07.11.2024

NHS waiting list shoots to ANOTHER record high as crisis leaves 6.5MILLION patients stuck in queue

The number of people waiting for routine hospital treatment in England has skyrocketed to another record high, official figures show.

As the NHS crisis deepens, one in nine people (6.48million) were queuing for elective operations such as hip and knee replacements and cataracts surgery by April — up from the 6.36m stuck in March.

There are now 323,093 patients who have been waiting at least a year for their op, up 5.5 per cent.

Meanwhile, 12,735 have been stuck on the list since before Covid reached Britain in early 2020, down by a quarter.

Health Secretary Sajid Javid has promised to axe all one-year-plus waits to zero by 2025, utilising the 1.25 per cent National Insurance hike which will raise the health service a extra £30billion over the next three years.

Despite the Covid-induced backlog worsening yet again, response times in A&E and for ambulances have actually improved slightly.

More than 19,000 patients attending casualty units were still forced to wait 12 hours or more to be given a bed, in conditions described by experts as ‘inhumane’. This was down by a fifth on the previous month — but emergency medics say NHS England figures are a ‘gross under-representation’ of the actual crisis.

Fewer than three-quarters of patients were seen within the four-hour target of arriving at overwhelmed emergency departments, a slight recovery from last month. This was still the third-lowest rate ever recorded.

Ambulance crews continued to arrive late, on average, to callouts for all types of illnesses or injuries, even though response times were faster than last month. Doctors say that ‘urgent action’ is needed to tackle to prevent patients dying unnecessarily.

It comes as a report today warned that record handover delays outside busy A&E departments have seen patients left waiting for up to 24 hours before being assessed. The knock-on effects mean that dozens have died at home because ambulances were stuck in queues.

As the NHS crisis deepens, official statistics show that one in nine people (6.48million) were queuing for elective operations such as hip and knee replacements and cataracts surgery by April — up from the 6.36m stuck in March. There are now 323,093 who have been waiting for more than a year for their operation, up 5.5 per cent, and 12,735 have been seeking treatment for more than two years, down by a quarter

Separate data on A&E performance in May shows a 19,053 people were forced to wait 12 hours or more to be treated, three times longer than the NHS target. The figure is a fifth lower than last month. Less than three-quarters of patients were seen within the four-hour target of arriving at emergency departments, a slight recovery from last month but the third-lowest rate ever recorded

Ambulances took an average of 39 minutes and 58 seconds to respond to category two calls, such as burns, epilepsy and strokes. This is 11 minutes and 24 seconds quicker than one month earlier but more than double the 18-minute target

‘Immediate’ response is needed to stop Britons dying unnecessarily as they wait in ambulances outside busy A&E departments, watchdog demands

An ‘immediate’ response is required to stop patients dying unnecessarily as they wait in ambulances outside busy A&E departments, a watchdog has demanded.

Record handover delays have seen patients left waiting for as long as 24 hours before being assessed, the Healthcare Safety Investigation Branch (HSIB) warned today.

The knock-on effects mean that dozens have died at home because ambulances were stuck in queues, it said.

The HSIB, an independent investigator working to improve patient safety and funded by the Department of Health, said the NHS needed to pull together in the same way it did during the pandemic to tackle the crisis.

In an interim report, it recommended that the Department of Health leads an ‘immediate strategic national response’ to address patient safety issues arising from flow into, through and out of hospitals.

Latest figures from the Association of Ambulance Chief Executives show that the average time for a patient handover in April was 36 minutes – more than double the 17 minutes recorded a year earlier, and well above the target of 15.

A staggering 11,000 handovers took more than three hours, with the longest delay 24 hours.

Unions say ambulance staff are working on intolerable pressure, with frontline medics and call handlers quitting for less stressful jobs.

As a result, many trusts are struggling to fill vacancies – with Monday’s Daily Mail revealing how people in some parts of the country are waiting more than nine minutes for their 999 medical emergency calls to be answered.

The HSIB said harm was being caused by patients waiting for ambulances, and waiting in ambulances outside hospitals, which could mean their condition deteriorates.

Meanwhile people in hospital becoming ‘institutionalised due to unnecessary extended stays’.

It called for a collective ‘strategic’ response across the health service akin to that prompted by the Covid crisis.

Neil Alexander, lead investigator at HSIB, said: ‘It is one of the most urgent issues facing healthcare, and sadly in the most serious of cases has resulted in deaths of patients who couldn’t access the treatment they needed in time.’

Calling for ‘immediate action’ to keep patients safe, he said it was time for a ‘national, strategically-led response that reduces delays and improves patient flow across the health and care system’.

NHS England’s monthly performance statistics, a key way of measuring how patients fare, showed that the backlog crept up by another two per cent in April.

For comparison, the waiting list stood at 3.95million in April 2020 — before Covid caused havoc on hospitals and forced tens of thousands of routine operations to be cancelled.

Health officials expect the list will keep growing until March 2024, with up to 10.7million patients in need of care at the peak.

Of the 6.5million waiting patients, 61.7 per cent joined the queue in the last four months as part of the NHS’s catch-up plan.

Under the health service’s own rulebook, all patients requiring treatment have the right to be seen within 18 weeks.

The number waiting for two years fell by 24.2 per cent month-on-month. But the 12,735 figure for April is five times higher than a year ago.

Ministers announced an elective recovery plan earlier this year, promising two-year waits would be scrapped by July and one-year waits by March 2025.

It is being funded by the manifesto-busting tax hike that came into force last month. The plan has been branded as ‘not ambitious enough’ by Labour, health unions and even senior Conservatives.

Tim Mitchell, vice president of the Royal College of Surgeons of England, said the drop in two-year waiters is a ‘light at the end of the tunnel for people who have been waiting excessively long for a planned hospital treatment’.

But he warned of ‘big challenges ahead’ as demand is ‘only going to get stronger’ as people return to the NHS, which faces a staff shortage.

NHS England data also shows 439,306 patients — or roughly a quarter — were forced to wait six weeks for standard tests like X-rays and MRIs.

It was up on the 310,802 the previous month.

Government plans set out that 95 per cent of patients should receive results of scans within six weeks by March 2025.

Meanwhile, A&E data shows 2.19m people in England showed up at emergency departments in May, making it one of the busiest months on record.

Just 73 per cent of people were seen within the health service’s own four-hour target — the third-lowest rate recorded since records began in 2010.

A total of 122,768 people waited at least four hours from the decision to admit to admission in May.

And 19,053 were forced to wait more than 12 hours. The number is down from 24,138 in April — a 21 per cent month-on-month fall.

NHS standards set out that at least 95 per cent of patients attending A&E should be admitted, transferred or discharged within four hours, but this has not been met nationally since 2015.

Professor Sir Stephen Powis, national medical director for NHS England, said: ‘The new figures show our hard-working NHS staff are making significant progress in ensuring people waiting the longest time for care are getting treated.

‘There is no doubt the NHS still faces pressures — including a renewed increase in Covid patients — and the latest figures show just how important community and social care are in helping people in hospital leave when they are fit to do so, not just because it is better for patients but because it helps free up precious NHS bed space.

WHAT DO THE LATEST NHS PERFORMANCE FIGURES SHOW?

The overall waiting list has jumped to 6.48million. This is up from 6.36m in March and is the highest number since records began in August 2007.

There were 12,735 people waiting more than two years to start treatment at the end of April, down from March but five-times more than April 2021.

The number of people waiting more than a year to start hospital treatment was 323,093 in April, up from 306,286 the previous month.

Some 19,053 people had to wait more than 12 hours in A&E departments in England in May. The figure is up from 24,138 in April.

A total of 122,768 people waited at least four hours from the decision to admit to admission in April, down slightly from 131,905 in March.

Just 73 per cent of patients were seen within four hours at A&Es last month. NHS standards set out that 95 per cent should be admitted, transferred or discharged within the four-hour window.

The average category one response time – calls from people with life-threatening illnesses or injuries – was eight minutes and 36 seconds. This is 26 seconds faster than April but 96 seconds slower than the seven-minute target.

Ambulances took an average of 39 minutes and 58 seconds to respond to category two calls, such as burns, epilepsy and strokes. This is 11 minutes and 24 seconds quicker than one month earlier but more than double the 18-minute target.

Response times for category three calls – such as late stages of labour, non-severe burns and diabetes – averaged two hours, nine minutes and 32 seconds. This is down from two hours, 38 minutes and 41 seconds in April. Ambulances are supposed to arrive at nine in 10 category three calls within two hours.

Some 389,855 patients people were waiting more than six weeks for a key diagnostic test in March, including an MRI scan, non-obstetric ultrasound or gastroscopy.

The equivalent number in March 2021 was 305,061 (24 per cent of the total), while in March 2020 there were 85,749 (10 per cent).

Some 439,306 patients queuing for one of 15 key diagnostic tests — including MRI scans and ultrasounds — were forced to wait longer than six weeks, 28 per cent of all waiters.

The figure is worse than one month earlier, when 310,802 (24 per cent of those in the queue) were waiting more than six weeks.

Government plans set out that 95 per cent of patients should receive it within six weeks by March 2025.

‘It is also a good reminder of how important it is to come forward for care and advice by choosing the right service for your needs — a patient survey showed one in five people would have called an ambulance if NHS 111 had not been available, while a quarter would have sought help from an emergency department instead.

‘By calling NHS 111 or using the online service for non-urgent health concerns, you can help us help you access the best care for your needs, quickly.’

But Dr Sarah Scobie, deputy director of research at the charity Nuffield Trust, said the Government cannot ‘hide solely behind Covid’ as the root of the A&E crisis, as four in 10 patients showing up at emergency departments were forced to wait more than four hours before the pandemic.

She said: ‘While the pandemic has made the situation worse, we are reaping the rewards of a long-term squeeze on staffing and space. The new normal and the long waits illustrated by these figures go far beyond an inconvenience and put patients at considerable risk.

‘Ambulance response delays are still a real concern. Patients in an emergency such as with heart attacks or strokes are not receiving help anywhere near the speed expected – one in 10 are waiting almost an hour and a half for an ambulance.

‘This is despite ambulance staff working flat out and under intolerable pressure. These bottlenecks are experienced throughout the system with hospitals still working under infection control measures unable to discharge or admit patients fast enough.’

Separate monthly NHS England cancer data shows 204,818 patients received an urgent referral from their GP in April — 50,000 fewer than last month.

Just 79.1 per cent of these patients were seen by a consultant within two weeks —  down from 80.6 per cent last month.

And only seven in 10 of these patients were diagnosed with cancer or had it ruled out within 28 days — the third lowest rate on record and missing the 75 per cent target.

Just 65.2 per cent of people treated began treatment within 62 days of being urgently referred for suspected cancer, down from 67.4 per cent in March 2022 and third lowest rate ever recorded. NHS targets set out that 85 per cent of patients are supposed to start treatment within two months of an urgent referral.

Professor Pat Price, an oncologist and co-founder of the #CatchUpWithCancer campaign, said: ‘It defies all reason that Government can look at these cancer statistics and not see a crisis.

‘We are desperately short of treatment capacity. Increasing diagnosis means nothing if all we do is pile backlog patients onto sky-high waiting lists.

‘Frontline clinicians are warning us of 11 week waits. Why is it that no priority or investment is being given to treatments to cure these patients faster?

‘There are solutions in areas like radiotherapy that could have an immediate impact, but they are ignored because ministers don’t seem to understand them. This is having a devastating impact on patients and cancer staff, I urge the Health Secretary to act.’

Meanwhile, figures on ambulance performance in May shows that the average category one response time – calls from people with life-threatening illnesses or injuries – was eight minutes and 36 seconds. This is 26 seconds faster than April but 96 seconds slower than the seven-minute target.

Amanda Pritchard has admitted the current state of A&E and GP services is ‘unacceptable’. Meanwhile, Sajid Javid, the Health Secretary, admitted the current state of emergency and GP services was ‘not working’. But he insisted ‘the answer to all the challenges that we face in healthcare cannot always be more money’

‘Can you please tell them to hurry up or I shall be dead’: 94-year-old dies following more than five-hour wait for ambulance after a fall

A 94-year-old died following a fall at home after being forced to wait more than five hours for an ambulance to show up.

Kenneth Shadbolt, from Chipping Campden in the Cotswolds, warned 999 call handlers in March that he would ‘be dead’ if paramedics did not arrive soon.

The retired factory worker and carpenter, who lived alone in a semi-detached house, was in good shape and was often seen cycling around on his electric bike.

Kenneth Shadbolt, from Chipping Campden in the Cotswolds, warned 999 call handlers in March that he would ‘be dead’ if paramedics did not arrive soon

But just before 3am on March 23, he fell, hitting a wardrobe and collapsing on the floor, when he got up to use the bathroom.

The father-of-five had badly hurt his hip and was unable to get up but was able to rach his mobile on his bedside table and dial 999, according to documents seen by the BBC.

He called South Western Ambulance Service three times between 3am and just after 4am, warning in his last call that he felt ‘terrible sick’ and his ‘breathing is going’.

Mr Shadbolt said: ‘I need an ambulance because I’m going to fade away quite quickly.’

A call handler told him the ambulance service was ‘under a lot of pressure at the moment… we are doing our best.

‘I appreciate that you’ve been stuck for quite some time, Ken… we’ve not forgotten about you at all.’

He told her 999 worker that he was cold but had been unable to reach his duvet or get through to his neighbours when he tried to call them.

Mr Shadbolt was then told to ‘try to be still’.

He said: ‘Can you please tell them to hurry up or I shall be dead.

‘Send me the undertaker, that would be the best bet.’

An ambulance finally arrived to Mr Shadbolt’s address at 8:10am – more than five hours after his first call.

Doctors at the Gloucestershire Royal Hospital, which he arrived at at 10am, said his injuries were ‘survivable’ and he passed away at around 2pm.

His son, Jerry Shadbolt, told the BBC: ‘The doctors were saying his injuries were non-survivable but would they have been non-survivable if he’d arrived at hospital four hours earlier? I’d like an answer to that question.

‘He was on his own and he knew he was on his own. He must have felt abandoned and alone on his bedroom floor. That’s the most troubling part of it for me.’

South Western Ambulance Service NHS Foundation Trust said ambulance handover delays and busy hospitals meant it was taking too long to reach patients.

‘This is a risk which we recognise is unacceptable,’ it said.

It comes after a report from the Royal College of Emergency Medicine (RCEM) warned more than 1,000 patients a day were waiting 12 hours or more in A&E for a hospital bed last year.

The RCEM said its figures, obtained from hospitals under freedom of information laws, highlight ‘serious and dangerous levels of crowding’.

The results show at least 381,991 people had to wait 12 hours or more after arriving in A&E until they secured a bed in 2021 – equivalent to 1,047 a day.

But the true figure is likely to be almost double that as only 74 of England’s 124 NHS trusts responded to the request.

Dr Adrian Boyle, RCEM vice-president, said: ‘These figures are staggering and show the critical state of the urgent and emergency care system…

‘The health service is failing, and failure to act will take it deeper into crisis and inevitably lead to another worst winter on record and further patient harm.’

Ambulances took an average of 39 minutes and 58 seconds to respond to category two calls, such as burns, epilepsy and strokes. This is 11 minutes and 24 seconds quicker than one month earlier but more than double the 18-minute target.

Response times for category three calls – such as late stages of labour, non-severe burns and diabetes – averaged two hours, nine minutes and 32 seconds. This is down from two hours, 38 minutes and 41 seconds in April. Ambulances are supposed to arrive at nine in 10 category three calls within two hours.

Dr Sonya Babu-Narayan, a cardiologist and associate medical director at the British Heart Foundation, said: ‘Minutes matter when you’re having a heart attack or stroke, and timely treatment could be the difference between life and death.

‘That is why it’s so serious that we continue to see dangerously high average ambulance waiting times and ever-growing waiting lists for time-critical cardiac care, despite NHS staff doing all they can.

‘Unless this is urgently addressed, we will see yet more avoidable heart attacks, disabling heart failure, and even premature death.

‘Heart disease is still one of the country’s biggest killers – the NHS needs significant help from Government now, with a strategy for cardiovascular care that ensures there are enough heart doctors, nurses and cardiac physiologists, and enough funding now and in future.’

Amanda Pritchard, chief executive of NHS England, yesterday admitted that the current state of A&E services, as well as general practice, is ‘unacceptable’.

Speaking at an annual health service conference in Liverpool, she said issues booking an appointment and seeing a family doctor in-person showed the ‘current model isn’t working’.

She also acknowledged the record waits in emergency departments faced by tens of thousands of Britons each month, saying it ‘underlined the issue’.

The crisis has been partly blamed on desperate patients turning up at A&E because they can’t get a face-to-face appointment with their GP.

But Mr Javid, who also spoke at the NHS ConfedExpo conference, warned there was ‘no quick fix’ and insisted the Government would not keep throwing money at the problem.

He defended his comments likening the NHS to the defunct video shop Blockbuster in the age of Netflix.

Standing by the comparison, he said the NHS must be ‘smarter’ with its funding, by growing the workforce and improving leadership.

‘There are a great deal of things we can do before we even think about turning to the taxpayer again,’ he added.

Meanwhile, a report, by the Healthcare Safety Investigation Branch (HSIB), an independent investigator working to improve patient safety and funded by the Department of Health, said the NHS needed to pull together in the same way it did during the pandemic to tackle the ambulance crisis.

In an interim report, it recommended that the Department of Health leads an ‘immediate strategic national response’ to address patient safety issues arising from flow into, through and out of hospitals.

Latest figures from the Association of Ambulance Chief Executives show that the average time for a patient handover in April was 36 minutes — more than double the 17 minutes recorded a year earlier, and well above the target of 15.

A staggering 11,000 handovers took more than three hours, with the longest delay being 24 hours.

Many A&E departments are overwhelmed, with more than 1,000 patients spending longer than 12 hours there every day, a damning report from the Royal College of Emergency Medicine (RCEM) revealed this week.

The RCEM data, obtained through a freedom of information request, shows at least 381,991 people had to wait 12 hours or more after arriving in A&E until they secured a bed in 2021 – equivalent to 1,047 a day.

Unions say ambulance staff are working on intolerable pressure, with frontline medics and call handlers quitting for less stressful jobs.

As a result, many trusts are struggling to fill vacancies — with Monday’s Daily Mail revealing how people in some parts of the country are waiting more than nine minutes for their 999 medical emergency calls to be answered.

The HSIB said harm was being caused by patients waiting for ambulances, and waiting in ambulances outside hospitals, which could mean their condition deteriorates.

Meanwhile people in hospital becoming ‘institutionalised due to unnecessary extended stays’.

It called for a collective ‘strategic’ response across the health service akin to that prompted by the Covid crisis.

Neil Alexander, lead investigator at HSIB, said: ‘It is one of the most urgent issues facing healthcare, and sadly in the most serious of cases has resulted in deaths of patients who couldn’t access the treatment they needed in time.’

Calling for ‘immediate action’ to keep patients safe, he said it was time for a ‘national, strategically-led response that reduces delays and improves patient flow across the health and care system’.

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