English waiting list grows again

English waiting list grows again

19/08/2015
by Rob Findlay

The English waiting list grew again in June towards its seasonal peak, and set a new record for the largest waiting list since January 2008. At the end of the month just under 3.2 million patients were reported waiting, which becomes just over 3.4 million if you add non-reporting Trusts back in.

This growth must now be reversed if waiting times are to be kept under control. The usual seasonal pattern is for waiting lists to shrink in the autumn months, which needs to happen decisively this year to sustain 18 week waits over winter. A longer queue means longer waits, so if the waiting list continues to swell then no amount of clever patient scheduling can prevent an eventual breach of the 18 weeks standard.

Nevertheless, for the time being the 18 weeks standard continues to be met nationally, as Trusts take advantage of their (now permanent) freedoms to treat routine patients on a first-come-first-served basis.

In the following analysis, all figures come from NHS England. If you have a national statistic that you’d like to check up on, you can download our Gooroo NHS waiting times fact checker.

England-wide picture

NHS England abolished the “admitted” and “non-admitted” targets on the 4th of June, making permanent the amnesty that was in place for most of 2014-15. In response, Trusts continued to treat large numbers of long-waiting patients, to hold down the number of long-waiters left on the waiting list and achieve the retained “incomplete pathways” target at national level.

Medway NHS FT resumed their waiting list reporting, which is good news. But the Lewisham Hospital site stopped reporting, which has required a bit of jiggery-pokery to add them back in to the table below (which uses the same method as the official statisticians.)

NHS England are now clamping down on non-reporting Trusts. So we should see fewer Trusts dropping out of the data, and more Trusts resuming their submissions (though not necessarily accurately), in the coming months.

Non-reporting Trusts are excluded from all the following data, so the true list size is much larger than shown in the following chart. Either way, it is the largest waiting list since January 2008 (before the 18 week targets were first met).

Admissions per working day were comparable to recent years, which is clearly not enough given the rising waiting list.

The number of one-year-waiters has risen again, mainly because University Hospitals of Leicester NHS Trust have been cleaning up their waiting list data and found a lot of very long waiting Orthodontics patients. It’s always good to get errors like this out in the open because then they can be dealt with properly – a theme we will come back to when we look at the local picture.

Most surgical specialties are breaching the target, with only ENT, Ophthalmology, Oral Surgery and Gynaecology remaining within 18 weeks (plus all the medical specialties).

The proportion of local services (specialties within Trusts) achieving 18 weeks remains roughly steady.

There is also little change in the distribution of waiting times across local services, although longer waiting services have deteriorated since a year ago.

Perverse waiting list management (giving short-waiting patients priority over long-waiters) has been fairly rare since the amnesty on perverse targets began last summer, and it is happily getting even rarer now that the amnesty has been made permanent.

Local detail

We’ve done some interactive maps showing the all-specialties position at every Trust and CCG. For specialty-level analysis at a particular Trust, independent sector provider or CCG, visit our 18-weeks reports page.

Medway have resumed their waiting list reporting, and jumped straight in at the top of the table of long-waiting providers. Hopefully we will see them improve quite rapidly over the coming months, now that they have improved their data and can see where their problems are.

Which, by the way, is exactly what has been happening at the Robert Jones and Agnes Hunt Orthopaedic Hospital. After excluding long-waiters from their data over a long period, they started reporting long-waiters properly in February’s data, when they also jumped straight in at the top of the table. In the latest June data they have succeeded in dropping off the table entirely, going from 12th to 37th place as their “92 per cent” performance improved from 20.7 to 18.0 weeks. Well done the Robert Jones.

Data for July 2015 is due out on 10th September – and is the first full month since the permanent abolition of the perverse ‘adjusted admitted’ and ‘non-admitted’ targets.

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