Surgeons call for ‘COVID-negative’ operating theatres across the UK to tackle 'hidden waiting list'

Leading surgeons warned of a ‘hidden waiting list’ today as NHS England figures showed referrals for treatment falling to the lowest level ever recorded. The total number of referrals in March 2020 was 1.2m, down nearly 400,000 on the previous month. 

The NHS statistics are first signs of the impact of COVID-19 on planned operations and appointments, with a lower percentage of patients treated within 18 weeks than at any time since June 2008.

NHS England’s ‘referral to treatment’¹ statistics, also report that the number of patients waiting more than 52 weeks to start planned treatment had nearly doubled from 1,613 to 3,097.

Professor Derek Alderson, President of the Royal College of Surgeons of England said:

“Today’s figures are a sobering reminder of the backlog of operations that we need to turn our hand to in the coming months. Even more worrying than the headlines are the hidden patients, yet to be added to the list because referrals are at their lowest recorded level.

“While Covid-19 has had a devastating impact on thousands of families who have lost loved ones to the virus, it has also affected thousands more patients who have had their operations postponed.  March is when surgery was being wound down for COVID, but thousands more patients’ treatment will have been delayed in April.

“The NHS has pulled together to ward off COVID, we need to stay together to tackle the waiting list backlog. To safely restart surgery, every part of the country needs to identify ‘COVID-negative’ operating theatres that the NHS can use, and hold on to the additional independent sector capacity.

“Provided staff also have adequate PPE and access to testing, we can get started again. We must rebuild confidence among the public that the NHS really is ‘open for business’ again.”

Notes to Editor:

1. The referral for treatment figures cover all consultant-led appointments and procedures. Many, but not all, are waits for surgery.
   1. New RTT pathways (referrals) fell to lowest level ever recorded in March 2020, down to 1,220,636 from 1,603,378 in February 2020. NB: Providers are asked to submit the number of new RTT pathways where the clock start date is within the reporting month. This will include those where the clock also stopped within the reporting month.
   2. Only 79.7% of patients were seen within 18 weeks in March 2020, now below 80% for first time since June 2008 (when the figure was 77.5%)
   3. The statutory target of 92% treated within 18 weeks has not been met since Feb 2016
   4. The number of patients waiting more than 52 weeks nearly doubled in March from 1,613 in February to 3,097 in March
2. The full data is available here: https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2019-20/
3. Both in the independent sector, and in parts of the NHS estate, COVID-light areas have been created to keep particularly cancer surgery going. However, these are not available everywhere, and their total capacity is not sufficient to meet projected demand unrelated to COVID.
4. We have published guidance for surgeons on how safely to restart surgery: https://www.rcseng.ac.uk/coronavirus/recovery-of-surgical-services/
5. 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.
6. For more information, please contact the RCS press office: telephone: 020 7869 6047; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 07966 486832