The NHS is continuing to make marginal progress reducing the number of people waiting for treatment – cutting the number on the waiting list by more than 36,000 people in England in February, according to official data.
The data showed the number of referral to treatment (RTT) pathways where a patient was waiting to start treatment was 7,539,716.
This was down from 7,575,914 in January, which itself was down 28,000 on the previous month.
The data also revealed the number of unique patients was estimated to be around 6.3m in February.
Among the 7.53 million awaiting treatment in February, in 305,050 cases the patient was waiting more than a year, in 75,004 cases they were waiting more than 65 weeks, in 9,969 cases they were waiting more than 78 weeks, and in 252 cases they were waiting more than two years.
In 57.6% of cases the patient had been waiting up to 18 weeks, so not meeting the 92% standard.
Over the month, 1,745,825 new RTT pathways were started and 301,266 pathways were completed as a result of admitted treatment while 1,175,470 were completed in other ways (non-admitted).
For those pathways where the patient was waiting to start treatment at the end of February, the median waiting time was 14.8 weeks. The 92nd percentile waiting time was 44.6 weeks.
Cycle of poor performance
While the NHS has made marginal progress in cutting waiting lists, Danielle Jefferies, senior analyst at The King’s Fund, said the service was “stuck in a cycle of poor performance”.
“The narrative of waiting 30 minutes for an ambulance to arrive when a person has had a stroke has become normalised,” Jefferies said.
“While bed occupancy, flu cases, and delays to discharge from hospital are all relatively similar to last year, it is worth remembering at the time many referred to it as the toughest winter the NHS had experienced in recent memory.”
Jefferies maintained the public were “acutely aware” of not being able to access all NHS services easily when they or their families need them.
“While the public stand by the principle of the NHS being free at the point of use, the latest British Social Attitudes Survey shows that public satisfaction with how the NHS is run has fallen to 24% – the lowest level recorded since the survey began 41 years ago,” she continued.
“Reasons for dissatisfaction include long waiting times for GPs and hospital appointments, staff shortages and the view that the government does not spend enough on the health service.
“While the latest NHS planning guidance for this year sets out ambitions to slowly improve performance, it will be a tough and long journey for the government to also recover public satisfaction.
“This will involve further progress to resolve industrial action, reduce lengthy waits for care, improve staffing levels and investment.
“In the long term, the solutions to improving performance will lie in bolstering out-of-hospital care such as primary, community and social care services, making health and care a more attractive place to build a career, and ramping up efforts to help people live healthier lives.”
Modest improvements
David Hare, CEO of the Independent Healthcare Providers Network, said while NHS performance had seen “modest improvements” on waiting lists, the sheer number of people on these lists was still “unacceptably high”
“The number of NHS patients currently being treated in the independent sector is well above pre-pandemic levels but, as both of the main political parties have made clear, it is vital that the NHS uses all available independent sector capacity and capability to cut waiting times for patients,” Hare said.
“The sector remains ready and able to increase the number of NHS patients it treats, whether that’s through delivering surgery or procedures, deploying mobile scanning or diagnostic capability, delivering community services to take the pressure off hospitals or bringing in teams to tackle the backlogs.
“With so many patients living in unnecessary pain, it’s now critical this capacity is used – including through ensuring NHS patients are aware of their “right to choose” to be treated in an independent hospital – and that an “all shoulders to the wheel” approach is taken to clear this care backlog.”
Struggling to get a grip
Brett Hill, head of health and protection at independent consultancy Broadstone, said that the data was further confirmation that the NHS is “struggling to get a grip on the waiting list”.
“While it’s encouraging to see the number of people waiting for treatment no longer seems to be rising, especially with the seasonal illnesses of the winter months behind us, the urgent need to reduce waiting lists down to at least pre-pandemic levels is the next major challenge facing the NHS,” Hill continued. “A major headwind facing the NHS in this endeavour is productivity, with productivity levels across the NHS significantly below where they were before the pandemic.
“With deteriorating access to primary care services like GP and A&E support, more serious underlying health issues are falling under the radar, ultimately putting more strain on NHS services in the long run and increasing costs as people are being diagnosed later and so often require more complex treatment.
“Employers are rapidly becoming the first responders to this need, with many building out their existing health and wellbeing offerings to cover end-to-end support, from more generous PMI coverage to on-site health screening, GP or mental health services, and other initiatives focused on improving the health of their workforce.
“We expect to see this trend towards employer-led private healthcare solutions accelerate as demand rises for fast, effective health support that expedites recovery and prevents against more serious health risks.”
Fallen for a fifth month in a row
Tim Gardner, assistant director of policy at the Health Foundation, said the data showed further signs of progress as the NHS waiting list has fallen for the fifth month in a row.
“But with over 7.5m still waiting for care – over 300,000 more than when the Prime Minister made his pledge to cut waiting lists in January 2023 – the scale of the task ahead remains huge,” Gardner said. “These figures represent millions of people often experiencing avoidable discomfort and pain that can also affect their ability to work.
“Urgent and emergency care remains under intense pressure, with nearly 43,000 spending more than 12 hours in A&E before being admitted to a bed last month. Despite the huge efforts of staff, targets set by government to improve A&E waits and ambulance response times have not been met.
“The NHS workforce is under immense strain, with just 1 in 3 believing they have sufficient staff to do their jobs. And while ministers have been quick to blame long waits on industrial action, our analysis last year found the strikes have only directly resulted in a small increase in the overall waiting list. Without bold, decisive action, the long-term problems facing the NHS won’t go away. If the next government wants to turn the tide then a commitment to stable, long-term investment is needed, alongside boosting the workforce and a renewed drive to increase productivity.”