NHS surgery waits run into years in Northern Ireland

Megan's mum, Karen Image caption Megan's mum Karen says she is considering paying privately for her daughter's operation

Patients in Northern Ireland are waiting three years to see a consultant about having surgery following a GP referral.

The BBC has obtained exclusive figures showing long waiting times before a decision to operate.

In Northern Ireland, targets say most patients should be seen within 9 weeks and none should wait over 15 weeks.

Yet some patients are waiting 155 weeks or more to see a specialist for spinal conditions.

A spokesman for the Health and Social Care board said it was 'unacceptable' that waiting lists had grown so long.

Longer and longer waits

The health service has not met the targets for several years.

Figures obtained by Freedom of Information requests in April this year and seen by the BBC show that in one of Northern Ireland's five healthcare trusts, the minimum waiting time for an appointment with an orthopaedic consultant specialising in spinal conditions was 155 weeks.

For upper limb conditions, the minimum wait was 127 weeks.

By June, waits for spinal appointments at the same trust had risen to 159 weeks.

Megan's story

Megan Fleming, who is 14 years old, needs an urgent operation to correct a curvature, or scoliosis, of her spine.

Image caption Megan Fleming needs surgery to help straighten her spine

Her health is deteriorating fast, and she has trouble breathing.Despite her condition, the teenager from Carrickfergus continues to go to dance classes, but says her future is on hold until her operation, which surgeons have told her will be a year away.

Her mother Karen said:"Megan loves dancing.It's just her life at the minute.She just wants to dance.

"But at the minute she needs the surgery to help her.You could see the consultant was absolutely gutted and you could see it was hurting to say a year, but it's out of his control.

"I've paid taxes, I've paid national insurance.So why can't I get the surgery that she deserves?"

Megan and Karen are now trying to raise the £50,000 that her surgery will cost privately, fearing that the long wait will put Megan's long-term health at risk.

Image copyright Megan Fleming Image caption Megan has a condition called scoliosis which means her spine is curved

Dr Ursula Brennan, a GP in Belfast, said that seeking private healthcare was a decision more and more patients were having to make in the current climate.

"You're going to have to wait, and it may be several months.It may be into 52 weeks, or 80 weeks, or beyond.

"It's very difficult to turn this conversation to - and these are our elderly folk - that you may have to use your life savings to actually improve your quality of life."

When asked about the long waits, which are far higher than in other parts of the UK, the deputy chief executive of the Health and Social Care Board, Michael Bloomfield, said:"That is absolutely unacceptable, and that's why we need to clearly illustrate the need for reform.

"There are about 35,000 more surgical procedures required than the health service currently has capacity for.

"Without the additional funding to see those patients or have them treated in different ways, it is regrettably inevitable that waiting times will increase to the position that they are now in."

Political vacuum

The political commentator Deirdre Heenan is working on a report with the Nuffield Trust into the emerging healthcare crisis in Northern Ireland.

She said:"In the last nine months we've had no government in Northern Ireland.We're in a political vacuum.

"This system reverts to keeping the show on the road, and any ideas about transformation or change are simply mothballed."

In a blog[1], she writes:"There is a difficult backdrop:austerity, increasing demand, rising expectations, and political uncertainty.

"It is not clear that the public are in a position to call for change.They may not have good information about how well the service meets their needs, and have not necessarily been made part of the long conversations about change, which as a result can sound like it brings bad news.

"But the impact on patients of the current impasse in implementing necessary changes is stark.In June this year, for example, one in six of the entire Northern Ireland population was currently on an outpatient or inpatient waiting list.In England the figure is one in 14.

"And over 64,000 people had been waiting over a year for their first outpatient appointment - a quarter of all those on the waiting list.In England, by contrast, around 1,500 people were still waiting over a year - just 2 per cent of the number in Northern Ireland for a population over 30 times larger."

On Wednesday, the BBC will be publishing its NHS tracker, which allows users to look at how their local hospitals are performing on waiting times for A&E, cancer and planned operations....

References

  1. ^ In a blog (www.nuffieldtrust.org.uk)

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Drug therapy 'restores breathing' after spinal injury

Spinal cord damageImage copyright Science Photo Library

A drug-based therapy appears to restore breathing in rats paralysed from the neck down by a spinal injury, according to scientists.

They hope their "exciting but early" findings could ultimately help free patients from ventilators.

The pioneering work, in Cell Reports[1], suggests the brain may not be needed for respiration if a nerve pathway in the spine can be awakened.

More studies are now needed to better understand and exploit this system.

'No brain' breathing

Normally, messages to and from the brain control breathing.

If the spinal cord is damaged high up in the neck, these messages can't get through and a person will need mechanical assistance or a ventilator to breathe.

Image copyright Getty Images

Experts have been looking at ways to repair spinal cord damage to reconnect with the brain, but the latest therapeutic approach, being explored at Case Western Reserve University, is entirely different.

Dr Jerry Silver and colleagues believe they have found an alternative nerve pathway for breathing in the spinal cord itself.

The researchers used a drug and a light therapy known as optogenetics to dial up this spinal system.

It appeared to control the body's main muscle of respiration - the diaphragm, a dome-shaped sheet of muscle that sits underneath the lungs, separating the chest from the abdomen.

The live adult rats that they studied had severed spinal cords, meaning the brain could not be the source of the diaphragm movement or breathing that the researchers saw after they administered the therapy.

They believe the treatment works by stopping other nerve signals that would normally silence the spinal system that they found.

Dr Silver said:"This is a primitive response that has been kept in the spinal cord for emergencies, like gasping and screaming in response to danger."

Although the researchers say the movements they saw resembled breathing, it's not clear yet if it would be enough to sustain life.They plan more animal studies to check.

Dr Silver said:"Ultimately, the goal of this research would be to free people with these neck injuries from having to use mechanical ventilators.

"Infections and other complications from mechanical ventilators are a leading cause of death after spinal cord injuries."

Dr Thomas Becker, an expert in neuroregeneration at Edinburgh Medical School, said:"This is an important discovery on the fundamental working of the spinal cord.

"Understanding the spinal network is the first step toward future therapies.

"This knowledge could be used for future therapies to restore breathing in patients who lost nerve connections from the brain as a consequence of spinal cord injury."...

References

  1. ^ Cell Reports (www.cell.com)

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AI used to detect breast cancer risk

Breast screeningImage copyright Getty Images Image caption AI could help prevent unnecessary surgeries, researchers say

US scientists are using artificial intelligence to predict whether breast lesions identified from a biopsy will turn out to cancerous.

The machine learning system has been tested on 335 high-risk lesions, and correctly diagnosed 97% as malignant.

It reduced the number of unnecessary surgeries by more than 30%, the scientists said.

One breast cancer specialist said that the research was "useful".

The machine learning system was trained on information about such lesions, the system looks for patterns among a range of data points, such as demographics, family history, biopsies and pathology reports.

"Because diagnostic tools are so inexact, there is an understandable tendency for doctors to over-screen for breast cancer," said Regina Barzilay, MIT's Delta Electronics Professor of Electrical Engineering and Computer Science, and a breast cancer survivor herself.

"When there's this much uncertainty in data, machine learning is exactly the tool that we need to improve detection and prevent over-treatment."

First study

In the US alone, 40,000 women die from breast cancer each year, but when cancers are found early enough they can often be cured.

Mammograms play a crucial role in detecting such cancers but they also throw up false positives, such as lesions that appear suspicious.

Once operated on, many such lesions turn out to be benign.

"To our knowledge, this is the first study to apply machine learning to the task of distinguishing high-risk lesions that need surgery from those that don't," said Constance Lehman, professor at Harvard Medical School and chief of the Breast Imaging Division at MGH's Department of Radiology.

"We believe this could support women to make more informed decisions about their treatment, and that we could provide more targeted approaches to health care in general."

Debashis Ghosh, a consultant breast surgeon based at the Royal Free London hospital, said the technology was good but may be of more use in the US than in the UK.

"Here we have less than 5% of patients who have these surgeries, whereas it is 30% in the US.

"We try to make a definite diagnosis before we operate but this technology is definitely useful where there is a lack of expertise."

The research is being conducted by scientists at Harvard Medical School, the Massachusetts Computer Science and Artificial Intelligence Lab, and Massachusetts General Hospital....

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Breast cancer warning after man's 'impossible' diagnosis

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Media captionPortadown man talks of breast cancer shock

When you think of breast cancer, you think of a form of cancer that affects only women.It doesn't.

While breast cancer in men is rare it's still an issue for the 10 men on average who are diagnosed with it every year in Northern Ireland.

Ian Cranston, 70, was diagnosed with breast cancer in May.Two weeks later he had a mastectomy.

The Portadown father-of-two was given the all-clear in June and has decided to speak publicly to make men aware that it's a cancer that doesn't just affect women.

He said "men also need to check their breasts for changes".

Inverted nipple

In May, Ian's wife Elizabeth noticed something wrong when he got out of the shower.

Image copyright SPL Image caption About 10 men in Northern Ireland are diagnosed with breast cancer each year

She told him he had an inverted nipple and needed to see his GP.

"I didn't know what that meant," said Ian.

"Men can't get breast cancer, I don't have to go to the doctor.

"I wasn't aware I had breasts.This is my chest, men don't have breasts, it's impossible," he added.

Eventually his wife persuaded him to go to his GP, who referred him to Craigavon Area Hospital.

Image caption Ian Cranston alongside breast care specialist nurse Annie Treanor

The diagnosis stunned him.

"Men having breast cancer, I couldn't believe it," he said.

"I couldn't do or say anything.My wife Elizabeth cried."

Four days later Ian said he "just broke".

He has decided to help try and raise awareness of the disease, saying that if his speaking out helped one man, it would be worth it.

"I can understand where women are coming from because I've had breast cancer myself," he said.

Signs and symptoms

In the past 23 years, 166 men have been diagnosed with breast cancer, according to the NI Cancer Registry at Queen's University.

While the majority of men diagnosed (99) are aged between 60 and 80, 26 men were under the age of 40.Forty were 80 years old or older.

Annie Treanor, a Southern Trust breast care specialist nurse, said:"Many people don't know that men get breast cancer because they aren't aware that men have breasts.

"But men do have a small amount of breast tissue behind their nipples and this is where breast cancer can develop," she added.

She said signs and symptoms to look out for are similar to that of a female and include:...

  • An inverted nipple
  • A lump anywhere within the breast tissue
  • Nipple discharge
  • Ulceration or swelling

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