Consultant-led hospital treatment decreased again last year, as the number of patients on the waiting list topped 4 million

The number of patient admissions to an NHS hospital for consultant-led treatment, including planned surgery, reduced again last year despite an increase in the overall number of patients on the waiting list.

Analysis by the Royal College of Surgeons shows there were 3,532,453 hospital-based treatments carried out in the NHS, by a consultant, in January-December 2018. This was 69,899 fewer than during the same period in 2017; and 196,917 fewer than in 2014. This is despite the fact that there were 253 ‘working days’* in the NHS last year, compared to 252 in 2017. Moreover, the number of admissions per working day was 13,962 - which was 333 fewer than in 2017.

Yet in 2018, the overall number of patients on the NHS waiting list topped 4 million for the first time in over a decade - reaching a peak of 4.19 million in October. The waiting list has not been this high since August 2007. Even though more patients were waiting - potentially in pain or discomfort for treatment - the number of hospital admissions has decreased over the past four years.

NHS England has today published ‘Referral to Treatment’ data for December 2018. This shows that 86.6% of patients were treated within 18 weeks to start planned treatment in December 2018 – well below the 92% government target.  There were 4.15 million people in total on the waiting list.

Data published today also shows only 84.4% of patients were seen within 4 hours in all A&E units. This is the worst A&E performance on record since the 4-hour target was introduced.

With the recent publication of the government’s NHS Long Term Plan, the Royal College of Surgeons (RCS) has called for an action plan to be implemented swiftly to ease pressures on hospitals.

Commenting on the admissions data, Professor Derek Alderson, President of the Royal College of Surgeons said:

“Anyone who works on the front line in the NHS knows first-hand the pressures that staff face, and the delays that some patients have in accessing the treatment they need. These figures shine a spotlight on the discrepancy between hospital activity and the number of patients still waiting for treatment. Despite the number of patients on the waiting list increasing, there has been a steady decrease in hospital admissions for consultant-led treatment over the past four years.

“The Government recently published its Long Term Plan (LTP) which set out an ambitious vision for the next decade of the NHS. It should help to ease pressure on hospitals by, for example, reducing unnecessary outpatient appointments and bolstering community care. However, to see an improvement in the forthcoming year, plans need to be executed quickly to avoid cancellations and further backlogs in elective care.

“The RCS strongly believes the NHS needs to commit to increasing hospital bed capacity.  This will help reduce the waiting list, improve A&E performance and increase productivity in the NHS.” 

Notes to editors

1. Full data is available here: https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/
2. See the analysis by the RCS below:

   3.  About our methodology

• The RCS has looked at the admitted patient care dataset. This covers patients whose consultant-led treatment started during the month and involved admission to hospital.
• These figures are for hospital admissions.  It may be that a patient with more than one condition is admitted to hospital multiple times.
• Over the last few years admitted patient care has decreased as more care is being delivered by non-consultants in the community. For instance in 2017 there were a total of 3.6 million admitted patient care pathways compared to 3.5 million in 2018.
• *‘Working Days’ exclude bank holidays and weekends, as the majority of elective, or planned, NHS care is carried out during the week. Although emergency surgery is performed at night and at weekends.

   4. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

   5. For more information, please contact the Press Office:

       Telephone: 020 7869 6047

       Email: pressoffice@rcseng.ac.uk

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