Orthopaedic waiting lists in NHS Wales soar by 56% since COVID-19 outbreak

Long waiting times for orthopaedic treatment in NHS Wales are having an adverse impact on patients’ physical health and mental wellbeing, according to a report by Wales’ auditor general Adrian Crompton.

The branch of medicine, which focuses on bones, joints, ligaments, tendons and muscles, was already facing significant challenges before the COVID-19 pandemic, and although the Welsh Government has committed to improving waiting times, it could take more than three years to return the waiting list to pre-pandemic levels.

Since the pandemic, waiting lists have increased by 56% and more than half of patients are now waiting more than the 26-week target, with over a third waiting over a year.

Although musculoskeletal problems are not life-threatening, the report highlights the impact that long waits can have on people’s physical and mental health, as well as on the wider NHS. The report calls for a renewed focus on efficiencies, capacity and community-based prevention.

The Welsh Government and NHS Wales have acknowledged the scale of the challenge facing the service and have committed to transforming orthopaedic services.

However, the report stresses that more needs to be done to make services sustainable for the longer-term.

It outlines several recommendations for both the Welsh Government and Health Boards, including the preparation of a clear national delivery plan, a constant focus on improving efficiencies and productivity, and arrangements to monitor patients waiting for treatment, providing communication, support and advice where needed.

The report acknowledges that securing timely treatment has been a challenge for the NHS in Wales for many years, and urges urgent action to secure short-term improvements in waiting times, to minimise the discomfort and pain patients experience, as well as creating more sustainable long-term improvements.

Mr. Crompton says that: “Our updated modelling shows that it could take three or more years for the waiting list to get back to pre-pandemic levels. But that will require a significant drive on community-based prevention and an increase in activity and capacity levels over and above those in place prior to the pandemic.”

Although the report’s figures are based on the NHS Wales’ ‘open’ referral to treatment measure, which counts the number of pathways which have started but not yet completed treatment, each pathway represents a patient waiting, and therefore the total number of people waiting for treatment will be lower than the total number of pathways.

Russell George MS, Chair of the Senedd’s Health and Social Care Committee says:

“I support the findings of the Auditor General’s report, especially its emphasis on providing adequate support for people waiting for Orthopaedic treatment or diagnosis.”

“The importance of supporting people to live well whilst waiting was a key finding of the Committee’s own report on NHS waiting times, published in April 2022. People must not be made to feel forgotten.”

“We continue to monitor the Welsh Government’s progress on reducing the backlog and, in a recent letter to the Minister for Health and Social Care, we acknowledge that progress is being made.”

“However, improvements are slower than envisaged in the Welsh Government’s programme and given the volume of patients still waiting to be seen, more must be done if the backlog is to be cleared.”