Written evidence submitted by The Medical Technology (CBP0053)
The Medical Technology Group (MTG) welcomes the Health and Social Care Committee’s consultation on clearing the backlog caused by the pandemic. The MTG has campaigned tirelessly to reduce the regional disparities that were present before the Covid pandemic, many of which were the result of arbitrary decision-making from Commissioners and have only been exacerbated by the pandemic. All patients, no matter where they live, deserve the same access to treatment. Everyone needs to be treated fairly and equitably as the NHS battles to recover from the enormous impact of Covid.
The MTG is calling for all patients in England to be treated fairly and equitably as we recover from the Covid-19 pandemic. In order to address this, we are calling for NHS England to agree to the ‘MTG Post-Covid NHS Standard: Patient Charter’.
The backlog is predicted to be anywhere between 7 million and 13 million people. The vast bulk of these will be people seeking access to elective surgery, with waiting lists already at record levels. This number does not take into consideration those people waiting to get onto the waiting lists, or who have not yet presented at healthcare settings, meaning the actual figure of the backlog is likely to be much higher.
It is important to note that many of the capacity issues seen in the NHS existed long before Covid. Waiting times have been creeping up for a number of years. This has led to various behaviours manifesting – such as the use of arbitrary thresholds on access to treatment.
The MTG believes strongly that the best way to reduce the backlog is to get patients treated effectively at the first time of asking. This will require a boost to the capacity in theatres to ensure that patients that require treatment are able to get the help they need. The NHS should look at the role of technology in supporting patients and focus on how this can support efficiencies. Technology that helps patients lead full and active lives should be prioritised. This would also increase productivity as many patients will be able to return to work and contribute to society, as set out in the MTG’s Keeping Britain Working report.
In order to avoid a general worsening of a patient’s condition, commissioners should not place arbitrary restrictions on patient access. These include; weight restrictions, pain thresholds and non-clinical mechanisms for stopping patients moving onto official waiting lists. The MTG believe rationing treatment for patients will only increase the backlog of patients on waiting lists following the pandemic. The MTG believes commissioning decisions which deny patients access to care will only further impact a patient’s quality of life and treatment after care.
In the short term, additional financial investment should be focussed on the delivery of much needed services. Many patients have now been waiting well over a year for treatment. It is important to remember that waiting lists are not just a number – they are real people, at home living their lives in pain, unable to get help.
The core focus of the NHS should now be to ensure as many people as possible are able to access treatment. Work should continue to increase operating theatre capacity. Alongside this, policy makers should look at tools such as remote monitoring that can be used to keep people out of hospital. These tools should be used for patients who have undergone treatment.
In the medium term the investment should look at how increased capacity can be embedded across the system. Do we understand where the capacity issues are both across the country and within the NHS as a whole? These issues should be the focus of work to ensure that investment made in the short term leads to long term benefits.
The NHS as a system needs to take a different view of giving patients access to technology. Too often technology is viewed in terms of cost and resource. Many of the wider benefits brought by technology are ignored as policy makers focus on the upfront cost, ignoring the long-term benefit.
Given the existing challenges around workforce, NHS organisations should be encouraged to look at the benefits of technology and implement new pathways and services that take full advantage of technology at the same time as freeing up NHS staff time.
Less invasive, more effective medical technology procedures can improve patient throughput and make more efficient use of resources. Minimally invasive procedures such as uterine fibroid embolisation (UFE) can reduce hospital stays and ensure people can get back to work more quickly, rather than having a hysterectomy. Similarly, minimally invasive cardiac procedures, such as Transcatheter Aortic Valve Implantation (TAVI), result in a short hospital stay and can help increase throughput, instead of open-heart surgery.
Alongside this, the MTG believes that the patient voice needs to be more prominent within the healthcare system. The patient should be at the heart of all decision making in the NHS. Prioritisation decisions will need to be made to address the backlog post covid. However, patients are those who are most affected and must be brought into the decision-making process. It is important to note that treatments which are not deemed life threatening, but do impact the patient’s quality of life, are still an important part of the discussion around the backlog of care and should be deemed as important to prioritisation.
There are examples of NHS organisations using technology to support the delivery of services in times of need. Remote consultations have increased dramatically. Tools such as remote monitoring have been used to support patients. Minimally invasive treatments have been used in place of traditional methods of delivery as they require less time in hospital.
Th MTG would like to see a ‘technology review’ that aims to capture how technology has been used during covid to then embed these changes right across the NHS.
First and foremost, the MTG would like to see the patient voice hard wired into the decision-making process. Tough decisions will have to be made and it is critical that patients are part of that process. As new NHS systems and structures are created, it is important that patients are given a formal role at every level of the system, not simply consulted on major decisions that affect them. This will help shape a more ‘person centred’ service that priorities quality of life and return to work in key decision making processes.
Secondly, we would like to see the implementation of the technology review, set out above. Positive changes that have resulted from the covid crisis should not simply disappear as we return to old and outdated practices. The covid crisis has given us a real world demonstration of what technology can do. The challenge is now to understand the impact of this and make sure we drive implementation across the system.
The ‘MTG Post-Covid NHS Standard: Patient Charter’
1. Rapid access
2. No arbitrary restrictions
3. Effective appeals
4. Choice of treatment and location
5. Patient voice and input into prioritisation decisions