Emilia Belli
Westminster correspondent, BBC Wales News
Mel Wallace
Mel Wallace was a keen motorbike rider but now, as she waits for a hip replacement, she struggles to put her own socks on
NHS patients from Wales who need knee and hip operations in England face lengthy delays after a health board asked English hospitals to copy Wales’ longer waiting times.
Powys health board announced the change as it could not afford the cost of how quickly operations over the border were being carried out, but patients have said they were not informed.
Mel Wallace, 59, from Howey, Powys, was initially told she would have a 12-month wait for her hip replacement, but now faces another 45-week wait after already waiting 59 weeks.
Health board chief executive Hayley Thomas said people in the area “should be treated in the same timeframe as residents of anywhere else in Wales”.
Previously there was no difference in how patients were treated but, since 1 July, the health board has asked that any planned treatment for its patients at hospitals in Hereford, Shrewsbury, Telford and Oswestry are based on average NHS Wales waiting times.
Almost 40% of Powys Teaching Health Board’s (PTHB) budget is spent on services outside its own borders – it does not have its own district general hospital.
Latest figures show there were 10,254 waits of two years or more for planned treatments in Wales, compared to just 158 in England.
The Welsh government said it remained “committed to reducing waiting times and ensuring everyone in Wales – including those in Powys – has equitable and timely access to treatment”.
With shorter waiting times in England, the Powys health board could not afford to pay the bills due to the speed the operations and other planned care like cataract surgery and diagnostic tests were being carried out.
According to its annual plan, applying NHS Wales waiting times would save £16.4m – the Welsh government has said it must save at least £26m and has intervened in the health board’s finances, strategy and planning to address serious concerns.
This means people from Powys face two-year waits for some procedures, but it does exclude various high-risk patients including children and those with cancer.
Mel Wallace says there is “far worse people suffering out there than me”
Ms Wallace used to enjoy walking her dogs, gardening, going to the gym and riding her motorbike but now struggles to get out of the car or put her socks on.
She moved to her home near Llandrindod Wells from Herefordshire in 2021 for the scenery and lifestyle, but her experience with the Welsh NHS has made her “wish I hadn’t moved here”.
Despite her wait for an operation starting before the rule change, Ms Wallace said “they can’t even be bothered to send a letter to let people know that this is going to affect them”.
She wants the policy overturned but, in the meantime, said waiting times given to those already on the list should be honoured.
Stephen Evans says he feels like he and others in his position are being “discriminated against”
Stephen Evans, 66, a local government officer from Builth Wells, was scheduled for a double knee replacement and told in May that his first operation would be “within the next few weeks” in Hereford.
When he called the hospital to follow up, he was told his wait would be at least another year and said he had not had any contact from the health board or Welsh NHS.
“When your life is put on hold because of a decision like this, you deserve the truth, not some excuse,” he said.
“I choose to live here, but I’m still entitled to the same sort of medical treatments as a person who lives across the border in England.”
John Silk, 92, from Talgarth, was a regular golfer and went to the gym until his osteoarthritis got too bad.
“I have a stick to walk down the path from the front door now and driving in the car is a nightmare,” he said.
He was due to have an operation in Hereford in June and had been to the hospital twice in preparation.
When he phoned to ask why his knee replacement had been delayed, he was told by an “apologetic” secretary that he would have to wait another year due to budget cuts.
Like others, he has not heard anything from NHS Wales. “I want them confronted with what they’re doing.
“They’re causing unnecessary pain and suffering. I don’t think that’s the idea of politics, do you?”
Health board chief executive Ms Thomas said: “We understand that the changes we have made to the way we commission planned care services will be frustrating and disappointing for patients and their families.
“It is vital that we live within our means. We cannot continue to spend money we do not have to offer faster access care to some parts of the county.
“Instead, we need to take a fairer approach that protects essential services for everyone.”
Liberal Democrat MP for Brecon, Radnor and Cwm Tawe, David Chadwick, said he could not understand the decision given reducing waiting lists and getting people back into work were priorities of Labour governments in Cardiff and Westminster.
“It’s not good enough and that’s why the Welsh government has to make sure that it gives Powys Teaching Health Board enough funding to process those people faster,” he said.
The Wye Valley NHS Trust has also raised concerns, with managing director Jane Ives telling a board meeting that 10,000 appointments or elective procedures would be affected there due to the knock-on effects.
“This is a very poor value for money proposition and has real impacts on patients,” she said.
Meanwhile a PTHB meeting last week also heard Shrewsbury and Telford Hospital NHS Trust had not yet implemented the policy as negotiations continue “with an increasing risk of escalation”.
Shropshire and Community NHS Trust said they would “continue to prioritise patient care on the basis of clinical need”.