The impact of record NHS waiting lists

31 Aug 2023 | Jodi Newton
waiting

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7.47 million people waiting for NHS treatment

England’s NHS waiting lists have hit the highest number since 2007, reaching a record number of 7.47 million people who are waiting to start routine hospital treatments with nearly 400,000 people waiting for over a year to start treatment. Whilst this may come as no surprise after the pandemic and long-standing staff shortages, this news also comes as junior doctors engaged in their walkout over pay and the longest period of industrial action in the history of the NHS.

Many people have been on the waiting lists for over a year, waiting for operations, with some waiting for three years for routine orthopaedic operations. This also consists of over 300,000 people with heart problems, and nearly half of these patients have been waiting for nearly five months for procedures such as tests and CT scans or transplants and stents. The British Heart Foundation have noted that these delays represent a substantial risk for those waiting for procedures, as thousands of extra deaths relating to heart disease have sadly occurred since the pandemic began, and the waiting list for heart-related treatment is thought to be a contributor.

NHS England guidelines are no longer meaningful

In January 2023, Prime Minister Sunak pledged to cut NHS England waiting lists, saying, ‘lists will fall and people will get the care they need more quickly’. He explicitly promised to eliminate all waits of 18 months by April of this year and all waits of more than a year by March 2025.

The waiting lists must be dragged back into some order. According to NHS England’s website, patients have a, ‘legal right to start non-urgent consultant-led treatment’, within a maximum of 18 weeks, while the maximum waiting time to be seen for a specialist for suspected cancer is just 2 weeks.

The problem is that more than 40 % of patients are waiting longer than 18 weeks to start essential treatment. In Accident and Emergency departments, just 73% of patients are seen within 4 hours, as opposed to the standard of 95%. Vulnerable cancer patients are also suffering. As a Cancer Research representative stated, ‘These figures are among the worst on record and represent anxious delays’ for patients with suspected cancer, while placing ‘immense pressure on NHS staff’.

It is clear that the guidelines are now breached to such an extent that they no longer serve any practical purpose.

Hidden statistics: backlogs and hidden waiting lists

While the current statistics on waiting lists are indisputable, the problem is even deeper than immediately apparent due to the ‘backlog’, ‘hidden backlog’ and the ‘hidden waiting list’.

The COVID-19 pandemic created a backlog in secondary care, which, according to the BMA, will ‘take years’ to clear while waiting times remain ‘far higher than pre-COVID’. BMA figures for July 2023 show that:

  • The median waiting time for treatment is now 14 weeks, nearly double the pre-COVID wait
  • Around 3.18 million people have been waiting for treatment for over 18 weeks, and of these, around 390,000 have been waiting over a year, nearly 308 times as many as before the pandemic took hold.

The BMA also cites a ‘hidden backlog’ which is growing relentlessly. This hidden backlog represents people who, in normal times, would already be in the secondary healthcare system but, for various reasons, have not yet been referred.

There is also a ‘hidden waiting list’ to get a hospital referral. New research shows that nearly 1 in 5 people have to attend 4 or more GP appointments before getting a secondary care referral and 11% of these waited over 4 months from their first GP appointment to being referred. Understandably, the people affected repeatedly return to their GP or refer themselves to Accident and Emergency for help, creating additional pressure on already depleted services.

Scapegoating the caregivers

Sunak admits that his January 2023 pledge will be hard to meet in the face of record waiting times. For this failure, he casts blame on junior doctors and other striking medical staff. He claims that until the strikes began, the Government had been making progress on whittling down the waiting list, ‘We were making progress on bringing the overall numbers down. What happened? We had industrial action.’

It is true that since December 2022, more than 885,000 inpatient and outpatient appointments have been cancelled due to industrial action. However, the number of elective surgeries and outpatient attendances is, ‘still well below pre-pandemic levels’. Indeed, the hidden statistics outlined above show that the problem goes deeper than the Sunak headlines suggest.

No resolution in sight

While the nurses’ pay dispute has been resolved, senior and junior doctors will continue to strike. Despite this, Sunak still refuses to meet with them. His position is that the current pay offer is generous and that strike action by medical staff will not change the Government’s mind.

Rather than negotiate with the medics, Sunak offers a short-term, headline-grabbing ‘solution’ in the form of an extra £200 million of funding. However, this cash is already spent. According to one NHS manager, the extra money will not, ‘come close to covering the costs of the strikes’ that have already happened, let alone those to come.

Impact of NHS waiting lists

Cancer diagnosis delays

Those who are waiting to be diagnosed with cancer are also suffering – having to wait for a cancer diagnosis delays the start of cancer treatment, and therefore reduces the chances of surviving cancer. NHS data experts found that there could be 25,000 people on the waiting list with cancer.

Children missing school

Over a third of the overall waiting list consists of children, waiting for treatments ranging from dental work to tests relating to breathing difficulties. Whilst these children are waiting for their treatment and tests, they are living day-to-day with symptoms of their illnesses which can encroach on their education, with many children missing school.

Patients opting for private health care

Many patients are giving up on these lengthy waiting lists, with some opting for private health care or some having to sadly live with their illnesses and ailments. The UK Government has promised to eliminate all wait lists of over a year by March 2025.

What is the impact of waiting lists on Medical Negligence Claims?

  • Increased waiting times can lead to a rise in the number of medical negligence claims, as patients and their families seek compensation for harm caused by delayed care.
  • Prolonged waiting times can be cited as evidence of substandard care, especially if they lead to significant harm. This can strengthen a claimant’s case in proving negligence.
  • The rise in claims can put additional financial and administrative strain on the NHS, diverting resources away from patient care.

Addressing waiting times is crucial to improving patient outcomes and reducing the incidence of medical negligence claims.

How can we help?

The NHS is facing an unprecedented challenge with 7.47 million people waiting for routine treatments. This crisis impacts everyone, from those awaiting critical heart procedures to children missing school due to untreated conditions. If you feel you have suffered adversely due to NHS backlogs or other similar issues, our Medical Negligence department may be able to help.

  • Fill in our online enquiry form; or
  • Call us on 020 7485 8811

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