Bleak winter ahead as NHS waiting list reaches record high of 7.7 million

The NHS waiting list has reached a new record high with 7.7 million people, including 6.5 million unique patients, now waiting for care, which is equivalent to one in nine of the population.

According to the latest NHS monthly performance statistics, more than 42% people are also waiting longer than the target of four hours to be seen in A&E and nearly 42 minutes for an ambulance for urgent cases when the target is 18 minutes.

However, NHS England said that despite this pressure and industrial action in September, NHS staff are continuing to reduce long waits for patients with year-long waits down by 5,500 in September (391,122, down from 396,643 the month before), while waits of more than 65 weeks have more than halved since their peak in June 2021 (from 233,051 to 109,138). Waits of over one year are now down to 5% of the waiting list.

The number is higher because the NHS is for the first time publishing the number of individual patients on the waiting list – 6.5 million – in addition to the total number of appointments and treatments currently on the waiting list – 7.77 million. In addition, it says that 25,256 more elective appointments and procedures were carried out in September compared with the same month in 2019.

Waiting list is “appalling situation” many years in the making

However, the British Medical Association (BMA) said that while the government would like to blame “these dire statistics” on strikes by doctors, waiting lists were at record highs before any industrial action began, and even before the Covid-19 pandemic and it is an “appalling situation” many years in the making.

It added: “Just this week the government rejected calls from the NHS for more funding to help meet winter demands – instead telling the NHS to find savings from existing budgets, even if this meant abandoning efforts to reduce the backlog. During eight months of industrial action by doctors, and even before this, the government had an opportunity to avert the costly impact of strikes. However, until recently a lack of engagement from ministers has left Trusts and patients paying the price.

“Without ending the disputes with junior doctors, consultants and SAS doctors, the government cannot hope to achieve its priority of reducing waiting lists, and we hope that talks with all three groups can reach deals that reverse pay erosion, retain doctors, and allow them to continue working in the NHS, giving the expert care that we were trained to provide, and our patients deserve.”

Some communities have a longer waiting list

Analysis by The King’s Fund published this week also shows that progress to tackle inequalities in the elective backlog is slow. To achieve its ambition of tackling backlogs in an inclusive way, it said that the government needs to set a clear vision on why inclusive recovery is important for delivering better and fairer services for patients and the public.

It said that this winter will be bleak for the NHS, particularly if it sees high levels of flu and Covid-19 in the coming weeks.

Danielle Jefferies, Senior Analyst at The King’s Fund, said: “The announcement of a financial package to help offset some of the impact of industrial action will not be enough for the NHS to do everything it would wish this winter to give patients the care that they expect and deserve. The upcoming Autumn Statement will be a real test to see how far politicians are willing to go to prevent the deep crises in the NHS from getting worse.

“If the purse strings are held too tightly, health care leaders may have to abandon their plans to install additional beds, hire more staff and bring in support from voluntary sector organisations – measures the NHS traditionally uses to get through seasonal pressures.

“To get the sector back on track in the longer term and break the cycle of ‘bad’ winters, bold action by government and national leaders will be necessary. This includes action to make health and care a more attractive career, bolstering out-of-hospital care such as primary, community and social care services, and helping people live healthier lives through a focus on prevention.”

Clarity needed on extra funding

With waiting lists creeping up ahead of winter, health leaders are calling for clarity on the £800m of ‘extra funding’ announced by the government. It says £200m of this was previously announced in September and is the only genuine new money, with the rest coming from budgets being raided elsewhere. And this will not enough to offset the costs of the strikes.

Matthew Taylor, chief executive of the NHS Confederation added: “The towering level of demand is something the government can ill-afford to overlook in the upcoming autumn statement. If the statement is not used as an opportunity to provide support, the service may well spiral even deeper into crisis.

“This is all against a backdrop of the long-term impacts of intense waves of industrial action. NHS leaders have already voiced their concerns for months about the extra costs of strikes which is already over £1 billion. The lack of clarity about where the extra savings will need to come from to make up the shortfall, risk causing further uncertainty for the health service in a time where certainty is key to ensuring that leaders can support their patients to the best of their abilities.”