NHS0015

Written evidence submitted by The Medical Technology Group

About the MTG

The Medical Technology Group (MTG) welcomes the Public Accounts Committee’s consultation on NHS backlogs and waiting times. The MTG has campaigned 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 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’.

MTG Ration Watch Campaign

The MTG’s campaign, Ration Watch, launched in 2017 to highlight the impact of rationing care across the NHS and demonstrate the postcode lottery of care. The campaign highlighted how in today’s NHS, where you live, not what you need, is likely to be the determining factor in the treatment you receive.

Following the COVID-19 pandemic and the subsequent growth in waiting list to over 5 million people, in 2021 the campaign changed focus, looking to analyse NHS data to see where the system is clearing waiting times quickly and where patients are left waiting longer.

In order to understand the speed with which every Clinical Commissioning Group (CCG) and NHS Region is working to reduce their backlog, using NHS waiting time data, the MTG has assessed the number of patients treated in each region and CCG / ICS.

By comparing NHS waiting time from month to month the MTG is able to calculate how many patients per 1000 per month the NHS is treating in both the 7 regions and the CCGs/ICSs.

Link to Ration Watch data: Click here.

Regional overview

The data shows that there are large disparities between the speed the different regions of the NHS are working through their elective backlog. The data highlights how patients on waiting lists in the North East are likely to have the shortest waiting times, while those in London can expect to wait longest.

Ration Watch regional waiting time data for August:

	Region	Population	Patients treated August 2021	Number of patients treated per 1000 people	% Change
1	North East	8,603,721	38,364	4.46	-8.96%
2	South East	8,897,835	36,381	4.09	-11.46%
3	South West	5,631,114	22,913	4.07	-11.28%
4	North West	7,061,412	28,196	3.99	-5.68%
5	Midlands	10,601,877	38,865	3.67	-7.14%
6	East	6,529,013	22,698	3.48	5.19%
7	London	8,961,989	25,753	2.87	-32.03%

CCG / ICS overview

The data below shows the top 6 and bottom 6 performing CCGs / ICSs in August for clearing the elective backlog. Patients in the Wirral can expect the longest wait for treatment in the whole country, with only 1.69 patients treated per 1000 on the waiting list. While patients in Wakefield can expect the shortest time, with 7.15 patients treated per 1000 on the waiting list.

Worst performing CCGs / ICSs in August:

Position	CCG/ICS	Population	Patients treated in August	Patients treated per 1000 population
106	NHS WIRRAL CCG	324,011	546	1.69
105	NHS STOKE ON TRENT CCG	264,651	590	2.23
104	NHS NORTH CENTRAL LONDON CCG	1,510,806	3,484	2.31
103	NHS WEST ESSEX CCG	310,040	731	2.36
102	NHS NORTH EAST ESSEX CCG	341,267	835	2.45
102	NHS LIVERPOOL CCG	498,042	1,305	2.62
100	NHS BIRMINGHAM AND SOLIHULL CCG	1,180,567	3,121	2.64

Best performing CCGs/ICSs in August:

Position	CCG/ICS	Population	Patients treated in August	Patients treated per 1000 population
1	NHS Wakefield CCG	384,312	2,491	7.15
2	NHS St Helens CCG	180,585	1,169	6.47
3	NHS Tameside and Glossop CCG	260,063	1,616	6.21
4	NHS Dorset CCG	773,839	4,759	6.15
5	NHS Stafford and Surrounds CCG	157,308	952	6.05
6	NHS Chorley and South Ribble CCG	178,547	1,003	5.62
7	NHS East Staffordshire CCG	129,944	713	5.49

The MTG has data for each month from April 2021, showing the performance of all CCGs/ ICSs and regions in clearing the elective backlog and would be pleased to share all this data with the Public Accounts Committee. To see the data click here.

Contact

If you have any questions or require additional information, please contact the MTG Secretariat at mtg@healthcommsconsulting.co.uk.

APPENDIX 1

MTG Post-Covid NHS Standard: Patient

Rapid access

Patients deserve information regarding waiting times for diagnostic tests and interventions.
Patients should have timely access to treatment on the NHS.

No arbitrary restrictions

CCGs and ICSs should not place arbitrary restrictions on patient access, this includes; weight restrictions, pain thresholds and non-clinical mechanisms for stopping patients moving onto official waiting lists.

Effective appeals

If a treatment is not given, or a patient is not happy with their care, there should be a clear pathway and plan for an appeals process.

Choice of treatment and location

Patients should be provided with appropriate information to make an informed choice about their treatment.
Patients should retain the right to choose where they want to receive treatment, even if it is outside their ICS area. The rights of patients are enshrined in legislation through the Any Qualified Provider requirement and this should be upheld.

Patient voice and input into prioritisation decisions

The patient voice should be mandated in decision making processes and on ICS boards.
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 regarding prioritisation.

December 2021