Top doctor claims Welsh NHS waiting lists are now ‘essentially in limbo’
THE waiting lists in Wales’ NHS are “essentially in limbo” with “no significant improvement for months”, a top doctor has claimed.
Professor Jon Barry, director in Wales at the Royal College of Surgeons of England, said the latest performance data relating to the Welsh NHS shows there has been limited improvement when it comes to reducing the amount of time people spend waiting for treatment.
In December, the number of patients waiting to start treatment decreased from 758,800 to just over 756,300.
Prof Barry said: “With the equivalent of one in four people in Wales on the waiting list for treatment, more needs to be done.
“Too many patients are being left to wait in pain, and uncertainty, for the day they might have their operation.”
He added there were a number of factors, outside of a pause in treatment during Covid, that were contributing to the long wait lists.
He said: “Factors contributing to long waits include a shortage of theatre staff, a lack of ring-fenced beds for surgical patients, and not enough operating theatres. Increased pressure on emergency departments will also have had a knock-on effect for planned surgery over the busy winter period.
“Creating more surgical hubs, which protect planned surgeries from emergency pressures, is part of the solution. The Welsh Government is investing in hubs but we need more hubs established at pace to see a meaningful reduction in waiting times.”
Key points from the latest NHS performance data show:
There were 240,764 patient pathways waiting nine months or more for treatments in December;
The longest waits were for trauma and orthopaedic treatment (98,285), general surgery (84,135), ear, nose and throat (58,939) and urology (42,266) in December;
In November, when there were just over 756,300 patient pathways, there were about 584,000 individual patients on treatment waiting lists in Wales;
The number of pathways waiting longer than 36 weeks increased in December to just under 240,800, remaining high in historical context;
The proportion of patient pathways waiting less than 26 weeks decreased to 56.5% in December;
Just over 24,200 pathways were waiting more than two years;
The average (median) time patient pathways had been waiting for treatment at the end of December was 1.1 weeks higher than the previous month at 21.5 weeks;
Pathways waiting longer than one year for their first outpatient appointment increased to just under 57,000;
The number waiting longer than eight weeks for diagnostic tests (the target maximum wait) increased to just over 50,500;
For cancer services, fewer people started their first definitive treatment in December than the previous month, falling to 1,603; and
Performance increased against the 62-day target in December to 58%, compared to 53.5% the previous month.
In relation to emergency care:
In January there were 5,009 red (life threatening) calls to the ambulance service, 13.9% of all calls. An average of 162 immediately lifethreatening calls were made each day, 13 less than in December, but still the third highest on record;
In January, although 48.8% of red calls received an emergency response within eight minutes, the number of patients to receive a “red” (life-threatening) ambulance response in eight minutes was the second highest on record, with an average response time of eight minutes and 11 seconds; and
In January around 27,000 hours were lost due to handover delays.
Winter pressures added to the already existing waiting list pressures, as this data shows. It is also predicted that any progress made will have been hampered by January and February’s junior doctors strike action.
Assistant director of the Welsh NHS Confederation, Nesta LloydJones, said: “As was to be expected given the exceptional pressures experienced in the peak winter months, the NHS’ performance took a hit in several areas in December and January, including the overall waiting list.
“Despite the exceptionally challenging environment, and in some areas the highest levels of demand on record, the monumental efforts of staff meant some services continued to see improvements.
“For example, the number of people waiting the longest for treatment continued to fall in December. This is an incredible feat given the circumstances.
“However, it’s inevitable that any progress made to bring down waiting lists will be hampered by January and February’s junior doctor strike action, given the significant proportion of planned care postponed and rescheduled to maintain patient safety.
“As highlighted last month, winter planning started earlier than ever this year, but good planning alone is insufficient to ensure the NHS can perform to the best of its ability.
“Without significant capital investment to improve NHS estates and infrastructure, a whole-nation approach to improving health and wellbeing and significant changes to social care funding and provision, there’s only so much progress NHS leaders can make.”
Calls have also been made to address the “chronic staff shortages and lack of specialist facilities” that are contributing to the long waits.
Minister for Health and Social Services Eluned Morgan said: “These figures cover the period of the year when our NHS and its heroic staff are under the most intense pressure.
“So I am delighted that the overall number of people on waiting lists has come down again, for the second month in a row.
“Those waiting more than two years for treatment also fell for the 21st consecutive month. I am pleased to see performance increased against the 62-day cancer target too, from 53.5% to 58% in December.
“The number of people told they
don’t have cancer was also the highest figure on record for any December.
“We have placed a clear focus on tackling both those patients with an urgent need and those that have waited the longest. The immense pressure on our health service continues. New referrals to secondary care facilities like hospitals are the highest on record, having increased 11% in the latest year.
“Attendances at emergency departments were the highest for any January on record. Despite this, performance increased against the four-hour target, while the average time spent in emergency departments decreased in January compared to the previous month.
“The number of patients to receive a ‘red’ or most urgent ambulance response in eight minutes was the second highest on record in January, with an average response time of eight minutes and 11 seconds.
“And despite pressure on the system, the average response to ‘amber’ patients improved on December.
“The new urgent primary care centre services we have funded to help deliver care closer to home and reduce pressure on GPs and emergency departments are helping significantly more people than this time last year.
“These centres are ensuring people receive the right care, in the right place, first time, with the vast majority avoiding the need to attend an emergency department following assessment.
“Progress continues to be made on Pathways of Care Delays, with significant reductions in the number of assessment-related delays.
“It is disappointing to see one-year waits for a first outpatient appointment increase, and the number of waits of longer than eight weeks for diagnostic services rise.
“The overall number of waits for diagnostic services did fall, however.
“I would again like to thank our dedicated NHS Wales staff.
“They have continued to provide a high quality service under extremely challenging circumstances this winter.”