THE number of patients in Gwent waiting more than 36 weeks for orthopaedic treatment topped 1,000 in December, as a hoped for reduction failed to materialise.

And of the 1,024 waiting beyond 36 weeks, 564 had waited longer than 40 weeks by December 31.

Aneurin Bevan Health Board's orthopaedic services have been under Assembly special measures since last October and it had been hoped the backlog of patients waiting longer than 36 weeks could be dealt with by the end of March.

That hope is now looking increasingly forlorn and revised plans are being drawn up - and with close to 2,000 patients in the 26-36 week bracket by December 31, the short term challenge will simply be to avoid further increases waits longer than 36 weeks. Overall however, the board has stabilised the number of patients coming onto the orthopaedic waiting list, due in part to plans being implemented to boost theatre capacity and consultant numbers. An additional orthopaedic theatre opened in January, and three new consultant surgeons began work.

Assessing patients on the orthopaedic waiting list with referrals for musculo-skeletal problems is also having an effect, with more than 4,000 cases reviewed.

More than a quarter have been deemed appropriate for diversion to therapy services, instead of having to wait to see a consultant.

All such patients on the existing outpatients list have been assessed, and referrals are now being assessed as they are made.

The Wales target remains a maximum referral-to-treatment time of 26 weeks, though valid clinical reasons for waits beyond this time mean a 95 per cent treatment rate within 26 weeks is tolerated. Thirty-six weeks however, is the maximum for all treatments.

In Gwent and other parts of Wales, specialities other than orthopaedics are struggling to meet both targets.

More than 800 ophthalmology, ENT (ear, nose and throat), general surgery and oral surgery patients in Gwent had waited more than 26 weeks by December 31, and dozens of these had waited beyond 36 weeks.