THE number of patients waiting more than 36 weeks for treatment in Gwent topped 1,000 in July for the first time in nine months, as a range of issues combined to stiffen the challenge of eliminating long waits by the end of next March.

By July 31, according to the latest figures, 1,038 patients had been waiting more than 36 weeks for treatment - from the point of referral - 405 more than at the end of June.

Of this increase, more than 300 cases were accounted for in orthopaedics and ophthalmology.

MORE NEWS:

Orthopaedics is among a number of specialities where treatments have been disrupted by an ongoing UK-wide issue with pension tax which has resulted in consultants reducing hours and turning down extra work to avoid being penalised.

Aneurin Bevan University Health Board's director of finance and performance Glyn Jones acknowledged that the issue is affecting treatments in Gwent, as elsewhere, with orthopaedics affected in terms of both treatments and outpatient appointments.

"This has knocked us significantly off course this year," he told board members, adding that the health board is formulating a plan "that will enable us to treat patients by the end of the year".

But he warned that "even if we can identify solutions to treat patients, the timing may mean we can't treat all patients (who have waited more than 36 weeks) by the end of March".

This is important because the health board received an extra £4 million from the Welsh Government in the summer, conditional on it eliminating these long waits, and may face having to return some or all of the funding if it is unsuccessful.

The health board has looked for extra orthopaedic capacity among other NHS providers in the region, but found none.

It is particularly difficult too, said Mr Jones, to find other providers for specialist orthopaedic treatments, such as spinal surgery.

More than half (538) of the patients waiting more than 36 weeks at the end of July were in orthopaedics, and a further 304 were awaiting ophthalmology surgery.

A major outsourcing programme was launched for thousands of eye treatments and outpatient appointments - mainly involving cataracts - in July, but Mr Jones said this has been disrupted by sickness issues among key staff at Care UK, the provider that is carrying it out.

"They could not treat as many patients during August and September as they wanted to, but we have been assured they will be back on track during October-December, and we expect to see a reduction in 36-week waits," said Mr Jones.

Another problem has been unrelenting emergency pressures - these have not really let up from last winter - which have meant that routine operations have on occasions during the spring and summer had to be cancelled due to a lack of beds.

Among the other specialties in Gwent hospitals to record increases in patients waiting more than 36 weeks for treatment by the end of July, were gastroenterology - 47 (none in June); dermatology - 28 (13 in June); and chemical pathology - 94 (64 in June).