Cost-cutting move to delay non-urgent surgery 'unprecedented and unfair'


The Royal College of Surgeons has hit out at a cost-cutting move to suspend non-urgent surgery branding it "unprecedented and unfair".

Cash-strapped West Kent Clinical Commissioning Group has implemented the policy in a bid to make financial savings of £3.2 million.

It means that until the new financial year starts in April non-urgent surgery will be delayed as the NHS body looks to stay within budget.

Clare Marx, president of the Royal College of Surgeons, warned that the short-term savings may have "major consequences" for some of the patients.

"West Kent CCG's suspension of non-urgent surgery until April is unprecedented and unfair," she said.

"Patients, some of whom may be in severe discomfort or pain, should not be made to wait longer for treatment because the CCG has run out of money and surgical patients are perceived as easily postponed.

"The CCG is trying to make short-term savings which may have major consequences for patients. While patients wait for treatment, their conditions could deteriorate, sometimes making treatment more complex and costly in the long term.

"In addition standing down surgeons and their teams is inefficient and a waste of scarce resource. Clinical decisions must not be made purely on a financial basis.

"Over the last few months we've consistently seen NHS financial pressures impact negatively on patients and policies like this indicate the situation is worsening

"It's time for the Government to be realistic about funding levels."

In 2015 - 2016 West Kent Clinical Commissioning Group spent £533.1 million on patient care - providing for the 463,000 residents in the area.

The move to halt non-urgent surgery was implemented with "immediate effect" on December 20.

Recent board documents highlighting the decision state that hospitals are being "asked to reduce non-urgent elective care until the end of the financial year".

And that these measures "will result in some patients waiting longer than expected, but will not affect those who have an urgent need for treatment".

Dr Ian Ayres West Kent CCG's accountable officer told the Guardian newspaper that some of those requiring a hip or knee replacement "although suffering continued discomfort, would be able to wait longer for their operation without there being an adverse outcome for their health".

"We are working with our providers to identify exactly which patients will be affected, but estimate the number of patients affected to be in the order of 1,700," Dr Ayres said.

"We have not prescribed in advance a list of procedures or patients to be delayed. Anyone who has had a procedure booked will be treated. No one will have their operation or procedure cancelled as a result of this policy.

"Patients will continue to be referred by their GP outpatient appointment and be seen by a consultant.

"A judgment will then be made as to whether the required procedure is urgent, or non-urgent and could wait. Therefore, no one with an urgent healthcare need will be made to wait."

It follows similar cost-cutting plans put forward by three West Midlands Clinical Commissioning Groups (CCGs) to ration who can receive hip and knee replacements.

Redditch and Bromsgrove, South Worcestershire, and Wyre Forest CCGs intend to slash the number of people who qualify for hip replacements by 12% and introduce a 19% cut over who is eligible for knee replacements.

This would include only treating "severe to the upper end of moderate" cases, and people who are obese with a body mass index of 35 or over needing to lose 10% of their weight unless their problems were very severe.

Patients in pain would now need to have such severe levels of pain that they cannot sleep or carry out daily tasks.

Board documents said a "patient's pain and disability should be sufficiently severe that it interferes with the patient's daily life and/or ability to sleep".

Hoping to save around £2 million a year, the proposals aim to prevent about 350 operations each year.