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Hospital Treatment Waiting Lists in England Reach 7.21 Million

The number of people in England waiting to start hospital treatment returned to record levels, although latest figures showed improvements to the longest waits.

Performance statistics showed hospital emergency departments remained under pressure as the NHS continued to face pressures from bed shortages, winter viruses, and strike action.

NHS England said it was making "significant progress" in its elective recovery plan, although other health bodies said the numbers continued to demonstrate the pressures faced by the NHS and warned the situation could deteriorate if junior doctors went ahead with planned industrial action.

Referral to treatment (RTT) waiting times edged up to an estimated 7.21 million in January from 7.0 million the previous month. It was the joint highest total, shared with October 2022, since records began in August 2007.

However, 18-month waits fell from 54,882 in December to 45,631 in January, and according to NHS England had fallen still further, to 32,786 by 26 February, citing more recently available data. The January figure represented a reduction of almost two thirds since a peak of 124,911 reached in September 2021.

RTT waits of more than 52 weeks stood at 379,245 in January – down from 406,035 in December.

Emergency Services

For A&E attendances and emergency admissions, the latest clutch of performance statistics showed that:

  • The number of patients waiting more than 12 hours for hospital admission following a decision to admit was 34,976 in February, down from 42,735 in January, but more than twice that seen in February 2022
  • 71.5% of patients were seen within 4 hours in all A&E departments in February, slightly down on the 72.4% performance rate the previous month
  • There were 473,000 emergency admissions during February – which was 2.8% higher than for the same period last year

The average response time in February for ambulances dealing with the most urgent C1 incidents was 8 minutes and 30 seconds, which was unchanged from January, and almost identical to the overall figure for the whole of 2021 to 2022 (8 minutes and 39 seconds).

For C2 incident callouts, average response time last month was 32 minutes and 20 seconds, compared with January's 32 minutes and 6 seconds. However, both figures were better than the overall average response time for 2021 to 2022 of 41 minutes and 18 seconds.

Hospital bed occupancy remained high throughout February, with more than nine in 10 beds occupied, NHS England reported. On average, 13,771 beds a day were taken up by patients medically fit for discharge – up a sixth on the previous year – it said.

Cancer Treatment Targets

Mixed performance for meeting cancer treatment targets were also reported today.

There were 228,197 urgent cancer referrals made by GPs in England in January for a first consultant appointment, up from 213,442 in December. Of those, 81.8% had a first appointment within 2 weeks against an operational standard of 93%.

However, only 54.4% of the 15,401 cancer patients who had their first treatment in January after an urgent GP referral waited less than 2 months, which was down from 61.8% the previous month, and significantly below the operational standard of 85%.

NHS England said it had made significant progress on the 62-day cancer treatment backlog, reducing it by around 10,000 from an all-time high of 33,950 last summer to 22,282 for the week ending 26 February 2023, despite record levels of demand on cancer services since March 2021.

Professor Sir Stephen Powis, NHS national medical director, said: "The NHS will not stop in its efforts to bring down 18 month waits for elective care and bring down the cancer backlog, but it is inevitable that if the upcoming junior doctors strikes happen they will have a significant impact on cancer care and routine operations that were scheduled to happen."

Junior doctors in England are due to begin a 72-hour strike on March 13 in their dispute about pay.

Health Bodies Respond to Latest Figures

Commenting on today's statistics, Sir Julian Hartley, chief executive of NHS Providers said: "Despite the reduction in 18-month waits, relentless pressure on the health service threatens recovery. Last month, waiting lists grew overall. Ambulance handover delays and delayed discharges remain very high, which reflects the fundamental mismatch between demand and capacity across all systems." 

He said it was vital for the Government to produce a fully funded NHS workforce plan and for negotiations to take place to settle the pay dispute with junior doctors. "Recovery is extremely fragile and trust leaders are concerned that ongoing pressure from industrial action and staff shortages could block progress," Sir Julian said.

Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said a "crisis" in emergency care remained, caused by a "significant shortfall of beds and staff". As a result, staff were "burned out and exhausted", he said. Dr Boyle also called for "meaningful workforce projections and figures", saying that "a workforce plan without numbers is not a plan, but a daydream".

On the cancer treatment performance figures, Dr Ian Walker, executive director of policy and information for Cancer Research UK, said: "If the Government is serious about being 'laser-focused' on cancer, it must publish a fully costed NHS workforce plan for England. Without this it is going to be extremely difficult to ensure more people survive cancer for longer." And Minesh Patel, head of policy at Macmillan Cancer Support, said next week's Budget was "an opportunity to throw services a lifeline with dedicated resources for cancer care and staffing".