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England’s waiting list for routine treatments his risen to new heights, despite the best efforts of the country’s hospitals.
The nation’s elective list — which represents those in line for procedures like cataract surgeries and hip replacements — grew to 7.42 million in April, official figures published this week show.
That’s an increase of around 3 million on February 2020 — before the pandemic — and growth of about 25,000 on March 2023.
In the U.K., most healthcare is provided by public hospitals, which send data on elective, emergency and cancer care to central bodies in each nation.
The 7.42 million figure is likely larger than the number of patients actually waiting for treatment in England, as some will be counted more than once if they’re in line for multiple forms of care.
Nonetheless, it’s still a significant number for a country of 56 million people.
And it’s a figure that keeps on growing, despite major efforts to reduce a backlog that was already rising before the pandemic.
A major focus for hospital leaders has been reducing not just the total number of people waiting, but the number waiting a particularly long time for care.
Before covid, it was rare to see significant numbers of patients waiting more than a year for elective treatment — the target for which was 18 weeks or less. In February 2020, around 1,600 patients had waited at least 52 weeks for care.
With planned operations cancelled and delayed as hospitals struggled to meet the emergency demands of the pandemic, many of these waits stretched far longer than a year.
At its peak in March 2021, more than 435,000 waits had surpassed the 52-week mark. By January 2022, nearly 25,000 waits had hit two years or more.
Those very long waits have reduced significantly, despite numerous competing challenges like increased demand, short staffing, poor patient flow through hospitals and ongoing industrial action from unions who argue poor pay and working conditions are preventing hospitals from recruiting and retaining staff.
The latest data show around 500 waits at the two-year-plus mark in April, nearly 11,500 at 78 weeks or more and more than 370,000 at one-year-plus. Concerningly, every single group, aside from those waiting over two years, has risen at least marginally since March.
Dr Sarah Scobie, acting director of research for think tank Nuffield Trust, said in a statement: “Despite a pledge to eliminate waits of a year and a half for patients for routine but often life-changing surgery, the numbers having waited 18 months or more grew in April.
“Even more worrying is the scale and speed at which the overall waiting list continues to grow, with nearly half a million patients added over the last five months alone.”
Although the effects of the pandemic on the length of waits is clear, it’s far from the only factor behind the total number of waiters. Chronic short-staffing, crumbling healthcare estates and an ageing and increasingly morbid population are all playing their part in the figures.
As Nuffield Trust and Health Foundation research suggested last year, the pandemic has exacerbated existing pressures on the healthcare system.
Even without covid-19, the organisations estimated the elective waiting list would still have hit five million last year.
Experts have called for more investment in workforce, in hospital buildings and equipment to shore up the health service.
Saffron Cordery, deputy chief executive of industry body NHS Providers, said in a statement: “Given the circumstances, trust leaders have been making remarkable progress reducing the longest waits for elective care, cutting down the diagnostic waiting list, and ensuring more people are starting urgent treatment for cancer compared to a year ago.
“However, demand continues to outstrip capacity in the NHS, and it’s not sustainable.”
She said hospital leaders needed action “on a national level” and called for the publication of a long-awaited fully-costed workforce plan from the government.
“We also need a resolution to the pay disputes between the government and health unions,” she added. “It’s vital all sides re-enter negotiations without delay.”