Tackling the elective surgery backlog

Despite reports that recent activity in operating theatres has been at an all-time high, an elective surgery backlog remains. A mobile operating theatre could provide the necessary physical capacity to cut waiting lists.

The hidden backlog

Although Australia’s hospitals have coped well during the past year, the decision to suspend all non-urgent, and most semi-urgent, surgery at the start of the pandemic left a legacy: substantially inflated waiting lists. Since then, health services have worked hard to catch up, but despite the increase in activity, there is still a substantial backlog in some areas.

Reasons for this include the fact that while some types of surgery have been going ahead, activity has been low for other types of operations. Cataract surgery, for example, not only had some of the longest waiting times following the initial suspension of non-urgent surgery, but waiting times have also continued to increase.

As well as lower throughput and other capacity issues due to social distancing requirements and extra infection control measures, far fewer people have also presented with symptoms and sought primary or emergency care.

These missing referrals mask a substantial ‘hidden’ backlog, which is only now starting to show. This has the potential to impact waiting lists in more ways than one — by the time patients seek care their condition may have worsened, meaning they need more urgent or complex care.

Increasing access

Something else that impacts the size of waiting lists is the access people have to health care. Indications are that, since the start of the pandemic, a large number of people have opted out of private health care because they can no longer afford it, placing additional and unexpected pressure on public hospital lists.

Access can also depend on a patient’s geographical location, with people in cities more likely to be referred than those in rural or remote areas, who also face longer waits for outpatient appointments. Flexible healthcare infrastructure can be used to provide greater access for patients in rural and remote areas, or to ‘blitz’ areas where waiting lists have built up.

Mobile operating theatres can be connected to any healthcare building with the necessary connections, can be easily moved between locations and are quick to set up, while modular facilities may be more suitable for longer periods.

A need for resilience

While the COVID-19 response caused lists to build up, waiting times were already at a record high — and increasing — in many states by the time surgery bans were imposed. A quick fix is not going to solve the problem — there is an underlying need for more capacity in the long term.

A resilient healthcare system has to have the flexibility to cope with temporary demand spikes and unforeseen events, so that cancelling or postponing elective surgery becomes a last resort to deal with a capacity problem. Achieving such flexibility is not always easy; with limited capital budgets, site limitations and planning processes taking many years, building resilience can take time.

With flexible healthcare, such as mobile clinical facilities which can be deployed rapidly to extend capacity in either the short or the long term, there is no need to wait for years for a new facility, or to cancel or postpone elective surgery to free up capacity.

Preparation is key

Although our health services are still busy dealing with the fallout from COVID-19, it’s clear that there is a more general need to increase the ability to adapt to changing demand in the long term. Waiting for the next outbreak of COVID-19 — or a new pandemic — to hit, could mean losing valuable time and could delay the implementation of suitable solutions.

And then there is the issue of deferred referrals. Some people take the view that during the pandemic, many people have realised they can manage without surgery, and therefore the ‘hidden backlog’ may never appear. But a more likely scenario is that people have been suffering in silence and have put off seeking care in fear of contracting COVID-19 or to avoid putting unnecessary pressure on the health system.

As confidence in attending health settings again increases, we could see demand increase dramatically, and hospitals need to have the capacity to deal with that. A number of Australian hospitals have already commissioned flexible solutions to boost surgical or diagnostic capacity in a bid to work through waiting lists more quickly.

Get in touch on info@q-bital.com to find out about Q-bital’s flexible healthcare solutions.