NHS Scotland: Trauma and Orthopaedic Surgery Inpatients Activity and Backlog

Latest data for Scottish hospital inpatient activity for Trauma and Orthopaedic Surgery up to 31 December 2023 shows a continuation of the backlog of 214,267 patient spells which is the equivalent of 10.5 months worth of activity.

During the Covid-19 pandemic hospital inpatient activity levels fell dramatically as the NHS focussed its efforts on dealing with the influx of severely ill patients affected by Covid-19. For Trauma and Orthopaedic Surgery the average number of spells in the quarters prior to Covid-19 (i.e. from 2017 Q1 to 2019 Q4) was 61,121. During 2022 Q2 onwards, when society returned to normal, inpatient activity quickly increased but has failed by the end of 2023 to return to pre-Covid-19 levels. Thus the total backlog in treatments and diagnoses (214,267) is not receding and will continue to grow during 2024. It is difficult to see how the deficit will be brought down without a significant increase in resources and funding. Even when activity reaches pre-Covid-19 levels, at that stage it will only maintain the backlog at the same level meaning treatment being delayed for everyone.

What it Takes to Reduce Backlog
Throughput above the levels achieved pre-Covid-19 are be necessary if the backlog in patients is to be reduced and waiting times reduced. If quarterly activity returns to the pre-Covid average of 61,121 plus an increase of 10% it will take 108 months (i.e. until 2032-12-31) to clear the backlog. If the activity was increased by 15% that would reduce the time to clear to 72 months (i.e. until 2029-12-31)

Trauma and Orthopaedic Surgery Inpatients Quarterly Activity
Inpatients Cumulative Backlog
It will take at least 108 months to clear the backlog

Spells as a surrogate marker represent one of the best measures of total hospital inpatient activity. Comparison of inpatient spells’ activity for the pre Covid-19, during and post Covid-19 periods provides a unique way of determining what is happening in the NHS. It is influenced by issues such as the cessation of normal in hospital diagnoses and treatment during the Covid-19 pandemic and a reduction of patients consulting their GP during post Covid-19 the pandemic and who have yet to re-enter the system for inpatient treatment and diagnosis. The cumulative deficit of spells is a measure of inpatient activity that has been lost since 2020 Q1 and as a result patients waiting significantly longer for treatment and diagnosis.

Methods and Sources
Methods are described in the summary page where the total inpatient spells activity is described
See methods on summary page.

The raw data was downloaded from the Scottish NHS Public Health website
public health Scotland hospital activity