KPIs report shows more patients treated but ongoing challenge with waiting time targets

But with more and more patients being referred for diagnosis and treatment, waiting times for non-urgent care continue to be a challenge.

The new figures are contained in the 2023 Key Performance Indicators (KPIs) report, published today by Health & Social Care (HSC) and the Medical Specialist Group (MSG).

Inpatient admissions went up to 15,601 in 2023, an increase of 1,142 patients, or 7.9% on 2022. There were 20,998 new outpatient referrals, an increase of 1,128, or 5.7%. And theatre activity also increased with an extra 319 patients, taking the total number of procedures to 4,640, an increase of 7.4%. This data highlights the increasing demand for care that HSC and the MSG must provide.

The report shows that despite the increased numbers of patients treated, important quality indicators such as length of stay, unplanned returns to theatre and emergency readmissions are all above target.

Waiting times are below target but stable, with just over two in three (68%) of all non- urgent patients seen within the eight-week target compared with 71% in 2022. However, 84% of patients were seen within three months and almost all (94%) within six months of referral.

The specialities with the longest waiting times continue to be gastroenterology and orthopaedics, despite the success of two waiting list initiatives in 2023. An extra 508 patients had an endoscopy as a result of HSC appointing Medinet to carry out nine weekend clinics during the summer. And we have seen an overall reduction of 22% in cancelled orthopaedic operations since we opened the de Haviland ward with its dedicated orthopaedic beds. Indeed there was an 88% reduction in cancellations due to unavailability of beds, meaning that 462 patients were able to have their bone or joint surgery during the year.

Waiting times for radiology are above target with 96% of patients getting an x-ray or scan within six weeks of referral, and a report on that scan being delivered within eight weeks of referral.

Dr Peter Rabey, HSC Medical Director, said:

‘The KPIs have been set to reflect high standards of practice and patient care and they encourage a culture of continual development, learning and improvement towards excellence. Where performance falls below the high thresholds that are set, we continue to analyse why this is and implement improvements collaboratively.

‘We cannot control demand for healthcare and there is no doubt that it will continue to increase as the population ages and more treatments become available. We do not have infinite financial, staff, ward or theatre resources, but we have created additional capacity through our gastroenterology and orthopaedic waiting list initiatives, and this is helping to stem the tide. In the climate of ever-increasing demand, maintaining waiting lists at a stable level should arguably be viewed as a success story.

‘Having said that, we recognise the impact of any delay for patients and their families who are waiting for surgery or are anxious to know the next steps for their diagnosis and treatment. We continue to work with the MSG to try and identify further opportunities for additional initiatives like those we successfully ran in 2023.

‘Our Hospital Modernisation is crucial in supporting plans to meet the increasing long-term care needs of islanders, with phase 1 and the recently approved phase 2 set to deliver essential new facilities including increased theatre capacity.’

Dr Steve Evans, MSG Chair, added:

‘We welcome the publication of the KPIs report. We are very happy to be held accountable for how we work in partnership with the HSC to deliver high quality secondary healthcare to islanders.

‘I’d like to pay tribute to all our consultants and support team members and to our colleagues at the HSC for their hard work, commitment to clinical excellence and for the way they put the patient first, always.

‘None of us want to see our patients waiting longer than they should and we are determined to continue to do all we can with HSC to reduce waiting times.

‘While we continue to increase the number of patients we care for, there has been no adverse impact on the standards of care. The average length of stay for a patient is just three days (against a target of less than six days) yet our emergency readmission rate is as low as 7% (against a target of less than 10%) which means that we are not discharging patients before they are ready to go home.

‘I’m pleased that we achieved our target of 100% of annual appraisals being completed for our doctors. Independent and objective review is essential to ensuring that high professional standards are maintained.

‘Recruiting specialists with the right experience and approach to patient care continues to be a top priority. Just last month we invested in a stand at a top anaesthetists conference to promote the unique benefits of being a consultant in Guernsey and managed to attract expressions of interest from more than a dozen anaesthetists. We’re now planning to take out stands at more conferences in the year ahead for our hard to recruit specialties.’