The Government has set out its plans to reduce NHS waiting times in England, but how far are hospitals from targets?
Health and Social Care Secretary Sajid Javid announced the NHS Delivery Plan for tackling the Covid-19 backlog on Tuesday.
There are plans for extra funding, buying new equipment, and expanding capacity for tests and treatment.
But doctors groups have warned that workforce pressures will make it a challenge to deliver the plan.
The latest NHS England figures released this morning, show the waiting list hit a new high of 6.07 million at the end of December.
Mr Javid warned that the number is expected to continue to rise before it starts to come down – with NHS modeling suggesting it could hit between nine and 10 million.
The backlog plan focuses on eliminating the longest waits.
Waits of more than two years will be eliminated by July this year – there were 19,461 people waiting that long in December, a rise from 18,585 in November.
The number waiting longer than a year for treatment also rose – the plan is to eliminate these waits by March 2025.
There were 310,813 people waiting more than a year at the end of December, up from 306,996.
Pre-pandemic, the target was for 92% of people to wait less than 18 weeks for treatment.
In December, just 63.8% waited less than 18 weeks, with a record 2.19 million people waiting longer than that.
Figures on canceled operations have also been published for the first time since the start of the pandemic.
There were 19,338 canceled operations in October to December last year, equivalent to 1.1% of elective admissions.
That’s a similar proportion to October to December 2019, the last figures published.
However, for those who had their operation cancelled, nearly a quarter (23.8%), or 4,603 patients, hadn’t been treated within 28 days of that cancellation.
That’s the highest proportion since October to December 2001.
Cancer waiting times
The plan is to return the number of people waiting more than 62 days from an urgent referral to starting cancer treatment back to the pre-pandemic levels by March 2023.
In December, 14,132 people started treatment, down from 14,889 in November, with 4,670 having waited longer than two months to start treatment.
That means just 67.0% of patients started treatment in 62 days, the lowest proportion on record.
The target is 85% – before the pandemic, in December 2019, 78.1% of patients were treated in 62 days, with 2,845 waiting longer.
The second cancer treatment target is for patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days.
This was put forward in 2015, with a recommendation of a target of 95% to be hit by 2020.
After being piloted, it was rolled out across the country, with a target of 75% of patients getting a definitive diagnosis by quarter three 2020/21.
In December, 70.5% of urgently referred patients were told they had cancer or not within 28 days – the lowest proportion recorded so far.
The plan is now to hit the 75% target by March 2024.
In December, 29.0% of people waited longer than six weeks for key diagnostic tests, up from 25.0% in October and November.
The number waiting more than six weeks rose to 419,254.
The target is for 95% of patients to wait less than six weeks (as opposed to the current 71%), by March 2025.
Pre-pandemic levels were 96%, although the target was 99%.
NHS national medical director, Professor Stephen Powis said: “While seasonal pressures are ongoing, we are now beginning to see the full picture of the Omicron winter on the NHS, and despite sky-high staff absences, hardworking NHS staff continued to make inroads on the backlog that has inevitably built up and delivered 120,000 more tests and checks in December compared to the same time last year.”
There were 1.79 million tests carried out in December, up from 1.67 million in December 2019 – although that was down from 2.01 million in November.
Long waits for diagnostic tests also impact on waits elsewhere.
Responding to the record numbers waiting to start treatment, Dr Jeanette Dickson, President of the Royal College of Radiologists said: “These performance figures reflect the significant challenges facing the NHS, which require long term strategies and investment.
“Workforce is absolutely critical – our data tells us that there is a shortfall of 2,000 consultant radiologists, a number that, on current trends, will grow to over 6,000 within ten years.
“With diagnostic imaging (such as X-ray, MRI and CT) featuring in 80-90% of patient journeys, we need a long term plan and significant investment in trainee numbers to meet demand. Equally, with the cancer backlog growing, the shortfall in the clinical oncology workforce is 189 consultants, a 17% gap.”
She added that equipment also needed updating, but warned there was no quick fix for the issues, instead needing sustained investment and delivery.
A&Es and emergency care
Other areas of the NHS not covered by the recovery plans are also still under pressure.
In January, a record 16,558 people spent more than 12 hours on a trolley in A&E waiting for a ward bed, the highest number since records began in August 2010.
That’s despite the number of attendances dropping in January.
As well as this, NHS staff dealt with the highest number of life-threatening ambulance call outs and the highest levels of 111 calls for that month since records began.
Responding to the publication of NHS England’s Elective Recovery Plan, Dr Chaand Nagpaul, BMA council chair, said the NHS and patients desperately need this plan to succeed but that there were some big questions still to be addressed if this plan is to be effective.
He said: “The biggest limiting factor will be workforce shortages, given that there are currently 100,000 unfilled vacancies across the NHS.
“Even more worryingly over six in 10 doctors are suffering stress and work-related anxiety, half wish to reduce their hours and 20% are considering leaving the NHS altogether.
“Retaining the current workforce must therefore be the immediate priority – we cannot afford to lose any more staff at this most critical time. Tangible plans must be in place to prioritize staff wellbeing and pay and conditions, at a time when many doctors do not even have access to rest facilities at work. It is vital that punitive pension rules are reformed to prevent talented, senior clinicians from reducing their hours or leaving the NHS altogether.”