“You listen to the news reports and some people apparently are still getting operations. How can they still be getting operations? Who are these people? When the likes of me have been told nothing’s happening.”
Russell Pugh, a 62-year-old from Weston-Super-Mare, has been waiting for a spinal operation since January, as well as surgery on his hand. He has a herniated disc in his spine, causing pain he compares to “being kicked by a horse”. On top of this, Russell suffers with sciatic pain “from hip to toe”. He needs a discectomy to release the pressure and free up these sensitive nerves which are spreading pain down his legs.
The other operation he’s waiting for is on his left hand, to remove the trapezium (small bone at the base of the thumb) which is affected by painful arthritis – he has had the right one removed already. Russell is managing his pain with co-codamol – “more than I should, to be honest” – and the long-term use of medication has led to digestive issues such as constipation.
The pandemic crisis has led to Russell getting stuck indefinitely in this agonising pain, alongside thousands of others whose operations are ‘elective’, which means planned in advance, unlike life-saving or emergency surgery. As many as 3.6 million people aged over 50 in England had hospital treatment cancelled between February and May this year, due to the pressures of coronavirus on the NHS.
Pain is nothing new to Russell, as he has been suffering for years. Russell has already had a similar spinal operation, in November 2018 at Weston General Hospital. When this second disc herniated, his consultant suggested he have the operation at private hospital Nuffield (as an NHS patient), which he said would be faster than going on the NHS waiting list of six months. “He didn’t want me to wait that long and suffer with the pain,” Russell says. That was back in January 2020, and that’s when things started to go wrong.
After the consultation he waited a few weeks without hearing anything. He rang Somerset Clinical Services and found out the request for the operation had accidentally been filed instead of actioned. He was referred for a consultation at Nuffield Hospital at the end of March – but only to find out that his operation had been put on hold because of coronavirus.
Time ticked on. Russell and his wife had bought in extra supplies as they knew they would have to isolate for two weeks before the operation; his wife had cleared with her work that she would be able to work from home during the isolation; they waited.
In July, Russell was told he wouldn’t be getting any operations “as long as there are people still getting the virus” and to go to A&E “if your back’s that bad”.
Russell did not want to go to the emergency department. “I thought what’s the point of going to an A&E department that’s going to be overflowing at the doors with patients, when I can control [the pain] with drugs? […] I don’t want to ring 999 because I know what’s going to be the outcome. Nothing will happen. They’ll turn round and say ‘carry on taking the pain killers, we’re sorry that you’re in so much pain.’”
More people waiting for surgery in second wave
Russell is just one of the millions caught up in similar nightmares: waiting for ‘non-urgent’ operations, while NHS resources are stretched to breaking point by the pandemic.
For a brief spell in May, it looked like normal service would be resumed, but then Covid infections started to rise again.
We don’t know how many operations have been cancelled during the second wave because data is not being collected, which NHS England said was in order to “release capacity to support the response”. But the number of patients having to wait for more than a year for surgery has soared. The 163,000 people waiting this long as of October 2020 was more than 100 times higher than the same time last year and the highest level since 2008.
The number of Covid patients in Bristol’s hospitals peaked in late November at just over 250, which meant some elective surgery had to be cancelled. The local NHS was under extreme pressure due to Covid outbreaks, high staff absence and difficulties discharging people back into social care.
On 27 November, Robert Woolley, the chief executive of University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) said the Bristol and surrounding areas was “one of the worst affected areas in England” for Covid-19.
“We are making every effort to make as much elective planned care as we can but it is true that we are seeing a higher proportion of cancellations of surgery than we would like, and that is just because of the pressure on our critical care facilities and ward beds.”
He added “We have very little in the way of lower priority elective care going on, particularly at the BRI. We are maintaining as much of the high-priority elective surgery, particular cancer surgery, as we can.”
Eventually, Russell became so frustrated with waiting and hearing nothing about his operations, he contacted his MP John Penrose. On 6 November, Penrose wrote to Colin Bradbury, the Area Director of NHS Bristol, North Somerset and South Gloucestershire CCG, putting forward Russell’s plea.
For Russell, it is the lack of communication or any indication of how long his wait will be that is causing the most stress, and is beginning to impact on his mental health. “It’s horrendous. I can not believe how much it gets you down. Mentally-wise. It really strikes you. And when there’s nobody you can talk to…it [compounds] it massively.”
But as high infections in the city have fallen in response to lockdown measures, the number of people in our hospitals has also fallen in the last few weeks.
With this finally came some good news for Russell. On 9 December, he got a call from Somerset surgical services saying they were looking to do some elective surgery at other hospitals. Russell would have to travel to Tetbury in Gloucestershire, but he might have his hand surgery in January. Still no news on his back surgery.
For Russell and many in his position, the waiting and uncertainty goes on. “The thing that bothers me is the people that are going about as if nothing is happening. People walking about with no face masks on in supermarkets and they just look at you, like…[pulls gormless expression]. That irritates me because the more they do that, the longer I have to wait.”