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The UK’s other health crisis: Huge backlog of delaying drain-free care

LONDON – Lara Wahab has been waiting for more than two years for a kidney and pancreas transplant, but months have passed without a word. So last month she called the hospital and received heartbreaking news.

The transplant coordinator told her there was a good match in October, which the hospital would normally accept. But with Covid-19 patients filling up the beds, the transplant team couldn’t find her a place in the intensive care unit for post-operative care. They had to decline organs.

“I’ve just been in shock. I know the NHS has been under a lot of stress, but you really don’t know until you’re waiting for something like that,” she said, referring to the Health Service. “It was there, but it slipped through my fingers,” she added of the transplant opportunity.

Ms Wahab, 34, from North London, is part of a huge and growing patient backlog in Britain’s free health service, who have seen planned care. plans are delayed or diverted, partly because of the pandemic – a crisis is largely invisible in a crisis. Problems can have profound consequences that we will have to feel for years.

The numbers are staggering: In the UK, almost 6 million procedures are currently delayed, up from a pre-pandemic backlog of 4.6 million, according to the NHS. The current delay most likely affects more than five million people – a single patient can have multiple pending cases for various illnesses – making up almost a tenth of the population. Hundreds of thousands more have yet to be referred for treatment, and many diseases simply go undiagnosed.

There was a huge and growing patient backlog before the pandemic, but the burden has not stopped over the past two years, with medical staff and hospital capacity getting thinner by coronavirus cases. , which sent it skyrocketing to record levels. The latest official figures are almost two months out, and experts say a severe staff shortage this winter and widespread wildfires of the Omicron variant have almost certainly made the situation worse. worse than.

Saffron Cordery, deputy chief executive officer of NHS Providers, a membership organization for healthcare workers, said: “Just because we’ve got Omicron doesn’t mean other diseases have stopped and gone and gone. development in humans”. .

Public health experts fear that even if the pandemic eases and relieves some of the immediate burden, the pandemic and delayed care could cause long-term harm to the health system, as well as to patient.

This month, a report from the congressional health committee revealed a complex and troubling picture of record waiting lists, high staffing and severe staffing shortages. It warned that a large workforce expansion was needed, but the government was not doing enough to recruit and train health workers.

Generations of Britons have have to wait longer to get treatment than many Americans are covered, with most accepting that it’s the price of caring for people. But the problem has worsened for nearly a decade, with critics accusing Conservative governments provide capital regularly for the system.

In 2012, there were 2.5 million cases pending specialist treatment in the UK. By early 2020, the backlog had grown to 4.6 million cases, according to the NHS

At the end of November 2021, the top-up is six million. More than 300,000 cases have waited more than a year for planned care. A decade ago, there were less than 500 units.

Experts and government officials say the real backlog is probably much larger. As the health commission noted in its report, the pandemic has disrupted many of the normal assessment and referral models of primary health care physicians, leaving people with no formal opportunity. .

Recently report from the National Audit Office It is estimated that there were 7.8 million to 9.8 million “missing” referrals – situations that would normally happen but never happen – by primary care physicians between the start of the pandemic and May. 9 2021, including 240,000 to 740,000 cases of suspected cancer.

“We can see a direct impact on people with other diseases, including but not limited to cancer,” said Peter English, a retired consultant in infectious disease control. , where treatment was delayed or postponed or we missed it.” “And they die because they don’t get the treatment they would otherwise have.”

Via when the pandemic hit the UKMs. Wahab has been on the transplant list for months. In April 2019, her doctor told her that the type 1 diabetes she had since the age of 7 had caused her kidney failure and her best chance of recovery was a glandular transplant. pancreas and kidney at the same time.

Her doctors told her it would take about six months to get the list of transplants and then usually about a year to pair with a donor.

But in the spring of 2020, overwhelmed hospitals across the country halted part-time care, including transplants, redirecting staff to the coronavirus response.

Since then, the transplants have continued and stopped, over and over. With each outbreak of a pandemic full of intensive care units, the first treatments to be shelved are planned procedures that require an intensive care bed — like implants.

Because she has managed to avoid dialysis despite her worsening condition, Ms. Wahab is a more desirable transplant candidate because of the better chance her positive outcome will be. But she wasn’t sure how much longer she could hold on.

“It has had a serious impact on my day-to-day life,” she said. “I feel really hopeless as we head into 2022 – I’ve been waiting for this surgery for almost three years.”

James Wilkinson, 46, was diagnosed with endocarditis, an inflammation of the endocardium caused by an infection eroding his aortic valve, and he was initially scheduled for surgery in May 2020. The surgery was canceled due to the epidemic. And then it was rescheduled and canceled three more times.

Mr Wilkinson, who testified before a congressional committee late last year about his experience, says he eventually turned to private care to perform surgery – something very few people can afford.

“If it weren’t for private healthcare, we don’t know when my surgery would have happened,” he said.

But it’s not just those waiting for care, they know they need those who have been hurt. Cancer charities have warned that a delay in diagnosis would also have serious implications.

Macmillan Cancer Support, a charity, estimates that some 50,000 people across the UK have yet to be diagnosed with some forms of cancer that should have been detected earlier, as a direct result of the pandemic that has hampered screening and referral. Number of women diagnosed with Stage 4 breast cancer – which means the disease has progressed to a very advanced and dangerous stage – has increased 48 percent in recent months.

Danni Moore, now 31, discovered a lump in her breast in early 2020, just before the pandemic. Ms. Moore, a mother of two who is still breastfeeding her youngest child, thinks she has a blocked duct. But her doctor referred her to a specialist clinic.

That appointment was canceled because of the pandemic. She rescheduled, but then had to self-destruct because her partner contracted the virus and their family was quarantined.

She said: “The Covid knock-out effect has made things a lot more difficult and I’ve had a longer ride than I should have. “And that was partly my fault. I should have gone much earlier, but being equally acutely aware is a wonderful thing. ”

Ms. Moore said she put off another appointment, and months passed. But then the lump grew, and in the spring of 2021, a year after she first discovered it, it was diagnosed as breast cancer. The months since have been an exhausting whirlwind of chemotherapy treatments and complications, which she has recorded on her Instagram account.

While her treatment this year has continued without delay and she credits the doctors and nurses for saving her life, she knows her initial diagnosis will come. sooner if there were no pandemic.

The surgery backlog also influenced her decisions about what’s next. Ms Moore has decided to have a double mastectomy, scheduled for early February. She said she feels she could more easily live with a bilateral mastectomy than with a unilateral removal and wait an indefinite amount of time for reconstructive surgery to achieve a “new normal”. “.

“I have two young children,” she said. “I gave up cancer over a year ago.”

She added: “I just don’t want to sit and just wait for two or three more people and make the process longer than ever.”

https://www.nytimes.com/2022/01/26/world/europe/coronavirus-uk-nhs-backlog.html The UK’s other health crisis: Huge backlog of delaying drain-free care

Fry Electronics Team

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