Providers in just two integrated care systems carried out more inpatient elective procedures in the first quarter of this year than before the covid pandemic, HSJ analysis of official data has revealed.
The analysis raises fundamental questions about whether key targets to significantly raise activity compared with pre-covid levels will be met, not least with the colder months just around the corner.
HSJ’s analysis shows the English NHS carried out around 9 per cent fewer elective procedures in the first quarter of 2022-23 compared to the same quarter from a pre-covid period, calculated by averaging out activity levels between 2018 and 2020.
Kudos, however, to Humber and North Yorkshire ICS (119 per cent) and South West London Health and Care Partnership (103 per cent) which were the only two ICSs to carry out more than their pre-pandemic levels of procedures between April and June this year.
The analysis does not include outpatient activity levels, which make up between 70 to 80 per cent of the referral to treatment waiting list and are a key component of national targets.
But a leading expert highlighted the significance of the inpatient activity performance, stressing this part of the workload was where the “heavy lifting” needed to be done to shrink the NHS’s huge elective backlog, and that the lagging performance was a significant concern for system leaders.
Call the midwife
A maternity model at the heart of NHS England’s future ambitions for how mothers and babies are cared for has had to be paused at most trusts because they do not have enough staff to safely run it.
Continuity of carer has been championed by chief midwifery officer Jacqueline Dunkley-Bent and key targets around the model were included in the long-term plan.
However, there is controversy surrounding it, particularly after the publication of the final part of the Ockenden review, which was critical of the model. Senior midwives have described how pressure to roll it out has placed additional strain on them and maternity services.
HSJ research has revealed more than two-thirds of trusts that provide maternity services have had to pause further roll out or suspend the model altogether. Just 12 trusts out of 103 that responded to HSJ’s questions have been able to continue with the service.
Despite this, NHSE is continuing to press for continuity of carer to be default for the NHS by March 2024. But with almost 600 midwives leaving the NHS between May last year and this year, trusts being able to safely staff and run a successful model seems like a very tall order.