IOM DHSC & MANX CARE

[Numbnuts]

19 minutes ago, asitis said:

My experience of Nobles Hospital, for balance, is the service has been fine, the problems have been actually getting to see someone in the first instance !

This ...I have been so fortunate to never spend a night in hospital but have had excellent treatment as a outpatient ,be it sometimes taking a long time. Eye consultation and  Rheumatology being the main problem. Currently waiting  for possible operation on my ankle due to osteoarthritis but my GP has said might be up to 5 years. I'm hoping this new initiative might help. Being 68 the thought of dealing with the pain and restrictive movement for another possible 5 years fills me with dread. If indeed they can cut waiting times to up to a year say, then I would be very happy with that as generally have found Nobles good. Not sure though over the seemingly many levels of management and the adminstration.   

Edited October 30, 2022 by Numbnuts

[WTF]

55 minutes ago, Numbnuts said:

This ...I have been so fortunate to never spend a night in hospital but have had excellent treatment as a outpatient ,be it sometimes taking a long time. Eye consultation and  Rheumatology being the main problem. Currently waiting  for possible operation on my ankle due to osteoarthritis but my GP has said might be up to 5 years. I'm hoping this new initiative might help. Being 68 the thought of dealing with the pain and restrictive movement for another possible 5 years fills me with dread. If indeed they can cut waiting times to up to a year say, then I would be very happy with that as generally have found Nobles good. Not sure though over the seemingly many levels of management and the adminstration.   

but if you have the money to pay for it the 5 years wait vanishes , same staff , same hospital , but all of a sudden they have the time.

[wrighty]

6 minutes ago, WTF said:

but if you have the money to pay for it the 5 years wait vanishes , same staff , same hospital , but all of a sudden they have the time.

Not true. There hasn’t been any private orthopaedics here for years now. 

[Jarndyce]

12 minutes ago, WTF said:

if you have the money to pay for it the 5 years wait vanishes , same staff , same hospital , but all of a sudden they have the time.

Please provide evidence for this statement.

ps: crossed over with Wrighty’s response - I imagine he would know.

Edited October 30, 2022 by Jarndyce
Additional ps.

[Numbnuts]

16 minutes ago, wrighty said:

Not true. There hasn’t been any private orthopaedics here for years now. 

Your in the know so in your opinion do you think this new initiative , 18 million , passed the other week is likely to do what they say it will . So understand if you cant answer this question for probably various reasons.

[quilp]

4 minutes ago, Numbnuts said:

Your in the know so in your opinion do you think this new initiative , 18 million , passed the other week is likely to do what they say it will . So understand if you cant answer this question for probably various reasons.

Snowman posted Rob's version of how the £18m will affect the lists...

On 10/19/2022 at 5:37 PM, snowman said:

Apologies if this information is already posted. It's from Rob Callister and contains some eye watering figures in relation to current wait times and targets.  Even the targets remain lengthy in some areas after the recovery phase ..

 

 

 

£18.3M FOR RESTORATION & RECOVERY PHASE 2

I enclose a copy of my full statement in Tynwald yesterday relating to the £18.3 million to undertake 3,800 surgical procedures over the next few months, which will improve the quality of life for many within our Manx community. 
 
Thank you Mr President,

Our ‘Island Plan’ has an objective to “address how waiting times and access to health and social care services can be improved as a priority” - and this motion for consideration here today directly supports that goal.

Manx Care inherited a significant waiting list backlog across all inpatient, day-case and outpatient specialties.

These waiting lists were prolonged by the impact of Covid-19 with most specialties reporting more than a 52 week wait for both inpatient surgeries and outpatient appointments.

I’m sure that many of us in this honourable Court have been contacted by concerned constituents who have had to wait far too long for appointments, which are seriously affecting their quality of life.

If Tynwald agrees here today to vote through the funding, around 3,800 surgical procedures will be completed over the course of the next few months.

As the new Health and Social Care Minister

I fully acknowledge the excellent work already undertaken…. and the success we have already seen in some specialities.

Funding of £1.8m was previously agreed by Treasury for the Restoration and Recovery Phase 1, which addressed some of the Covid-19 backlog, along with providing virtual hospital outpatient appointments across certain specialities.

Mr President

I confirm that 458 endoscopy procedures were completed in phase 1, which eliminated that waiting list.

We also completed 356 cataract operations with patients returning home on the same day.

Further funding of £908,400 was also agreed to fund hip and knee surgery, and this work started on Island in April and delivered 115 operations.

To date we have invested £2.7m to undertake 929 individual procedures, which will help improve the quality of life for many members from within our community.

In support of the “Island Plan” objective, and as part of their Mandate, Manx Care are required to address waiting times to levels comparable with other health and care systems…

….and to improve waiting times across services, with the ultimate target of an 18 week “Referral to Treatment time” (known as RTT).

Therefore this next phase of the programme, Restoration and Recovery Phase 2 plans to address the backlog in the three areas that have the largest numbers of patients waiting for an inpatient or day case procedure.

These are orthopaedics, general surgery and ophthalmology.

The aforementioned specialties are also those that have been targeted in the UK by NHS England.

With this plan, waiting list numbers as at the end of 2022/23 would be reduced by 2,200 cases across the three specialities.

This should bring the waiting list sizes to a level that should enable patients on the Orthopaedic, Ophthalmology and General Surgery inpatient waiting list to have average RTT waiting times of around 52 weeks… which includes the outpatient element of the pathway.

At present, the average waiting times for day cases across the 3 specialities is about 85 weeks.

Treasury and Council of Ministers has approved interim funding of £5m, which has allowed the work to begin in October.

If we are unable to secure the necessary funding here today, the department will need to give immediate notice to end the work in 8 weeks’ time, meaning that no further Restoration and Recovery activity work can take place after December.

If Tynwald approves the funding then we anticipate completion of the work in quarter 1 of the new financial year subject to winter pressures, human capacity and supply chain pressures ect.
 
Mr President

As for the cost - I fully understand that £18.3 million is a lot of money.

However, the plan addresses a legacy of issue, which means that waiting lists have unfortunately grown to beyond what can be considered safe.

The financial governance for this project is robust given the blend of independent provider and internal resources providing services … 
and a contingency of £2m is inclusive of the £18.3m to address any rise in costs associated with consumables and equipment.  

Following delivery of these procedures, we expect the waiting lists in 3 defined areas to be reduced significantly….
…and the quality of life for many within our community will be enhanced.

In Orthopaedics the current average waiting time for in-patient and day case is 46 weeks and that is expected to reduce to just 4 weeks, with the numbers waiting being reduced from 669 to 100.

In General Surgery the current average waiting time for in-patient and day case is 43 weeks and that is expected to reduce to just 3 weeks, with 554 people being removed from the waiting list, leaving just 60 patients awaiting for treatment at the end of the programme.
In Ophthalmology the current average waiting time for in-patient and day case is 58 weeks and that is expected to be reduced to 18 weeks at the end of the programme.

The number of people waiting is forecast to reduce from 1,359 to 300

To summarise Mr President,

The Island Plan has made a clear commitment to reduce our historic waiting list backlog and this funding is critical, in order to help deliver against that commitment.

Failure to address these backlogs will undoubtedly have a detrimental effect on a patients’ condition in the longer term.

It could also create even greater cost pressures in the future due to the increased complexity and risks around conditions that have worsened whilst on the waiting list.

Addressing the waiting list position quickly also has an economic benefit to the wider community, and the economy.

The proposed model of using external resources to support Manx Care’s teams to deliver additional activity over and above business as usual on-Island is already proving successful as I have already outlined.

It's quite a long post but worth the read for the projection. 

[wrighty]

3 minutes ago, Numbnuts said:

Your in the know so in your opinion do you think this new initiative , 18 million , passed the other week is likely to do what they say it will . So understand if you cant answer this question for probably various reasons.

In orthopaedics, I think it will. In 6 months we’ve cleared almost half the backlog of joint replacements.  That’s the in-house surgeons and visiting surgeons working with the team from Synaptik. Personally, my own team has done 50 joint replacements in the last 7months, far more than a usual April-October given that we lose a month due to motorbikes, and people go on holiday etc. My own list should be under control with reasonable waits by March I reckon. The stories people tell about 5 year waits are not at all accurate. There are some people on a routine waiting list that long in some sub-specialties still waiting to be seen - many of them probably shouldn’t have been referred in. But for surgery, I expect we’re down to a year wait already (for people listed now, their surgery will be in 2023. There may still be some who have waited longer, but they’ll get done soon)

 

Can’t speak for eyes and general surgery as I’ve not studied their figures, but I’ve no reason to believe that the project won’t work just as well there. 

[Numbnuts]

2 minutes ago, wrighty said:

In orthopaedics, I think it will. In 6 months we’ve cleared almost half the backlog of joint replacements.  That’s the in-house surgeons and visiting surgeons working with the team from Synaptik. Personally, my own team has done 50 joint replacements in the last 7months, far more than a usual April-October given that we lose a month due to motorbikes, and people go on holiday etc. My own list should be under control with reasonable waits by March I reckon. The stories people tell about 5 year waits are not at all accurate. There are some people on a routine waiting list that long in some sub-specialties still waiting to be seen - many of them probably shouldn’t have been referred in. But for surgery, I expect we’re down to a year wait already (for people listed now, their surgery will be in 2023. There may still be some who have waited longer, but they’ll get done soon)

 

Can’t speak for eyes and general surgery as I’ve not studied their figures, but I’ve no reason to believe that the project won’t work just as well there. 

Thanks so much for that. To be fair to the 5 years I mentioned it was what my GP said it could be , worst scenario. So encouraging your explanation and possible time spans. 

[Numbnuts]

14 minutes ago, quilp said:

Snowman posted Rob's version of how the £18m will affect the lists...

It's quite a long post but worth the read for the projection. 

Thanks so much . 

[WTF]

1 hour ago, wrighty said:

Not true. There hasn’t been any private orthopaedics here for years now. 

perhaps out of date locally, but nothing to stop folks paying and going away, why was private orthopaedics really stopped locally at nobles ?? ,  

[wrighty]

16 minutes ago, WTF said:

perhaps out of date locally, but nothing to stop folks paying and going away, why was private orthopaedics really stopped locally at nobles ?? ,  

At the back end of 2018 the hospital management decided to scrap all private operating in Noble’s theatres. At that time there were 2 orthopaedic consultants routinely doing private practice, plus me doing private consultations without operating. By the middle of 2019 it had all stopped. 
 

Reasons? Cultural issues in theatres - it was suggested that the workplace culture would improve if the perceived conflict over private practice was no longer there (newsflash - it didn’t) - and the PPU itself. It needed refurbishment, and the plan was to get this done in 2019 while external private providers were sought to take over its running. This got delayed then covid came. 
 

There are whispers about it coming back online but I wouldn’t hold your breath. And it’s highly unlikely that any of the current orthopaedic surgeons will take it up again. 

[Boris Johnson]

18 hours ago, Jarndyce said:

I trust you’ll have the courage of your convictions if you are ever unfortunate enough to be bleeding out in the back of an ambulance while the paramedics attempt to take you to Nobles to save your life.    I hope you’ll have the integrity to tell the medical staff what you think about them when you get there.

However, this is an anonymous forum: so no-one will be in a position to check whether you take your own fatuous advice when you or your family are next in need of urgent medical treatment.  

If that scenario did happen,would I, upon arriving at Nobles be looked at by the "Feral" * doctors in A&E?

*Quote taken from the Care Quality Commision leaked report, not my words.

P.S. I have not met a bad paramedic on the island to be fair, good guys and gals including the ones who live in England and commute to work here.

[littlebushy]

Obviously not....because by definition they would be nowhere to be found!

[Anyone]

I have pretty much accepted the fact that if I’m a little bit ill then I will get no help from the NHS. That’s fine as we should not be burdening the system with little things . I have also accepted the fact if I get really ill then I’ll die as I have no faith in the NHS. The NHS will fail us all as it’s not fit for purpose. Point being that as you can’t get access to medical care unless you win the telephone lottery by the time you get to see an actual doctor ( as opposed to a typist ) and if you are really ill it will be too late.  And you’ll be dead or terminal. 
 

 

 

 

[Boris Johnson]

13 minutes ago, littlebushy said:

Obviously not....because by definition they would be nowhere to be found!

" in a wild state" is the dictionary definition.

Just how you want someone to be who may be about to try and save your children's lives.