The NHS waiting list for treatment in England bounced back up by almost 32,000 in October.
According to the latest data, there were 7,541,373 treatment pathways waiting to be completed in October, up from 7,573,212 in September.
With some patients on multiple pathways, the number of unique patients is estimated to be around 6.3 million people.
Among the 7.5 million, in 234,885 cases the patient was waiting more than a year, in 20,930 cases they were waiting for more than 65 weeks, in 2,446 cases they were waiting more than 78 weeks, and in 148 cases they were waiting more than two years.
In 58.9% of cases the patient had been waiting up to 18 weeks and so not meeting the 92% standard.
During October 2024, 1,907,643 new RTT pathways were started and 339,789 pathways were completed as a result of admitted treatment and 1,328,807 were completed in other ways (non-admitted).
For those pathways where the patient was waiting to start treatment at the end of October 2024, the median waiting time was 14.2 weeks and the 92nd percentile waiting time was 42.4 weeks.
Target not met for 10 years
Tim Gardner, assistant director of policy at the Health Foundation, said the figures underline the scale of the challenge the government needs to overcome to meet the 18-week standard for routine hospital treatment within this parliament.
“While promising progress has been made in recent months, the 18-week target hasn’t been met for nearly a decade,” Gardner said.
“The waiting list remained stubbornly close to record levels in October with more than 234,000 waits longer than 12 months.
“With the NHS facing the prospect of a very difficult winter, making further headway over the next few months will be very tough.
“The government cannot afford to neglect performance in other parts of the health and care system.
“Hospital capacity is being stretched by early outbreaks of influenza and other seasonal viruses.
“And while A&E waiting times have noticeably improved compared to last year, November still saw over 45,000 patients waiting on trolleys in A&E for over 12 hours to be admitted.
“As government focuses on developing its 10-year plan for the health service, the elephant in the room is the lack of any plan for social care.
“On an average day in November, over 12,000 patients who were ready to leave hospital couldn’t be discharged – many of whom need social care support.
“After getting through a likely difficult winter, the long-term focus of the government should be on rebuilding the nation’s health and tackling deep inequalities in health between different parts of the country.
“This is essential, not just to deliver the government’s health mission but to get more people working and to achieve its goal of increasing economic growth.”
Significant hill to climb
David Hare, CEO of the Independent Healthcare Providers Network (IHPN), said the latest data showed that there is a “significant hill” to climb if government is to ensure that the 18 week NHS target can be met once again.
“While it will not be easy to meet this target, IHPN analysis has found that overall NHS activity needs to immediately increase by around 21% of current levels to enable 92% of patients can be seen within 18 weeks, which is stretching but achievable,” Hare said.
“Independent providers have already removed over 1 million people from the NHS waiting list this year and collectively are able to do even more.
“An estimated 90,000 appointment slots are made available each month by the sector but currently go unused by the NHS.
“Tackling this would alone increase the number of patients treated in the independent sector by 20% – going a long way to setting the NHS on track to deliver improved access.”
Deeply troubling winter
Danielle Jefferies, senior analyst at The King’s Fund, said the situation in the NHS is “fraught” as it enters what looks to be a deeply troubling winter.
“Levels of flu and other respiratory illnesses are already substantially rising and putting pressure on services, there are considerable ambulance delays, and 95% of beds in hospitals are occupied which is well above the level considered safe,” Jefferies said.
“While hospitals are running red hot, ministers are right to reiterate that keeping patients safe should be the number one priority – something local leaders and staff will be acutely aware of.
“The sticky issue is that the health service now must navigate a long list of priorities – keeping patients safe in A&E through winter, meeting the 18 week waiting times target by the end of this Parliament, and delivering long-term ambitions to shift more care into the community and more focus on prevention.
“When there are many priorities to juggle and extremely tight financial constraints, local leaders will be looking for clarity in the upcoming annual planning guidance for NHS services, to support them with the difficult conversations and trade-offs which are already happening.
“Winter pressures impact on all parts of the NHS and social care.
“How the health service is faring cannot just be measured by what is happening in hospitals – a true assessment must look at the care patients need from community and primary care services. Many people are struggling to access GP appointments and unable to get the support with social care services they need.
“There should be a more wide-ranging review of performance targets to shine a spotlight on these services and incentivise much-needed reform of the health service.”