Question NW2474 to the Minister of Health

Province

Total number of backlogs on surgeries

Eastern Cape

5373

Free State

2947

Gauteng

13433

KwaZulu Natal

17906

Limpopo

45690

Mpumalanga

3005

Northwest

5531

Northern Cape

4000

Western Cape

77139

Eastern Cape Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Nelson Mandela Academic

Livingstone

Port Elizabeth Provincial

Frere Hospital

Cecilia Makiwane

Dora Nginza

Frontier

Orthopaedics

Not specified

Obstetrics and Gynaecology

Not specified

General Surgery

Not specified

Ophthalmology

Not specified

Urology

Not specified

Plastic Surgery

Not specified

Paediatric surgery

Not specified

Eastern Cape Province

(d)(i) What actions are being put in place to eradicate the backlog?

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• Moratorium on elective surgery was lifted in 2021

• Monthly monitoring of the waiting period

• The hospitals have rescheduled all non-emergency operations

• Providing theatre services during the weekends and extended hours to reduce backlogs

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Free State Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Manapo

Universitas

Pelonomi

Bongani

Boitumelo

Dihlabeng

Orthopaedics

3 months to 4years

Obstetrics and Gynaecology

8 months

General Surgery

3 to 8 months

Opthalmology

3 years

Urology

6 months

Plastic Surgery

8 months

Cardio Thoracic

6 months

Oncology

Not specified

Free State Province

(d)(i) What steps have been taken to deal with the backlogs

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• Monthly monitoring of waiting period.

• Marathons arranged if department notices backlog

• Patient education to ensure patients show up for appointments

• A team on call for emergency theatres

• Sometimes using theatre at private hospitals

• Increase of theatre time

• Prioritizing according to severity or quality of life

• Conducting Blitz over weekends

• Outreach to district hospitals.

Human Resource

• Recruitment of additional staff

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Gauteng Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Chris Hani Baragwanath Academic hospital,

Charlotte Maxeke Academic hospital,

Dr George Mukhari Academic Hospital,

Steve Biko Academic Hospital,

Tembisa Provincial Tertiary Hospital,

Kalafong Provincial Tertiary Hospital,

Rahima Moosa Mother and Child Hospital

Orthopaedics

2 weeks to 7 years

Obstetrics and Gynaecology

2 weeks to 2 years

General Surgery

2 weeks to 2 years

Paediatric Surgery

3 weeks to 1 year

Opthalmology

6 months to 1 year

Urology

1 month to 1 year

Plastic Surgery

3 months to 2 years

Neurosurgery

3 weeks to 3 months

ENT

2 weeks to 9 months

Cardio Thoracic

3 to 6 months

Maxillo Facial

Not specified

Gauteng Province

(d)(i) What steps have been taken to deal with the backlogs

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• District outreach surgical teams provide services once a week per quarter and spent time in a district conducting various surgeries using all hospitals (Rural Health Matters campaign).

• A team of volunteers (orthopaedics and anaesthetics) from other provinces form part of the outreach teams.

• Introduce electronic theatre booking system

• Re-purposed COVID wards to increase post-operative care space

• Dedicate specific “catch-up” days e.g., surgical cataract.

• Rescheduling of elective surgeries; Planning to increase High Care Unit beds.

Human Resources

• Theatre has fourteen (14)posts recruitment activated 4 vacant consultant posts and 6 registrar post (Maternity) and 4 vacant medical officer posts (Interviewed April and awaiting appointment).

• Appointed a dedicated clinical Manager to oversee all 46 theatre efficiencies.

• Beefing up of human resource through sessional appointments for specialists and nursing agencies for nurses.

• Through the National Health Insurance Grant, public patients are taken to accredited private service providers (hospitals) where surgery is conducted as part of addressing the surgical backlog.

Infrastructure, Maintenance And Equipment

• Renovation of theatres to increase the number of functional theatres.

• Contractors sourced to repair and maintain tunnel washers

• Contractor appointed for repair and maintained autoclaves

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

KwaZulu Natal Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Madadeni Hospital

King Edward Hospital

RK Khan Hospital

Ngwelezana Hospital

Port Shepstone Regional

Murchison Hospital

GJ Crookes Hospital

Grey’s Hospital

Harry Gwala Regional Hospital

Northdale Hospital

Manguzi Hospital

Mosvold Hospital

Ladysmith Regional Hospital

Orthopaedics

6 months to 2 years

Obstetrics and Gynaecology

3 to 6 months

General Surgery

6 months to 1 year

Urology

12 months to 3 years

Plastic Surgery

Not specified

Neurosurgery

Not specified

ENT

6 months to 1 year

KwaZulu Natal

(d)(i) What actions are being put in place to eradicate the backlog?

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• Catch up has been done by increasing theatre times

• Elective slates done over the weekend to catch up. Camps have also been planned

• Increase theatre times

• Use after hours to reduce backlog

• Elective theatre slates run even after hours

• Electives commenced in 2021

• Emergencies are given priority

• Maximum utilization of theatres with added slates on weekends.

• Weekend camps are planned

• The hospital is increasing theatre time. Additional days added

• Weekend cataract camps held to reduce the backlog

• Additional half day theatre planned for every Thursday

• No waiting for emergencies or malignancies as these were all done under emergency slates. No new dates given but electives are called back according to priority and bed availability.

• For Gastrointestinal Tract (GIT) procedures i.e., endoscopy and colonoscopy- are limited to emergencies only, e.g., GI bleeds, malignancy and selected elective cases after discussion with a specialist.

• There is a plan to conduct a marathon (i.e., Request for two theatres to do only elective cases)

• Theatre time increased

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Limpopo Province

Hospital Names

(b)Discipline

(c) Duration of backlog

Groblersdal

Jane Furse

Mecklenburg

Philadelphia

Mokopane,

Philadelphia

St Ritas

Letaba,

Van Velden

Dr CN Phatudi

Kgapane

Nkhensani

Maphuta Malatji

Thabazimbi

Lephalale

George Masebe

Witpoort

Bela-Bela

Voortrekker

FH Odendaal

Botlokwa

Helen Franz

Seshego

Lebowakgomo

Thabamoopo

WF Knobel

Zebediela

Tshilidzini

Elim

Donald Frazer

Siloam

Malamulele

Messina

Mankweng

Pietersburg

Orthopaedics

12 months to 2 years

Obstetrics and Gynaecology

6 to 12 months

General Surgery

12 months

Opthalmology

4 years

Urology

12 months

Plastic Surgery

12 months

Neurosurgery

5 years

ENT

6 months

Maxillo Facial

12 months

Limpopo Province

(d)(i) What steps have been taken to deal with the backlogs

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• Groups of in-house specialists and volunteers from other provinces visit a district at a time to conduct elective surgeries in obstetrics and Gynaecology

(hysterectomy), general surgery (mastectomy and thyroidectomy every quarter

• From May 2022, monthly outreach services under the theme "Rural Health Matters" for urology (prostrate and hydrocoele), orthopaedic (hip replacement and knee surgery), Paediatric, maxillo-facial and cataract extraction

• Specific month's focus is the Programme from 13th- 21st August 2022 in Waterberg District where 428 surgeries conducted.

Human Resources

• Through the National Health Insurance Grant, public patients are taken to accredited private service providers (hospitals) where surgery is conducted as part of addressing the surgical backlog.

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Mpumalanga Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Rob Ferreira

Witbank

Mapulaneng

Themba

Ermelo

Orthopaedics

3 to 6 months

Obstetrics and Gyanaecology

2 to 3 months

General Surgery

2 months

Opthalmology

3 to 9 months

Urology

Not specified

ENT

Not specified

Mpumalanga

(d)(i) What steps have been taken to deal with the backlogs

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• Orthopedic surgeries are also conducted on weekends,

• Cataract increased theatre times to two days per week,

• Operationalization the 7 theatres and 2 emergency theatres,

• Allocation of an extra theatre per department and increase the theatre time,

• Developed and implementing marathons over weekends,

• Increased outreach to districts

Human Resources

• Headhunting a second Orthopedic Surgeon for the Province, and an Ophthalmologist has commenced

• A plan for a planned Orthopaedic Marathon is in process,

• Month of October planned for Ophthalmology marathon.

• Recruitment processes for General Surgeon is also underway

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Northern Cape Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Robert Mangaliso Sobukwe

Orthopaedics

2 days to 3 months

Obstetrics and Gyanaecology

Not specified

General Surgery

Not specified

Opthalmology

2 to 3 years

Urology

8 months to 1 year

Plastic Surgery

Not specified

ENT

Not specified

Maxillo Facial

Not specified

Northern Cape Province

(d)(i) What actions are being put in place to eradicate the backlog?

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• The suspension of non -emergency cases was lifted in 2021

• The tertiary hospitals conduct outreach service where minor orthopaedic operations in the district hospitals are performed (Upington, ZK Matthews and De Aar)

Human Resources

• Recruitment of specialists, especially anaesthetists

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Northwest Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Klerksdorp/Tshepong

Job Shimankana Tabane

Mafikeng Provincial

Joe Morolong Memorial

Potchefstroom

Orthopaedics

3 years

Obstetrics and Gynaecology

6 months

General Surgery

6 months

Urology

6 months

ENT

6 months

Opthalmology

7 months

Northwest Province

(d)(i) What actions are being put in place to eradicate the backlog?

(d)(ii) What are the timeframes in this regard?

Optimising Efficiency

• Implementation of surgical blitz

• Providing theatre services during the weekends and extended hours to reduce backlogs

• Utilization of all available theatres to improve efficiency

Human Resources

• Public/Private partnership where it is feasible

Cannot be pre-determined as prioritization is done in terms of urgency, status of the patient and surgical procedure to be conducted.

Western Cape Province

Hospital Name

(b)Surgery Discipline

(c) Duration of backlog

Alan Blyth Hospital

Beaufort West

BreedeValey

Caledon

Ceres

Citrusdarl

Clanwilliam

Eerste River

False Bay

George

Groote Schuur

Helderberg

Hermanus

Karl Bremer

Khayelitsha

Knysna

Laingsburg

Mitchells Plain

Montagu

Mossel Bay

Murraysburg

New Somerset

Otto du Plessis

Oudtshoorn

Paarl

Prince Albert

Red Croos War Memorial Children

Riversdale

Robertson

Stellenbosch

Swartland

Swellendam

Tygerburg

Victoria

Vredenburg

Vredendal

Wesfleur

Worcester

Orthopaedics

• Backlogs on elective surgery have been building up over the past (two)2 and a half year due to the COVID pandemic.

• There is not a set waiting list being kept for elective theatre lists.

• Patients are booked 6 months in advance as well as according to capacity. They are also constantly being reviewed.

Obstetrics and Gyanaecology

General Surgery

Opthalmology

Urology

Plastic Surgery

Neurosurgery

Oncology

Western Cape Province

(d)(i) What actions are being put in place to eradicate the backlog?

(d)(ii) What are the timeframes in this regard?

Optimisation of Efficiency

• The province allocated an additional R 20 million from internal prioritization of funds to deal with backlogs.

• The Province is also increasing day surgery activities as far as possible, and this will assist us in dealing with backlogs

• The Province also procured two (2) surgical robots at a cost of R 80 million, this will reduce the recovery time and allow patients to be discharged earlier.

• Elective cases are being discussed with specialists as they present again.

• Patients are booked 6 months in advance as well as according to capacity. They are also constantly being reviewed.