42% spike in red flag referrals and hike in fractures having impact on elective waiting lists: Guckian

A 42 per cent increase in red flag referrals has had a knock-on effect on elective care procedures aimed at reducing health waiting lists, according to Neil Guckian.

The Western Trust boss also says there have been significant increases in patients presenting with fractures year-on-year and this too has had an impact on the resources available for non-emergency and non-urgent operations.

“We have to acknowledge that at times our elective care suffers from other pressures. Red flag referrals are up by on average 21 per cent across NI...but it is over 42 per cent in the Western Trust,” he told the Stormont Health Committee last Thursday.

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“So clearly clinicians will have to concentrate on red flag referrals because of the pathway that people are on and it is quite right that they do so but that is often at the expense of elective sessions.”

Western Trust Chief Executive Neil Guckian.placeholder image
Western Trust Chief Executive Neil Guckian.

Mr. Guckian outlined to the committee how an increase in demand in orthopaedic trauma was equally having an impact on elective care.

“Basically that is significantly increased as well since pre-pandemic levels. So we have more of hip fractures, by a factor of 28 per cent up in the Western Trust. Other fractures are up by over 30 per cent.

"That means we have to stand down elective sessions in order to treat the trauma. Now the patient doesn't recognise that that is the implication of their operation.

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"Clinicians get very frustrated because they recognise the needs in their waiting lists but they have to be reminded they are doing the right thing.

"They are treating the patients' need. So we have to acknowledge that the emergency is having an impact on our elective work,” he observed.

Mr. McGuckian said health systems in other countries tended to completely separate out elective care from all other services and suggested this was a route that could be followed in the North.

"That's a real challenge for us in NI to go further than we currently are because of our emergency needs and the needs of our population,” he said.

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Elective sessions being delivered in the Western Trust, meanwhile, have increased significantly from last year and since COVID, said the Trust Chief Executive.

‘Mega clinics’ have been rolled out locally in order to ensure as many people can be treated as possible and this has been having an impact.

He acknowledged that some people have been on elective waiting lists for so long that they are sometimes unable to be treated as day case patients and have to be admitted to hospital by the time their turn comes round.

“Because patients are on waiting lists for such a long time it is really important that they are fit for the operation that they are receiving so we are now organising what's called 'mega-clinics' on Saturdays so we have a wide pool of patients for every session that is being delivered so that we don't have any fallow time in our sessions, so that every patient is allocated to the right session because they might arrive for a day case but they might need an inpatient clinic because they have actually deteriorated during the course of their waiting list,” he explained.

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