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.
Figures Reveal a '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, nursing staff are 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."
Moreover, these figures were based on the old system with waiting time measured from a decision to admit to actually being admitted. In future, the clock will start ticking the moment a patient arrives in the department – a change that has been hailed as meaning that reported breaches of the 4-hour target are “set to rocket”. According to the RCEM, based on a project reporting delays from time of arrival at 40 participating UK sites, against the time of arrival standard there have actually been 121,003 12-hour waits since October 2021.
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 quality of care and patient safety."
Cancer Wait Targets Also Widely Missed
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 as against a target of 93%, which according to the Health Services Journal , had not been met since February 2019. Of those of those urgently referred for breast symptoms, only 49.4% were seen within 2 weeks, down from 50.9% in December 2021.
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.
Ms Cordery said: "NHS staff are working extremely hard under the circumstances, and delivered increased levels of diagnostic and elective activity this month. It is testament to the hard work of our frontline staff that the number of people seen by a consultant after an urgent cancer referral is higher than pre-pandemic, as is overall mental health activity.
Referring to the Health and Social Care Secretary's new plan, she said: "We need to see a long-term workforce plan to help make this vision into a reality, and to help keep performance levels high."
Eve Byrne, director of advocacy at Macmillan Cancer Support commented on the latest numbers: "It is deeply troubling to see these figures now at yet another worst-ever record, as we know that any delay to diagnosis and treatment causes huge amounts of anxiety and distress for people living with cancer.
"The NHS was at breaking point even before the pandemic. After years of failing to deliver the long-term funding that the NHS cancer workforce needs, we were thoroughly disappointed to hear the Health Secretary say this week that there would be no new investment behind NHS workforce plans. Without concrete investment to urgently increase the number of cancer staff to provide the care and support that people with cancer need, any new ambitions of the upcoming 10-year cancer plan will fail."
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Cite this: Dr Sheena Meredith MB BS. Disastrous NHS Performance Figures Show Record 6.1 Million on Waiting List - Medscape - Mar 10, 2022.