Follow-up appointments scrapped in NHS waiting lists plan

Patients will not get automatic follow-up appointments after NHS treatment unless they need them, under a new Welsh government plan to shrink waiting lists.

Ministers hope the changes will mean consultants can spend more time in surgery rather than clinics.

It is hoped the move will free up "tens of thousands" of hospital appointments in Wales for those waiting to be seen by a specialist for the first time.

The plan also makes clear that patients who have been waiting the longest should be treated first - unless there is a "clear clinical reason" for someone else to jump the queue.

The plan is backed by £145m of funding, already announced by Welsh health minister Mabon ap Gwynfor, which includes £20m for maintenance and equipment, £25m for developing new surgical hubs and £100m to increase NHS day-to-day activity.

But health boards will only be paid by the Welsh government when they can prove they have completed treatments, rather than on the basis of what they have promised to achieve.

The Welsh government insisted the reforms would be overseen by clinicians and not led by "managers and officials".

In its last year, the previous Labour government succeeded in reducing waiting lists by using £120m to fund an extra 20,000 cataract operations, for example, and pay private companies to reduce the number of people waiting for out-patient appointments and treatments.

But the new government's plan wants to make more use of existing NHS capacity to shorten waits at every stage of a patient's journey - so that doctors can spend 70% of their time seeing new patients, compared with 30% currently.

There are also more than a million cases waiting for follow-up appointments in Wales.

The proposal to reduce these, it is hoped, will allow consultants to spend 80% of their time operating and 20% of their time in clinic - compared with the current 50:50 split.

The plan also includes pledges to:

• Increase surgical capacity, including at weekends, in the specialisms where people have been waiting the longest
• Speed up reviews of GP referrals so that patients do not have to wait as long to know if any further treatment, tests or investigations are necessary
• Increase diagnostic capacity and use "digital tools" to cut the time between referral and diagnosis

These will happen in tandem with Plaid Cymru's manifesto commitment to develop "up to 10" treatment hubs across Wales.

Health boards will also be required to work together to share the "best ideas".

According to ap Gwynfor, the approach will result in a permanent reduction in waiting times instead of short-term fixes.

"Waiting two years for planned care is not acceptable. This investment is tied to health boards changing how they work, permanently, so the progress I expect to see doesn't slip back as it has in the past," he said.

"That's the difference between a short-term fix and lasting change."

He continued: "Patients should receive timely advice, diagnosis and treatment through services that are designed around their needs, not around organisational boundaries.

"None of this is possible without the hard work and expertise of NHS staff. Their leadership sits at the heart of this approach, and every health board must now work together to deliver further improvements for patients."

The latest statistics show there were more than 698,500 cases on an NHS waiting list in Wales in June - a figure that has grown since the new government was elected.

Of these, almost 4,100 had been waiting two years or longer - up from just under 2,600 in March.

The first minister and health minister previously promised waits of two years or longer for NHS treatment would be eliminated in a matter "of months".

But the new plan does not set an exact date for when this will be achieved - although it states the total size of the waiting lists will be brought down to pre-Covid-19 levels (about 460,000 cases) by the end of this Senedd term.

More details about timescales are expected later this year.

Last month, the health minister promised he would unveil a waiting list reduction plan that "would be a fundamentally different approach to what came before... not more of the same".

But BBC Wales understands the new plan does not contain lots of new ideas, instead bringing together reforms that have been proven to work and rolling them out consistently across the country.

The Welsh NHS Confederation, the body that represents health boards, has welcomed the plan, claiming "the emphasis on regional working, diagnostic capacity, surgical hubs and more sustainable planned care pathways is the right direction of travel".

However, the organisation's assistant director in Wales, Nesta Lloyd-Jones, warned "waiting lists cannot be viewed in isolation from the wider pressures facing health and social care".

"This summer was proof that the system remains under unrelenting and escalating pressure, and there is no quick fix," she said.

James Evans, Reform's health, prevention and sport spokesperson, said: "It beggars belief that Plaid Cymru has waited so long before starting work on trying to cut waiting lists, but when the Welsh Gender Service paused referrals, they sprung into action.

"NHS waiting lists are still on the rise in Wales, and every time you ask a Plaid Minister how long it will take for them to eradicate two-year waits, you get a different answer. Meanwhile, Plaid's first 100 days was spent announcing reviews and committees."

Welsh Labour's spokesperson for health, Ken Skates, said it was "disappointing that Plaid are still unable to say when two-year waits will be eliminated".

"After 10 months of waiting lists falling, they've started to creep up in Wales - those on waiting lists need answers, vague timelines for the next four years do not help or inform the people suffering right now," he added.