HUNDREDS of Gwent patients have had cataract and orthopaedic operations in Bristol since January, as health board chiefs battle to reduce long delays for surgery.

And the treatment exodus is set to continue in 2015/16, to try to reverse a rise in the number of patients waiting more than 36 weeks from referral to treatment that has gone almost unchecked for a year.

To date 399 Gwent patients - 168 requiring orthopaedic surgery and 231 needing cataracts removed - have gone to an NHS treatment centre in Bristol run by independent provider Care UK.

This followed Welsh Government approval late last December for 450 cataract and orthopaedic procedures for Gwent patients to be carried out across the Severn Bridge. The exact cost has not been revealed, but the bill will have run into several hundreds of thousands of pounds.

Long waiting times for orthopaedic surgery are a problem across Wales, but the situation is particularly acute in Gwent where the number of patients waiting longer than 36 weeks rose by more than 500 per cent during the year to January.

Aneurin Bevan University Health Board's director of performance improvement Allan Davies predicted that the position regarding referral to treatment waiting times will remain difficult, particularly in orthopaedics.

Referring to the extremely busy winter for Gwent hospitals, he said the normally ringfenced orthopaedic ward at the Royal Gwent had been breached seven times in recent weeks, with "a significant impact on the numbers of longest waiting patients in orthopaedics."

Of the use of external providers for treatments, he said surveys showed that patients' experiences had been very positive.

"We are looking at doing it again next year and believe as a safest and best option that we take a decision to commit to that," he said.

By the end of this January, 1,766 orthopaedic patients in Gwent had been waiting longer than 36 weeks for treatment, compared to 308 in January 2014, in an area that already had the largest number of people in Wales (13,587) awaiting orthopaedic treatment.

Several factors combined during the past year to send the number of patients waiting more than 36 weeks for treatment soaring, and though it is problem common across Wales, Gwent has been hit hard.

Cancellations of operations during winter 2014 began a year of difficulties, and capacity has failed to keep up with demand throughout.

Capacity was reduced further in Gwent hospitals late last year due to lower than expected numbers of extra surgery sessions, while additional surgical lists at weekends could not be sustained because of a lack of theatre staff.

The effects of what proved an extremely busy winter for hospitals was also making itself felt by January, a health board report stating that "significant" numbers of operations were cancelled because of a lack of ward and critical care beds.

In ophthalmology meanwhile, keeping pace with demand has proved difficult in Gwent for much of the past year, and the 846 patients who had waited longer than 36 weeks by the end of January was a more than four-fold increase on the figure 12 months earlier (196).