The impact of coronavirus on NHS waiting lists has been laid bare – with the number of patients waiting more than a year for treatment in London alone now almost 20 times the figure for the whole country in March 2019, leaked data shows.
Experts warn that increases of a similar scale are likely to be replicated across the UK after hospitals were forced to cancel thousands of operations in order to cope with 100,000 Covid-19 patients.
Across the capital, 19,775 patients had been waiting more than 52 weeks by 19 July according to leaked data seen by The Independent that had been submitted to NHS England by 23 hospitals in London.
That compares with a total of 1,154 across England less than 18 months ago.
Concern over long waits for treatment is shared at the highest levels of the health service, with hospital bosses being instructed to get back to “near-normal” levels of activity by NHS England chief executive Sir Simon Stevens.
Waiting times expert Rob Findlay, who runs the demand and capacity planning company Gooroo, told The Independent: “If you can’t keep up with demand then waiting lists are going to grow, almost without limit. Wherever you draw the line it will inevitably be breached and waiting lists will continue to grow until the NHS can keep up with demand.
“The rest of this financial year will be about doing as much as they can in difficult circumstances. It won’t be until April before the NHS can turn its hand to a prover recovery plan and that is likely to take several years.”
He said the figure on those waiting in London was not a surprise but “it is a large number, because it is a large problem”.
He said every week the numbers waiting were growing, with a lot of patients yet to be seen for routine appointments.
“What really worries me is that those patients have not been seen and some of them will have cancer and urgent needs that have not yet been picked up.”
The overall number of patients waiting for treatment on the NHS could hit 10 million this autumn and comes after years of the NHS failing to hit its benchmark target to treat patients within 18 weeks. This hasn’t been achieved since March 2016.
Part of the problem for the NHS is the lack of capacity to treat routine patients while needing to keep them safe from infection. Some hospitals have been forced to reduce their numbers of beds and limit the number of operations they can carry out.
According to the data obtained by The Independent, the hospital with the largest number of long waiters is the Royal Free hospital in Hampstead, run by the Royal Free Foundation Trust, which had 6,488 patients waiting more than a year by the week ending 19 July.
The trust reported its level of activity was 60 per cent down from normal.
Also hit hard by the crisis was Barts Health Trust, which runs the Royal London Hospital in Whitechapel. It had more than 2,469 patients waiting more than 52 weeks, with business-as-usual activity down 50 per cent.
Chelsea and Westminster Hospital Foundation Trust reported activity down 76 per cent.
On Friday NHS England chief executive Sir Simon Stevens wrote to hospital bosses telling them to return “to near-normal levels of non-Covid health services” and to make full use of what he called a “window of opportunity between now and winter”.
He told hospitals they would be expected to use private hospitals for routine surgeries and cancer operations until March next year and he said cancer services must be fully restored.
By September, he said, hospitals must be achieving at least 80 per cent of what they were doing last year for both overnight and day-case procedures. This should rise to 90 per cent in October.
Hospitals should achieve 100 per cent of outpatient appointments and follow-ups either face to face or virtually from September.
Sir Simon said waiting lists should be managed at a “system” level, suggesting patients will be transferred to other hospitals if they have more capacity.
He added: “Clinically urgent patients should continue to be treated first, with next priority given to the longest waiting patients, specifically those breaching or at risk of breaching 52 weeks by the end of March 2021.”
Imelda Redmond, national director of Healthwatch England which represents patient views, said: “For those living with pain or in need of treatment for a potentially life-threatening condition, any delay in recent months will have been incredibly worrying.
“Where people do end up facing longer waits we also need services to think differently about how lists are managed. We need to have a much greater focus on the other factors that people tell us also matter deeply to them, including greater shared decision making between patients and professionals to create treatment plans that work around people’s lives. We also need to see much greater options for interim support to ensure people don’t ever feel forgotten about.”
Professor Neil Mortensen, president of the Royal College of Surgeons of England, said: “It is right that the system pulls out all the stops to get planned surgery going again in every corner of the country.
“There are thousands of patients on a ‘hidden waiting list’, waiting to be referred into the system, and thousands who had already been waiting some time at the start of the crisis, and have now waited more than a year.
“The proposal to end the current independent sector national contract in March 2021 should be reviewed at the turn of the year. It may well be that these arrangements have to stay in place to ensure patients get the treatment they need.
“It is also essential that surgical trainees are accommodated by independent hospitals so that they get the time they need in theatre, and the experience necessary to deliver more treatment.”
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