The Ombudsman received 3 complaints about the orthopaedic care (treatment of bones and joints) received at Swansea Bay University Health Board (“the Health Board”).


Mrs B, Mrs C (on behalf of her husband, Mr C) and Mr D said that they had waited a long time for orthopaedic surgery and that their understanding of how they would be treated was not managed well regarding the pre-operative assessments.


The waiting time for orthopaedic surgery at the Health Board is more than 4 years. The Health Board had issues including not enough staff, not enough suitable places to operate, unclear management arrangements, and unclear processes for these operations.


The Ombudsman identified that in these 3 cases, in addition to the long delays experienced by all patients awaiting orthopaedic surgery, the complainants had been treated unfairly because of errors in the way the waiting lists were managed. These issues raised the Ombudsman’s concerns about how the whole waiting list has been managed.


The failings relating to the waiting time clock and the impact included:


  • – Mrs B was referred in 2018 for right hip pain and again in 2021 for left hip pain. The referral for her left hip was closed in error, but in2023 her left hip was treated (instead of her right hip as it was clinically worse) and she was removed from the waiting list for her right hip, even though this still required treatment. She continues to experience severe pain in her right hip 5 years after initial referral and is still waiting for it to be operated on.
  • – Mr C, who had been assessed as needing surgery within a month, waited 43 months (3 years 7 months) for surgery in severe pain. During that time his position on the waiting list was reset in error and he was also removed from the list in error.
  • – Mr D was removed from the waiting list when he missed surgical appointments because he was in hospital for another illness. Despite provision in the guidance for this type of situation, Mr D was removed from the list and is waiting to be “treated in turn” which appears to be outside of the process. 65 months (5 and a half years) after being added to the list for surgery, he is still waiting for treatment. He is in a lot of pain, and this has affected his wellbeing significantly.


The complainants were also put through the stress and pain of pre-operative assessments, which had raised their hopes that surgery would happen soon. In Mrs B’s case, this was due to an error, but in Mr C’s and Mr D’s case, the Health Board would have been aware that it was unable to provide surgery before the pre-operative assessment expired but failed to take this into account or tell the patients. There appears to have been no thought for the impact this would have on the patients’ wellbeing.


The Ombudsman noted that the Health Board is taking action to address the length of its waiting lists so made no recommendations about that. However, because of the issues identified in these cases she has asked the Health Board to review the decisions it made in respect of these complainants and their positions on the waiting list. The Health Board was also asked to audit the whole of its waiting list to establish whether errors had been made on the waiting list times or improper removal from the list for other patients and if so, it should apologise to those patients and correct the errors.