THE NHS in Gwent may not have enough capacity to carry out enough orthopaedic treatments to eliminate waiting times of longer than 36 weeks by the end of next March.

An Aneurin Bevan Health Board report on plans for tackling long waits for treatment warns that the number of orthopaedic operations needed during the next 10 months to meet this goal is “significant” and consideration may have to be given to using other sources.

That is most likely to mean buying up surgical slots at private hospitals, a solution that has been used in the past but which the NHS in Wales is keen to avoid.

In Wales, no patient should have to wait more than 36 weeks from referral by their GP to the beginning of definitive treatment, known as the referral-to-treatment time (RTT).

But the numbers of people waiting longer than 36 weeks has increased across Wales as health boards have struggled to cope with increasing demand, while trying not to overspend on ever-tighter budgets.

Orthopaedics - particularly procedures such as hip and knee replacements - is a high demand speciality and the situation in Gwent has been made more difficult recently, as three posts, two consultant and one locum, have been vacant.

By the end of March, 442 patients had waited longer than 36 weeks for orthopaedic treatment at a Gwent hospital, out of 878 across all specialities.

But the health board report warns that the position in orthopaedics “is likely to deteriorate in the short term.” The plan is to recruit three locum specialists in July, though there is risk around timing and availability.

Temporary treatment capacity has been restarted and extra operating sessions, including evenings and weekends, are being planned.

“Based on current modelling, the number of treatments to be delivered by the end of March is significant, and there may be a requirement to consider outsourcing,” states the report.

Despite this, the board expects to eliminate waits of longer than 36 weeks in orthopaedics by March 31 next year, and to maintain that situation afterwards.

Another March 2015 target for eliminating such waits is in oral surgery, where again outsourcing might be needed.

Other specialities are expected to eliminate waits of more than 36 weeks for treatment by November this year.

Plans are also being put in place to tackle long waiting times for diagnostic procedures including MRI and ultrasound scans, and endoscopies.