The Number of Patients Waiting for Treatment in the UK is Now More Than 6 Million

The latest NHS England (NHSE) performance data show that in January waiting lists grew to a record 6.1 million people waiting to start treatment following a consultant referral.

This was up from 6.07 million in December 2021, and 4.59 million the previous January – an increase of just under 1.5 million, or almost a third, in a year.

Other newly-released NHSE figures revealed that 16,404 people in England had a wait of more than 12 hours in A&E departments in February, less than 1% down from January’s record number of 16,558, which was the highest for any calendar month since records began in August 2010.

Nearly 1 in 30 emergency admissions were delayed by 12 hours or more, and 60.8% were delayed by 4 hours or more – also the worst performance since records began.

Health System Under Severe Pressure

Royal College of Nursing (RCN) England Director Patricia Marquis said:  "These figures show the scale of the challenge nursing staff are facing in trying to reduce the backlog while all the other pressures they are under remain.

With a record 6.1 million still waiting for routine treatment and thousands of patients waiting more than 12 hours to be admitted to hospital from A&E, the nursing staff is struggling to provide safe and effective care with a severely-depleted workforce."

Dr. Katherine Henderson, president of the Royal College of Emergency Medicine (RCEM), said that to put in perspective the total 63,653 patients who have faced a 12-hour delay in an A&E since October 2021, the comparable figure for the 11 years from August 2010 to September 2021 was 52,181 patients.

"This statistic is staggering and should alarm all health and political leaders," she said. "The burden of responsibility can no longer be placed on burned out and overwhelmed staff who are struggling to manage this crisis."

She added: "The system is interlinked, a crisis in urgent and emergency care is a result of pressures elsewhere and may cause pressure down the line, for example in derailing elective care recovery. These all amount to a major patient safety risk."

The latest figures "reveal a health system under severe pressure", she said. "Patients are coming to serious harm."

Staff Vacancies Adding to Pressures

Saffron Cordery, deputy chief executive of NHS Providers, commented: "These figures demonstrate that the NHS is still under intense pressure, despite moving towards Spring when we normally expect to see seasonal winter pressures ease.

Urgent and emergency care remains under considerable strain, with 19% more incidents requiring an ambulance compared with 2 years ago," she said. "It remains deeply concerning that 6.1 million people are on waiting lists for routine care, with significant backlogs across mental health and community services as well."

However, she added: "Workforce shortages continue to be a real concern, as are recent increases in COVID-19 patients in hospital following weeks of falling admissions. Staff absences increased yet again this week, demonstrating why we need more staff in place to help ease the burden when colleagues are absent from work. The NHS now has 110,00 staff vacancies, and these gaps are putting significant pressure on the quality of care and patient safety."

People With Suspected Cancer are Also Waiting

On top of this, NHSE’s provisional January 2022 cancer waiting times data also released today showed that the current 2-week wait target for urgent referrals for suspected cancer was also widely missed, and was in decline. Only 75% of people referred were seen by a specialist within 2 weeks, down from 78.6% in December 2021, and against a target of 93%, which according to the Health Services Journal, had not been met since February 2019. Of those urgently referred for breast symptoms, only 49.4% were seen within 2 weeks, down from 50.9% in December 2021.

The targeted “2-week waiting period” rule is also being revised according to a 28-day standard before a cancer diagnosis is made or the person is determined not to have cancer.

The new targets of the NHS under the Faster Diagnosis Standard are:

• Patients who have been urgently referred, have symptoms of breast cancer, or have been picked up through screening, should have cancer ruled out or receive a diagnosis within 28 days, also known as the Faster Diagnosis Standard.
•  Patients who receive a cancer diagnosis will start treatment within nine weeks from the date of referral, dubbed a 62-day referral to treatment standard.
• Cancer patients should receive their first treatment within a month of a decision to treat the following diagnosis, which the NHS calls a 31-day decision to treat to treatment standard.

The NHS said that the plan would help diagnose more cancers earlier and save more lives.

Targets Widely Missed

The 2-week-wait target is also undergoing an overhaul, to a 28-day standard before cancer is diagnosed or ruled out. This new 'Faster Diagnosis Standard' (for all routes urgent suspected cancer, urgent breast symptomatic, and urgent screening referrals in aggregate) is being introduced as the target from Q3 2021/22, initially at a target level of 75%. However, the latest statistical release shows it is already not being met. In January only 63.8% of people were told by a specialist if they had cancer, or if cancer was definitively excluded, within 28-days of an urgent referral, down from 70.5% in December 2021. The NHS needs to meet a threshold for each target. For example, at least 85% of patients should start their first cancer treatment within 2 months (62 days) after the emergency referral with suspected cancer. Unfortunately, many of these goals are not achieved. Only 67% of patients received their first treatment within this time frame. While the NHS targeted 93% of patients to be seen by a specialist within 2 weeks of their GP referral, 79% of patients were seen by a specialist in December, according to recent data.

Target 95%

Michelle Mitchell, chief executive at Cancer Research UK, said: "The new Faster Diagnosis Standard is a more meaningful target than the current two-week wait that will hopefully improve early diagnosis. If all trusts met the 75% target, it would be an improvement from where we are now.

However, in the long-term to improve cancer survival, we’d like to see a 95% target originally proposed in the 2015 cancer strategy in Sajid Javid’s upcoming 10-year plan for cancer.

We recognize the target was set lower because of a shortage of cancer specialists, critical to diagnosing cancer across the NHS."

The Government must provide the extra investment they have promised to grow the NHS workforce. Every moment of delay risks more people waiting for diagnosis and treatment."

But when asked about the workforce, Health Secretary Sajid Javid suggested on Tuesday that there would be no new cash to tackle workforce shortages.

Mr Javid said that he would set out a 10-year cancer plan later this year.

Commenting on the new standards, he said: "These proposals will help us speed up diagnosis times and treatment, and save more lives."