of my independence and had to turn to painkillers to ease my pain while waiting for surgery.”

Sybil’s outcome is good.  She said: “When the day finally came, I felt extremely well looked after by the NHS.  The surgery went very well too.  I have now regained my independence and joy of life.  You wouldn’t even know there had been anything wrong with that hip.”