NHS can’t be allowed to return to waiting times of the past, warns RCS

• August 2017 marks ten years since NHS started collecting current waiting times target data
• 18-week waiting times target has not been met for 18 months and it is the worst performance since March 2011
• There are now over 400,000 waiting more than 18 weeks, the highest since September 2008
• Delayed transfers of care leading to longer waiting times for planned treatment
• NHS England must reprioritise the 18-week waiting time target

The Royal College of Surgeons (RCS) has today praised NHS staff for the hard work they have put into reducing waiting times for planned treatment over the last 10 years.

But it has warned this now risks being undone unless more help is given to hospitals and social care providers to reduce delayed transfers of care.

The NHS first began collecting data on patients waiting for treatment in its current form (incomplete pathways) in August 2007. The target is for 92% of patients to wait less than 18 weeks for planned treatment. At that time, only 57.2% of patients on the waiting list had been waiting less than 18 weeks and over half a million patients waited more than a year for treatment. The target was met or exceeded between January 2012 (92.2%) and November 2015 (92.4%).

However, the target was missed in December 2015 and then again since March 2016. The target has now not been met for 18 months. At the end of March 2017, NHS England announced it was removing the 18-week waiting time target for planned surgery from its list of priorities for the next 12 months.

NHS England performance data published today for August 2017 show 89.4% of patients on the waiting list at the end of August 2017 had been waiting less than 18 weeks. The total number of patients on the waiting list continues to grow with 4.1 million patients at the end of August 2017 (including non-reporting trusts).

Earlier this week the Care Quality Commission warned that the NHS was ‘straining at the seams’ with adult social care also badly affected. The regulator said there were 4,000 fewer beds in nursing homes in March 2017 compared with two years ago.

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

“Looking back at the figures, it is alarming that half a million patients waited more than a year for treatment in 2007.

“NHS staff have worked incredibly hard over the last 10 years to make sure that patients are seen and treated more quickly. A combination of factors contributed to the improvement we saw leading up to October and November 2012, when 94.8% of patients waited less than 18 weeks for planned treatment.

“This included increased funding for the NHS, a focus on targets and performance management, an NHS pricing system that ensured money followed the patient, and initiatives to reduce the waiting list size such as using the independent sector to increase capacity.

“Our concern is now that waiting times are starting to go in the wrong direction.

“We are nowhere near the poor level of performance we started from in August 2007, when only 57.2% of patient waited less than 18 weeks, however we’ve not met the 92% target for a year and half now. With growing demand on the system and difficulties in moving patients from hospital to social or residential care, it’s easy to see how quickly things could deteriorate. We cannot let all the good work we’ve done be so easily undone.

“As Simon Stevens told the Health Committee this week, more money is needed in this November’s Budget if we are to meet current demand in the health service. In the shorter-term we need a clearer focus on protecting beds in hospital, and reducing delayed transfers of care, in order to enable patients to have their operations. As things stand, the NHS is not well prepared going into this winter to prevent mass cancellations of operations.”

Delayed transfers of care remain a major concern for hospitals. August 2017 is also the 7-year anniversary for delayed discharges data being collected (on a monthly basis).  Although there has been an improvement over the last few months, NHS England performance data shows there were 180,065 delayed days in August 2017. This is an 63.8% increase when compared to August 2010, when there were 109,918 delayed days.

Notes to editors

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.

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