Comment: Nothing routine about routine operations

1-Mar-2022

Bernard Ross, chief executive of Sky Medical Technology, discusses how MedTech is uniquely placed to support healthcare systems by offering faster and more-cost-effective solutions to recovery, while giving patients greater opportunities to manage their conditions independently at home

Medical technology will play a crucial role in helping the NHS to recover from the COVID-19 pandemic

Medical technology will play a crucial role in helping the NHS to recover from the COVID-19 pandemic

The BBC recently reported that, as of the end of November 2021, more than six million people were waiting for routine operations in the UK.

This was the first time this figure had been hit in the history of the NHS and demonstrated the scale of the backlog in routine operations caused by the COVID-19 health crisis and its knock-on effect on the wellbeing of the nation.

And the number – which represents not far short of 10% of the entire UK population – covered a reporting period before the Omicron variant of COVID-19 threw the NHS under additional pressure over the festive period.

An international fight for healthcare

Pre-pandemic, the UK Government aimed to offer those that needed non-urgent surgery a procedure within 18 weeks.

In 2018, it was reported that hospitals achieved this around 88% of the time.

This demonstrates that, even before COVID-19, many patients were waiting a significant amount of time for surgery.

As COVID-19 challenged the traditional healthcare processes it forced healthcare systems to quickly implement new solutions, such as teleconsultations and the increased use of remote monitoring to manage patients

But this is not an issue unique to the UK.

Research conducted by the Organisation for Economic Co-operation and Development (OECD) suggests that waiting times for elective, or non-emergency, surgery have increased across the economies surveyed, with median wait times for cataract surgery averaging 92 days, while for hip replacement, it was 113 days, and for knee replacement, it was 189 days.

Magnifying existing issues

In 2020-2021, The King’s Fund – an independent charitable think tank working to improve health and care in England – reported that the UK spent £192billion on health and social care.

This was some £50 billion more than the previous year and represents approximately 10.2% of the country’s GDP.

This is by no means out of sync with other countries.

Indeed, it is close to the average figure reported by the OECD.

But, despite this increase in spending, and the NHS vastly increasing the number of tests and treatments offered in the summer of 2021 in response to the COVID-19 backlog, elective surgery waiting lists continued to rise.

And the reality is that the COVID crisis has brought into sharp focus an issue that has developed over decades.

The global population has been growing older and living longer and the proportion of people retired, compared to those in work, has increased exponentially.

MedTech can have a significant impact, driving transformation around how care is provided and enabling healthcare professionals to focus on the critical

Across the world, whether countries deploy a national healthcare service or not, the demand for healthcare is growing just as the number of people that are in work and can pay for it is falling.

The pandemic has acted as a perfect storm to accelerate these issues, with overstretched healthcare workers having to focus on the immediate crisis at the cost of the wider wellbeing of the population.

Furthermore, the nature of the virus has led to thousands of healthcare workers having to isolate for periods to avoid this risk of further transmission, leaving less people to carry out both routine and emergency procedures.

The burden of delay

For each of the six million people on a waiting list in the UK, there is nothing routine about their condition.

Patients waiting for a cataract operation suffer with sensitivity to light and glare as well as clouded, blurred, or dimmed vision. They may also struggle to see well at night and this can impact people’s ability to work and therefore support to themselves and their families.

Those waiting for a hip or ankle replacement can be in constant pain and many are unable to walk, leading to issues around lack of social contact and independence.

The burden of delay is not only limited to the individual.

If people are unable to work because of their condition, they may require increased access to benefits systems, adding to the overall national cost of a condition.

And, if their condition means reducing their working hours, they will be paying less taxes.

They are also likely to need more GP and hospital appointments.

In addition, prolonged delays to surgery may lead to other conditions such as obesity through lack of movement or mental health issues caused by loneliness.

Like many industries, COVID-19 has turbo charged a trend in healthcare that was already manifesting

While a hip replacement operation may cost somewhere between £10,000-£15,000, it is not unreasonable to estimate the total impact on the economy of such an operation as comfortably double this – and more as delays increase.

This is not to say that healthcare systems are not doing everything they can to reduce this burden.

Healthcare professionals have a history of challenging the status quo to improve patient outcomes.

Surgical techniques have radically changed to deliver better healthcare outcomes, and doctors are constantly looking to speed recovery to avoid issues of bed blocking and increase the volume of elective operations.

Innovation breeds new solutions

Perhaps the biggest opportunity to address these challenges to healthcare system capacity comes in combining technology with medicine in a bid to generate better patient outcomes.

The medical technology (MedTech) sector has seen substantial growth in recent years – a trend that is expected to continue.

The European medical technology market is estimated to be worth more than £102.5billion, with Germany, France, and the UK leading the way in research, development, and implementation of new medical devices.

Indeed, prior to the pandemic in 2019, the total annual revenue of the global MedTech industry stood at £370.9billion — representing an increasing share of the overall global healthcare sector.

If any positive has come from the pandemic it is that change that would ordinarily have taken a decade has been implemented in weeks, or months

By 2025, the global medical devices industry is expected to reach a valuation of £440.5billion, growing at an average of 5.4% per year.

This trend has been accelerated by the pandemic.

As COVID-19 challenged the traditional healthcare processes it forced healthcare systems to quickly implement new solutions, such as teleconsultations and the increased use of remote monitoring to manage patients. This helped demonstrate the transformative potential of technology to healthcare systems.

MedTech can have a significant impact, driving transformation around how care is provided and enabling healthcare professionals to focus on the critical.

For example, remote monitoring can provide doctors with alerts that inform them of patients’ vital signs, but healthcare professionals will still need to interpret these.

Faster recovery, more capacity

One of the areas with most potential is MedTech devices that empower patient recovery.

Devices that reduce swelling, for example, or heal wounds more quickly, can enable patients to manage an increased part of post-operative recovery at home.

This has several positive outcomes.

For the healthcare system, reducing time spent in hospital recovery reduces bed blocking and can free up extra capacity to perform more operations.

And faster recovery after surgery also reduces the risk of patient complications.

Immobile patients are at a higher risk of blood clots, known as venous thromboembolism (VTE).

Around 55-60%of all VTE cases occur during, or following, hospitalisation, resulting in approximately 25,000 deaths in England each year alone.

Sustained time in hospital can also increase risk of infection.

According to the World Health Organization, healthcare associated infections are the most-frequent adverse event in healthcare delivery worldwide, with 10% of patients in developing countries, and 7% in developed countries, acquiring at least one healthcare associated infection during their time in hospital.

The MedTech industry has a critical part to play in delivering the ingenious solutions that will help healthcare systems manage demand, today and tomorrow

Perhaps, most importantly, patients that are using MedTech devices to hasten recovery are playing a significant role in their own wellbeing.

Empowering improved patient wellbeing

Like many industries, COVID-19 has turbo charged a trend in healthcare that was already manifesting.

Hospital waiting lists for routine operations were growing before the pandemic, but the impact on the healthcare crisis has hastened the need to generate meaningful positive change.

If any positive has come from the pandemic it is that change that would ordinarily have taken a decade has been implemented in weeks, or months.

The challenge now is to create healthcare systems that can address not only current needs, but future ones and effectively manage the backlog of elective surgery.

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The MedTech industry has a critical part to play in delivering the ingenious solutions that will help healthcare systems manage demand, today and tomorrow.

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